INDIVIDUALS AND FAMILIES

You never know where life will take you, and navigating today’s health insurance marketplace is challenging. Whether it is your first time shopping for a health insurance plan or you have years of experience, we can help you find the right plan for your budget and personal situation.

Health Insurance Basics

OE24 for Individuals.

The Open Enrollment Period (OEP) is when individuals can search and enroll in health plans. Suppose an individual does not enroll during the designated OE. In that case, individuals and families can only enroll in or change health plans if they qualify for a Special Enrollment Period (SEP), Medicaid, or CHIP. Visit our open enrollment page for more details.

 

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What Is Health Insurance?

Health insurance protects you from health and financial risks. Most people need medical care at some point in their lifetime. Health insurance covers these costs and other essential benefits.

The Need for Individual Health Insurance.

No one plans to get sick or hurt, but illnesses and injuries can happen at any time. In some cases, they can devastate your health and leave finances. Health insurance protects you from costly illnesses and injuries by covering medical care and other services, such as hospitalization and surgery.

 

Protection from high medical costs –

Health insurance provides essential financial protection if you have a severe accident or sickness. People are exposed to these costs without health coverage. These costs can sometimes lead people without coverage into debt or even into bankruptcy.

People can underestimate how much medical care can cost:

  • Fixing a broken leg can cost up to $7,500
  • The average cost of a 3-day hospital stay is around $30,000
  • Comprehensive cancer care can cost hundreds of thousands of dollars

Having health coverage can help protect you from high, unexpected costs like these.

 

How a health insurance plan protects you –

When you have coverage, your plan protects you from high medical expenses in three ways:

  • Reduced costs: Once your spending for covered services reaches your plan’s applicable deductible, the plan covers part of your medical expenses.
    • Example: If your plan has a $1,000 deductible, you pay the first $1,000 in covered services. After that, your plan pays the designated coinsurance.
  • Out-of-pocket maximum: This is the total amount you’ll have to pay no matter how much covered care you get in a plan year.
    • Example: If your plan has a $3,000 out-of-pocket maximum, once you pay $3,000 in deductibles, coinsurance, and copayments, the plan pays for any covered care for the rest of the year. 
  • No yearly or lifetime limits: Health plans can’t put dollar limits on how much they’ll spend each year or your lifetime to cover essential health benefits.

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Need Individual Health Insurance?

You can enroll in or change plans during the Open Enrollment Period (OEP) or use the Special  Enrollment Period (SEP) if you miss the OEP and have certain life changes. You can also enroll anytime throughout the year if you qualify for Medicaid or CHIP.

New Jersey Marketplace

Before you shop for health coverage, find out if you qualify for financial help to lower your costs. Find which plans have your doctors, and compare plans and prices before enrolling.

Pennsylvania Marketplace

Pennie is the official online marketplace made possible by the State of Pennsylvania and helps Pennsylvanians find affordable, high-quality health insurance plans.

We are here to help!

United Benefits offers personal support for you and your family at no additional cost. You can talk to a representative if you need help determining a plan that best fits your needs, billing, or claims issues, and even if you have general questions. In addition to a team of dedicated support representatives, insurance carriers offer plan members 24-hour access to claim and benefit information via secure member websites and mobile apps that put your family health plan information at your fingertips when you are on the go.