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Claire Smith Last Updated On: August 29, 2024

What’s Best For You: Employer Health Insurance Or Individual Plans?

If the company you work for offers health insurance, it may seem like a no-brainer to accept it, but is it in your best interest?

Also known as group coverage, employer health insurance alongside the economy has gone through the wringer, forcing employers to scale back money allocated to benefits.

It doesn’t help that the cost of healthcare is also rising.

Sometimes, group coverage isn’t the best option; so how do you find the best coverage for you and your family?

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The differences between employer and individual coverage

One of the best ways to determine the best healthcare coverage for you is to compare employer vs. individual healthcare insurance features side-by-side to determine which insurance works best for you.

Term Permanent
Cost The employee pays pre-tax:
- Individual: $1,200+
- Family: $5,500+
The employer foots the remaining 50% or more
Varies depending on income, location and family size:
- Average: $7,000+
- Tax-Credit: $1,000+
You’re on the hook for tax
Purchaser You’re insured so long as you’re at your job You have the choice of insurer or ACA coverage
Coverage Options - Your plan is chosen by your employer; you can opt for individual or family care
- You’re stuck with the coverage provided
- Your choice of coverage options and preferred locations (doctor, hospital)
- You also have the flexibility to add supplemental coverage
Eligibility No questions asked acceptance, even if you have existing health concerns Subject to medical exams, so if you have medical concerns, this could reduce your coverage options

The differences between employer and individual coverage

You have the right to decline group health insurance coverage, but before you do, make sure you’re turning it down for the right reasons.  Some of the most common reasons for opting out of employer health insurance are:
  • It’s too expensive
  • You’re eligible for ACA Marketplace coverage
  • You decide to use your spouse’s plan
  • You’re eligible for military-sponsored health insurance
If you plan on going with alternative coverage, ensure that you’re covered under, e.g., Marketplace insurance, before you officially opt-out.

Do I have to accept group coverage?

Ultimately the most important thing is that you have health insurance because life happens; if you get sick or injured, protect yourself from rising healthcare costs by having some form of medical insurance. 

Whether this means going with employer coverage or striking out on your own and getting individual insurance, figure out what you need from your health insurance and pick the best option for you!

Free Health Insurance
comparison - save up to 30%

Claire Smith Claire is a creative entrepreneur with a variety of marketing and content creation skills, including blog and web copy writing, research, and strategy. She has a Masters in Cultural Studies from Queen's University and is known for thinking laterally about marketing, based on her deep knowledge of people and behavior.