Individual health insurance is meant for people who are not in an employer-sponsored or government-assisted health plan. Group insurance, as the name implies, refers to the coverage that an employer sponsors for his employees and their dependents. Most people have this kind of coverage. The employer co-shares the payment towards the monthly premium with the employee. Besides this basic difference, Kentucky individual health insurance differs from group insurance in many ways.
Individual Health Insurance KY – Features
The rules for individual health insurance in Kentucky are different from that in other US states. The main features of individual health insurance KY are:
• In Kentucky, health insurance companies may deny individual health insurance to people who are in a high health risk category.
• All indemnity, HMO and PPO health plans are standardized in Kentucky, though customized plans are also available. An insurer cannot cancel your health plan due to your illness, but can raise premiums or deductibles at the time of renewal.
• Benefits offered in Kentucky individual health insurance plans are usually not as extensive as with coverage obtained through the work place. For instance, while maternity coverage or substance-abuse treatments are standard offerings in group policies, these would be add-on options at an extra cost when you buy health insurance on your own.
• Individual health plans have the advantage that they can be customized to suit specific needs. So you don’t have to pay for coverage that you do not need, which often happens when you are in a group plan.
• Individual health coverage stays with you even when you are out of a job, a great advantage in these uncertain times.
The individual health insurance scenario is changing. Health care reform now incorporates the Pre-Existing Condition Insurance Plan (PCIP) so that people with conditions such as cancer, diabetes, or heart disease will have the opportunity to obtain insurance coverage. In 2014, insurers will be prohibited from denying coverage to people on the basis of the state of their health.
Kentucky Group Health Insurance – Coverage Through an Employer
A company qualifies for Kentucky group health insurance, if it has between 2 and 50 employees. Employers select one or two health plans and invite their employees to enroll.
• Group health insurance in Kentucky is available to all employees meeting the necessary conditions regardless of the current state of their health or pre-existing conditions.
• In the case of a group plan, the benefits are determined by your employer in negotiation with the provider. So that means you have little choice.
• With group insurance, all the employees are subject to medical underwriting as a whole. So the premium level that everyone will pay is determined by health status of the entire group. This also means that if there are one or more persons with a serious condition, the premium would go up.
• The amount paid towards employee premium is usually tax-deductible.
The advantage of group health insurance is that it helps employers hire and retain the best workers. Group policies also offer coverage for family members who are uninsured.
Find the Right Kentucky Health Insurance Plans
Whether you are an employer looking for suitable coverage for your work force or an individual seeking a comprehensive health insurance plan in Kentucky, your best option is to contact an informed, professional health insurance agent in for assistance. A reliable agent would be able to offer you all the guidance you need, including quotes from leading health insurance providers. Their valuable expertise can help you choose the right Kentucky individual health insurance or group plan.
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