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How does individual health insurance differ from group health insurance? Answer: An individual policy is a contract between you and the insurance company. In a group insurance policy, the group is insured and individual members are issued insurance certificates.

The advantage with group insurance policy is that this works out cheaper for all involved and the individual can get some special cover that would otherwise have been very difficult to obtain because of the high cost.

• What are the different types of individual health insurance policies that I can choose from?

Ans. Here is a list of the common health insurance policies available to individuals –

1. Major medical – This gives cover for visits to the doctor and also covers the expense for treating ongoing illnesses.

2. Hospital and surgery – This covers the cost of surgery and hospital stay and will also pay for diagnostic tests.

3. HMO – Health Maintenance Organizations (HMO) team up with general practitioners and specialists. These cover doctor visits and preventive care.

4. Short term – A short-term policy covers major medical expenses for a specified duration.

5. Accident only – This policy covers the cost of medicines, hospital visits, and surgery but only related to accidents.

• What are the different types of group health insurance coverages available?

Ans. Group health insurance comes with some distinct advantages over individual coverage; here is a list of common group insurance policies.

1. Fully insured employer – The employer gets either major medical or HMO coverage for the employees.

2. Small employer group – Insurance for small employers; the small employers are grouped together to form a larger group so that the insurance company can offer a better deal mutually beneficial to all involved.

3. Health maintenance organization – This is a group program where the group can select from a panel of general practitioners who refer the group employees to specialists should the need arise.

4. Self-funded ERISA – Mainly for very large groups where the group lets a third-party handle the management of the insurance-related paperwork.

• What is meant by secondary health insurance?

Ans. Secondary health insurance comes into play when an individual has more than one health insurance plan to cover a given condition. This can happen when one has a primary cover from one’s own employer and then being nominated for cover at the spouse’s company insurance plan. A secondary insurance is usually one where you are covered as a dependent or have been covered for a shorter period of time as against the other insurance coverage that you have. Secondary insurance comes into play once the primary insurance has been exhausted.

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