If you buy health insurance on your own

Individual health insurance is the hardest kind to buy, because you can't rely on the expertise of an employer, union, or association to screen out bad plans. And without an employer to pick up at least part of the cost, it's also usually the most expensive.  Until the health-care reforms are fully in place in 2014, you can be turned down or charged more for an individual policy in most states if you have a pre-existing condition.

Here's what you should know about buying insurance on your own:

Consider alternatives

The options below can be cheaper, more comprehensive, or both compared with an individual health plan, and are available to people with pre-existing conditions. But not everyone is eligible.

• A group plan through the job of a spouse, domestic partner, or parent. If a family member has a job that offers dependent coverage, you can join it at any time if you have lost other coverage. And adults 25 and younger can now stay (or go back) on their parents' insurance thanks to health-care reform. (The exceptions are retiree-only plans and Medicare.)
• Public insurance options. They include Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Check at HealthCare.gov for income and other eligibility requirements.
• COBRA. It's a federal program that lets you continue your employer-based coverage for 18 months (and sometimes longer) if you lose or leave your job. You'll have to pay the full premium, including the part your employer used to pay, but that might be cheaper than buying your own especially if you have a pre-existing condition.
• Other special options for people who have quit or lost a job . They include being allowed to convert a group plan to an individual one.

Understand what you need

Good insurance not only helps with your current medical needs but also protects you against ruinous future expenses for accidents or illnesses. That's why you should get a comprehensive policy that covers doctors, outpatient treatments like chemotherapy, diagnostic and screening tests and procedures, prescription drugs, hospital care, rehabilitation, and mental-health care. Learn more about what to look for in a plan.

Make sure you buy real insurance

Beware of sales pitches from agents, telemarketers, e-mail, faxes, roadside signs, door-to-door salesmen, or websites that seem to promise too much, offer "discount" insurance, emphasize very low premiums and "big savings" even if you're in poor health, or tell you that you have to buy health insurance because of the new reform law. You risk ending up with junk insurance that could leave you broke if you ever get sick. Read more about how to choose a good plan.

Scope out the market

Start by checking out our rankings of health-insurance plans. You can also go to HealthCare.gov, the federal government's insurance information portal, which lists some 11,500 health-insurance plans. You can look them up by ZIP code and sort them by key details such as deductibles, co-payments, co-insurance, and out-of-pocket limits.

You'll also find links to a plan's provider networks and drug formulary. And you can see the "preferred" (best) premium for each plan for a person of your age and gender, as well as the percentage of applicants who are refused coverage or charged extra because of pre-existing conditions.

Apply to multiple plans for coverage

If you have any concern about pre-existing conditions, apply for multiple policies simultaneously from several companies. Companies might treat the same conditions differently depending on their underwriting guidelines and other factors.

Be aware that certain serious illnesses, such as diabetes, schizophrenia, and multiple sclerosis, will get you automatically turned down in most states. If you do get turned down for a pre-existing condition, here are some options.

Most carriers will accept applications directly online or over the phone. But also consider working through an independent licensed broker who represents several of the companies you're interested in. (Avoid "captive" agents who sell only one company's insurance.) An experienced broker can help you understand the trade-off between, say, higher deductibles and lower premiums. And if you have a pre-existing condition, a broker can also request what's called a "pre-screen" from each carrier, which is an assessment of whether the carrier might insure you, and at what estimated cost, based on your health history. This can be done without disclosing your identity, and it's something you can't do on your own.