Health Insurance Basics
4 Basic Questions and Answers about Individual Health Insurance
1. What is individual health insurance?
Individual health insurance is coverage you purchase on your own, from the insurance company. You can purchase coverage by working directly with an insurance company or with the assistance of an insurance agent* (versus group insurance, which you typically receive through your employer). You can also purchase coverage through your state exchange or federal marketplace.
If you are an early retiree, self-employed or on COBRA, you can purchase major medical health insurance to help protect you and your family against health care costs and get access to care.
You pay the entire premium each month; your employer makes no contributions.
* Insurance agents can be found in your community or on the Internet.
2. What doctors can I see?
Many individual health insurance plans let you visit any doctor or hospital you choose, without a referral. Note, however, that you’ll pay less out of your own pocket if you see doctors and hospitals in the insurer’s participating network.
To learn about the network for Innovation Health individual plans and to see if your doctor is in the network click here.
Providers are independent contractors and are not agents of Innovation Health or Aetna. Provider participation may change without notice. Neither Innovation Health nor Aetna provides care or guarantees access to health services.
3. Are my prescriptions covered?
Many individual health insurance plans will usually cover your prescriptions, in some cases; a deductible (the amount you pay before your insurance begins paying benefits) is required before the plan pays.
Many insurance companies offer a choice of major medical plans, some with prescription coverage and some without. Be sure to check how an insurer covers preferred, non-preferred and generic prescription drugs, because plan details may differ.
We receive rebates from drug manufacturers that may be taken into account in determining our Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions.
4. What is a Health Savings Account (HSA)?
A Health Savings Account, or HSA, is a tax-advantaged account that helps cover your current and future medical expenses. It is designed to be combined with a High-Deductible Health Insurance plan.
An HSA has three tax advantages: You and/or your family members make contributions to your HSA tax-free. That money earns interest tax-free. And withdrawals you make for medical expenses are tax-free.
Any money you haven’t used at the end of the plan year rolls over to the next year. You never lose it because you own your HSA. If you are 55 or older and not enrolled in Medicare, you can make catch-up contributions to your HSA.
When you open an HSA (typically through a financial institution that offers these types of accounts), you pair it up with a High Deductible individual health insurance plan that is specifically designated as “HSA-compatible.”