Individual & family health insurance
Individual and family health insurance is coverage a household purchases directly rather than receiving it through an employer. Depending on where you live and when you apply, that can include plans offered through the Health Insurance Marketplace as well as plans sold outside of it. The structures, provider networks and benefit rules differ between those options.
Who commonly considers it
- People without access to employer coverage
- Households where one partner has employer coverage and the rest of the family does not
- People who recently left a job or aged off a parent's plan
- Families comparing what a household plan covers versus separate plans
Potential advantages
- You choose the plan structure rather than accepting one employer option
- Coverage stays with you if your job changes
- Household members can often be covered under one plan
Important considerations
- You typically pay the full premium yourself unless you qualify for financial help
- Networks vary widely — the doctors you use today may not participate in every plan
- Enrollment is generally limited to Open Enrollment or a qualifying life event
Questions worth asking
- Which of my current doctors and facilities are in this plan's network?
- What is the deductible, and which services apply before it is met?
- What is the out-of-pocket maximum for one person versus the whole family?
- How are my regular prescriptions covered?
- When can I enroll, and what would qualify me for a Special Enrollment Period?
How Dave helps
Dave starts with your household, your doctors and your expected healthcare use, explains how the available options differ on those points, and then walks through the actual plans available to you so the tradeoffs are visible before you decide.
Related reading
Plan availability, eligibility, benefits, exclusions, underwriting requirements, enrollment periods and coverage vary by carrier, product and state.