Health Insurance in South Bend

Who offers individual health insurance in South Bend?

Individual health insurance in South Bend is available through Independent Brokerage Agency, Page 1 Benefits, Inc. They specialize in all types of health insurance: Individual health plans, Group health plans, and government health plans such as Medicare and Medicaid.

Page 1 Benefits - located in South Bend, Indiana - represents many of the leading health insurance carriers who provide varying insurance plan types for individuals and families, along with a wide range of employee benefit plan designs for the small to large group employer.

Page 1 Benefits strives to provide clients and Brokers with the best and most affordable health insurance products available in South Bend. The Agency representatives will work with you to find a health insurance plan that best fits your personal and financial goals.

What is individual health insurance?

Five percent of the population purchases private health coverage on an individual basis while the majority of Americans get their health insurance coverage through an employer or through a government program. Page 1 Benefits offers individual health insurance which is coverage that a person buys independently. It can be sold to a single individual, to a parent and dependent children, or to a family. Individual health insurance in South Bend can be purchased in through Page 1 Benefits.

Page 1 Benefits is an independent Brokerage Agency that sells insurance plans from many companies, and we can help you find the coverage that best suits your individual needs. We also provide service on the policies we have sold, and can help you process claims or with anything else you need regarding your individual health insurance policy in South Bend.

Page 1 Benefits agents and brokers sell coverage and are paid a commission for their work, so you will not be charged a direct fee if you want to use the services of their agents or brokers.

How is individual health insurance different from group health insurance?

Individual health insurance is very different than group health insurance, which is the type of insurance that is offered through an employer. Benefits are generally less extensive for individual health insurance than what most people would receive when covered with a group policy from work since laws mandating what types of services must be included in individual policies are often different than those dictating what must be included in group policies. Individual consumers may be surprised to learn that some benefits that may be considered "standard' in a group policy, like maternity coverage or substance-abuse treatment, may not be included in an individual plan. Sometimes with individual health insurance in South Bend consumers have the option to pay extra for coverage of additional services like maternity coverage. This extra coverage is referred to as an optional rider. Cost is often the primary factor for individual health insurance consumers, which is another reason why the benefits included in individual policies are often simpler. In addition, deductibles (the amount you have to pay before insurance benefits begin) and cost-sharing (the fees you pay directly to medical providers at the time of service) are also generally higher.

South Bend Indiana individual health insurance companies are much more limited than group insurance companies in their ability to spread risk, so the laws concerning individual health insurance are different in most states.

Applicants for individual insurance need to complete a brief medical questionnaire when applying for benefits and, unlike a group insurance policy, in most states a company can decide not to cover people with very serious medical conditions (e.g., HIV or cancer), deeming them "uninsurable."

How are health insurance premium rates determined?

When you apply for individual health insurance coverage Page 1 Benefits will ask you to provide health information about yourself and any family members to be covered. We use the medical information on these applications when determining rates and at times Page 1 Benefits will request additional information from an applicant's physician or the applicant may be asked for clarification.

If Page 1 Benefits is unable to obtain information necessary to accurately determine the risk of a particular applicant, the assumption relative to the missing information will be negative rather than positive. For example: A person has a history of high blood pressure, but it is controlled with medication and he is not overweight. If the company is unable to determine if that individual smokes or if he has normal cholesterol, the company will assume that the missing information is negative and rate accordingly.

Once one of Page 1 Benefits South Bend agents have determined your health status, you will be assigned a rate class by the company and put into a pool of other insured individuals with similar health status. Your premium will be the rate charged to that entire class of customers. Subsequent annual renewal premium rates will be determined not by your individual claims, but instead by the claims experience of the entire rating class pool.

At Page 1 Benefits, are any pre-existing medical conditions covered?

Even though Page 1 Benefits health insurance company in South Bend can choose not to offer coverage to people with serious medical conditions, most Americans don't have perfect medical histories and most still qualify for individual coverage. However, there are some individuals who do not decide to purchase health insurance coverage until they know that they have a medical problem that will require the use of benefits. This is known as "adverse selection," and it can be a serious problem for individual market insurance companies since their ability to spread risk is so limited.

To help prevent adverse selection, Page 1 Benefits health insurance company in South Bend is allowed to look back at your medical history for pre-existing conditions and may choose not to cover certain conditions for a specified period of time. This is known as an exclusionary, or pre-existing condition, waiting period. The amount of time Page 1 Benefits can look back at your medical history, and the length of time an exclusionary period can last, is determined by the state of Indiana.

In some states, you can receive credit against a pre-existing condition waiting period if you have had prior health insurance coverage within a specified number of days. The amount of the credit against the waiting period is generally proportional to the length of the prior coverage.

Many states allow health insurance companies to issue elimination riders to people who have pre-existing medical conditions. Elimination riders allow for insurance companies to offer an individual with preexisting condition coverage but exclude coverage of that condition. Contact Page 1 Benefits for information about elimination riders in Indiana.

Example: An individual has severe seasonal allergies but can control them with medication. A company may offer the applicant two policy options: a policy at a more expensive rate with full allergy coverage and a pre-existing condition waiting period, or a cheaper policy with no waiting period that excludes allergy coverage. The individual may find that it is more affordable to buy the cheaper policy and pay for his allergy medication out-of-pocket.

Can I still buy individual health insurance if I have a very serious pre-existing medical condition?

In most states you can be turned down for individual coverage if you have a very serious medical condition (e.g., HIV or cancer). Fortunately, even though they are not required to do so, most states have developed a way to provide uninsurable people with access to individual health insurance coverage. Thirty-three states provide coverage to medically uninsurable people through high-risk pools. Twelve states use other means of providing uninsurable people with access to individual coverage (e.g., requiring that all individual health insurance companies issue individual policies regardless of health status, coverage through a designated health insurance company of last resort, etc.). There are five states that still have no means of providing individual health insurance access to people with catastrophic medical conditions. Check out Page 1 Benefits Health Care Coverage Options Database to find out what Indiana's options are for medically uninsurable individuals.

Since each state sets its own requirements for individual health insurance policies, how can I find out what the requirements are for health insurance in South Bend?

To find out about Indiana's specific requirements regarding individual health insurance policies, please see NAHU's Health Care Coverage Options Database. The database also contains contact information for the state regulators of individual health insurance policies to use if you have questions or concerns.

Portions reprinted with permission from the website of the National Association of Health Underwriters website at www.nahu.org.