Individual and Family Health Insurance Plans

Individual and Family health insurance plans, sometimes called private health insurance plans, are for people who buy coverage on their own instead of getting it through an employer, Medicare, or Medicaid. These plans are often a good fit for individuals, couples, families, self-employed people, part-time workers, or those who do not have access to employer-sponsored coverage.

The Affordable Care Act (ACA) Marketplace health insurance plans can cover either one person or multiple eligible family members. If you're enrolling just yourself, you'll have individual coverage. If you're enrolling eligible family members, everyone can be covered under the same policy.

Choosing an Individual and Family health plan starts by considering your healthcare needs and how much care you expect to use during the year. The right choice depends on who in your family needs coverage, how often each person uses care, whether preferred doctors or hospitals are in network, and what prescriptions or benefits each person may need. When comparing plans, also look at the monthly premium, deductible, copays, coinsurance, and out-of-pocket maximum.

Anthem offers Individual and Family health insurance plans in 14 states, including California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin. Plan availability, benefits, and coverage options vary by state, where you live, and plan year.

The cost of an Individual and Family health insurance plan can vary based on where you live, your age, household size, tobacco use, coverage level, and whether you qualify for financial help. Anthem plans include cost-saving features like $0 online doctor visits, $0 annual physicals, and prescription drug coverage.

When comparing health insurance options, look beyond the monthly premium. Deductibles, copays, coinsurance, and the out-of-pocket maximum can also affect your total cost of care.

Depending on your household size and income, you may qualify for financial help to lower the cost of an ACA Individual and Family health insurance plan. Financial help, also known as a premium tax credit, can help lower your monthly premium. Some people who enroll in a Silver tier plan also qualify for extra savings that can help lower out-of-pocket costs, like deductibles, copays, and coinsurance.

You can enroll in an Individual and Family health insurance plan during the annual ACA Open Enrollment Period. Outside of Open Enrollment, you may be able to enroll or change plans if you qualify for a Special Enrollment Period. Special enrollment qualifying events include losing health coverage, moving, getting married, having a baby, adopting a child, or other life changes.

If you are covered by a parent’s health insurance plan, you can usually stay on that plan until you turn 26. Some states extend this age depending on the situation. When that coverage ends, you may need to choose your own health insurance plan. An Individual and Family health insurance plan may be an option if you do not have coverage through an employer, Medicare, or Medicaid.

Depending on your situation, losing coverage may also qualify you for a Special Enrollment Period.