Over the last year, we’ve been doing research on health insurance and whether we would be able to find fertility coverage through a group plan.  Unfortunately, this has not panned out in our favor as neither mine nor my husband’s job provide this type of coverage.  Still, this wasn’t a surprise, but we’d hoped to find a light at the end of this tunnel somewhere.

What we did find out is that depending on the type of plan you have, individual or group, you may not even have maternity coverage!

After consulting with many individual plans about fertility coverage, it just didn’t make sense as the premiums paid would equal the cost of the procedure itself.  So we have that money put aside instead of plunking it into an insurance policy.  That said, the inquiry often went towards the fact that the individual plans do not cover any conditions related to maternity care.   This would mean any visits related to prenatal care or delivery would leave me with a large bill as they are not covered under the individual plan.

TIP:  Check your policy for exclusions and note specifically what is covered or you could be left with a large bill!  Ask about possibly adding riders which may meet your specific needs.

This of course is a deal breaker for me as I currently have full coverage through my husband’s health plan which is a group policy.  While the individual policy is much cheaper, the cons outweigh the financial pros of a lower premium.

Individual vs Group Health Insurance

This lead me to research further the differences between an Individual vs Group policy.  In short when considering the two, it is important to remember:

  • Group insurance is obtained through your place of work and Individual insurance is obtained on your own, often through an insurance agent.
  • You have more control around what’s included in an individual plan than you do with a group plan.  Individual plans are often customized whereas a group plan is tailored to the needs of your employer.  They decide what’s covered, you have no say in it.
  • Do not cancel a group policy before researching the merits of an individual policy.  While the latter is cheaper, they come with many exclusions such as maternity care.
  • Read the fine print!  Read the fine print!  Read the fine print!  This goes for any insurance policy.  What are your exclusions and are you able to add an affordable rider?  These are questions to ask your insurance agent or human resources representative.
  • While prescription coverage is optional on an individual plan, it is worth having if you are ill and need medication.

Do you have an individual insurance plan?  What are the pros and cons for you?