Individual Market Health Insurance

The individual insurance market provides coverage to more than 14 million people who purchase health insurance on their own. Because individual health insurance is not subsidized by employers or through the tax code, each consumer is forced to pay the entire cost of the premium. The nature of the individual market differs greatly from the group markets because of many variables that make it a challenge to predict costs. In fact, many people who do not have employer-sponsored coverage only purchase individual market coverage when they anticipate needing medical services.

Coverage in the individual market is more affordable and available than often portrayed. According to an AHIP survey of health plans, nearly nine out of ten people who apply for individual coverage are offered a policy. Consumers are offered a wide range of benefits in the individual market, including mental or behavioral health, prescription drugs, preventive, and maternity benefits.

The Affordable Care Act includes significant changes to the individual insurance market. Please click here to learn more.

Latest Documents

2011 Health Insurance: Overview and Economic Impact in the States

This report is a compendium of reference information on health insurance in the states.

Research | Center for Policy and Research | 09/28/2011

The Federal Medical Loss Ratio (MLR) Calculations -- Background and Initial Costs of Compliance - [PDF]

In January 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new national Medical Loss Ratio (MLR) rule, as enacted in the Affordable Care Act (ACA) and described in an “interim final” rule issued by the Department of Health and Human Services (HHS) on December 1, 2010.

Research | Center for Policy and Research, Product Policy | 06/06/2011

Fact Check on Individual Health Insurance Coverage

This fact check from the AHIP Coverage blog compiles research on the critical role of the individual insurance market, which serves more than 14 million people. The blog post also highlights what thought leaders, think tanks and the media are saying about the importance of a personal coverage requirement.

AHIP Coverage Blog Posts | 10/12/2010

AHIP Statement on the Status of Health Care Reform

Washington, D.C.

Press Releases | Strategic Communications | 02/22/2010

Individual Health Insurance 2009: A Comprehensive Survey of Premiums, Availability, and Benefits - [PDF]

The latest in a series of AHIP surveys shows that the market for individually purchased coverage is more affordable and accessible than may be widely known.

Research | Center for Policy and Research | 10/21/2009

Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate

Washington, DC - Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate. Under the new proposal, health plans participating in the individual health insurance market would be required to offer coverage to all applicants as part of a universal participation plan in which all individuals were required to maintain health insurance.

Press Releases | Strategic Communications | 11/19/2008

AHIP Releases Guaranteed Access Proposal for the Individual Market - [PDF]

Research | Center for Policy and Research | 12/19/2007

Individual Health Insurance 2006-2007: A Comprehensive Survey of Premiums, Availability, and Benefits - [PDF]

The latest in a series of AHIP surveys shows that the market for individually purchased coverage is more affordable and accessible than may be widely known.

Research | Center for Policy and Research | 12/19/2007

Health Insurance: Overview and Economic Impact in the States, 2006 - [PDF]

A compendium of reference information on health insurance in the states.

Research | Center for Policy and Research | 12/19/2006

Individual Health Insurance: A Comprehensive Survey of Affordability, Access, and Benefits - [PDF]

A comprehensive survey of AHIP members shows that individually purchased major medical insurance was more affordable and accessible than may be widely known, and offered a broad array of benefits.

Research | Center for Policy and Research | 08/29/2005

Health Savings Accounts Off To a Fast Start in the Individual Market - [PDF]

Preliminary data from AHIP members show 438,000 people covered by September 2004.
View slides for this report. 

Research | Center for Policy and Research | 01/12/2005

Health Savings Accounts Off To a Fast Start in the Individual Market (Slides) - [PDF]

Preliminary data from AHIP members show 438,000 people covered by September 2004.

View the full report. 

Research | Center for Policy and Research | 01/12/2005

Individual Health Insurance: Wide Choice of Benefits Available - [PDF]

In July of 2003, the then-Health Insurance Association of America (HIAA) asked member companies active in the individual health insurance market to provide detailed data on the benefits provided under policies and certificates sold during the 12-month period ending on March 31, 2003.

Research | Center for Policy and Research | 02/01/2004

Individual Medical Expense Insurance: Affordable, Serves Young and Old - [PDF]

A survey of in force individual health insurance policies to determine both the cost of coverage, and the distribution of covered individuals by age.

Research | Center for Policy and Research | 07/09/2002

Summary of Benefits and Coverage and Uniform Glossary Proposed Rule: Implementation and Annual Ongoing Costs of Compliance - [PDF]

In September 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new Summary of Benefits and Coverage (SBC) and the Uniform Glossary requirements detailed in a notice of proposed rulemaking (NPRM) issued by the Department of Health and Human Services (HHS), Department of Labor, and Department of Treasury on August 22, 2011.

Research | Center for Policy and Research