Consumer Guide: Health Insurance for Individuals
Some people have access to health insurance through their job. Others don’t, so they have to buy health insurance themselves. This page lists what to think about as you look at health insurance options.
Before you get started, answer these questions:
- Do you belong to, or could you join, a professional or trade organization that offers a discount on health insurance? This can be a great way to save money on your plan. Keep in mind that some discount plans may limit what they cover. It’s always good to research the plan and make sure you know what you’re getting.
- Will you work with an insurance agent? When you’re looking for health insurance, you have the option to work through an insurance agent or to contact insurance companies yourself. Some insurance companies only work through insurance agents or brokers. Some insurance agents only offer insurance from one or two insurance companies. It’s important to think about these limits when making your choice to work with an agent or not. If you choose to work through an agent, make sure their license is active. Look for them in the National Association of Insurance Commissioners’ database.
Affordable Care Act and the Health Insurance Marketplace
The Health Insurance Marketplace is through the federal government. It’s a way to get health insurance that meets your needs. The Marketplace is based on guidance from the Affordable Care Act.
Learn more at HealthCare.gov. Here are some pages you may find helpful:
- 3 Things to Know Before You Pick a Health Insurance Plan
- Getting Health Coverage Outside Open Enrollment
- Glossary of Health Coverage and Medical Terms
- HealthCare.gov Tips & Troubleshooting
- Plans & Prices
- Saving Money on Health Insurance
- Top Questions
Health spending accounts
Health spending accounts help people save money to pay for medical costs. You may want to choose a health insurance plan where you can use a health spending account. There are a few types of accounts, including a health savings account (also called an HSA).
Learn more about health spending accounts.
How to buy health insurance—tips and warnings
Finding and choosing the right health insurance plan can be hard. There also are insurance scams to watch out for. Here are some tips to help you know your rights, avoid scams, and choose the best plan for you.
- Learn about your options—Start your search for health insurance by learning about what’s available to you. Find out how to look for insurance in a way that’s safe. These resources can help:
- Know your rights during medical underwriting—Before you can buy an individual health plan, you must give the insurance company details about your health. This is called medical underwriting. Learn about your rights during this process.
- Watch out for unlicensed insurers—They may offer cheap plans but then refuse to pay for a claim. Be wary of discounts or deals that sound too good to be true. They may not offer insurance at all. If you’re not sure, don’t sign or make a payment until you confirm they are real. There are a few ways to confirm if an insurer is licensed:
- Search the National Association of Insurance Commissioners directory. It lists all licensed insurers in Wisconsin.
- Contact the Wisconsin Office of the Commissioner of Insurance. They can confirm that you are working with a real, licensed insurer.
- Protect yourself from fraud—It’s important to know how to protect yourself and your loved ones from health care fraud. These resources can help: