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Question

Asked: May 01, 2010

What is my individual quote lower than my group quote?

I got some quotes for an Aetna individual health plan and for an Aetna group health plan provided by my employer. How come the quote I got for the individual plan was significantly cheaper than the quote for the group plan? I thought group insurance had lower rates?

Categories: In California

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Answers

Group coverage is traditionally more epensive than individual coverage whether it’s an Aetna Individuals plan or some other individual health plan from another carrier. This is because group insurance has to take in everyone who's eligible for coverage. Group plans are required to cover everyone in the group regardless of his age and medical conditions. Compared to an Aetna Individuals plan, group health plans are mandated to provide coverage for maternity, mental illness, autism treatments, eating disorders, or chiropractic care, among many others. The health plans' prices usually go up as a reflection of these increases in benefits. If you are deciding between getting an Aetna Individuals plan and participating in the Small Business plan that your employer provides, then the individual plan might be the better option especially if you are concerned about the premium. Individual plans usually have a lower premium because insurance companies can put eclusions or riders on certain health conditions that you may have. This means that you will not have coverage for this health problem but other medical services will be covered. With a group plan, there are no pre-eisting conditions eclusions, so the premiums are higher. You can also tie in a Health Savings Account (HSA) with your high deductible Aetna Individuals plan. You can use the money you put in this account for other medical epenses not covered by your plan in the future. - July 3, 2009 @ 1:35 pm

Answered: May 02, 2010

 

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