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Several of the nation's largest health insurers are gambling that more Americans soon will find themselves shopping for their own health insurance, or saving money in special accounts to cover medical costs.
Traditionally, most big insurers have left the individual market to smaller companies or to the Blue Cross/Blue Shield plans, except in a few states where they were required to offer such policies.
But UnitedHealth Group, the nation's largest health insurer, surprised many late last month when it reported in financial documents that it will acquire Golden Rule Financial, a private firm selling individual health policies and medical savings accounts.
With that move, United directly challenges Humana, which this year expanded to 13 states a major medical policy aimed at individuals.
Aetna, too, has gotten in the game, launching an individual policy in Pennsylvania with plans to expand to a half- dozen other states next year.
All three are aligning themselves to capitalize on expected growth in the individual market and a renewed interest in medical savings accounts. More than 16 million U.S. residents buy their own policies, or nearly 7% of the insured population.
That number could grow as the Bush administration promotes tax credits to help individuals buy policies, the number of uninsured rises and more employers cut off coverage for spouses or children of workers.
In addition, employers stung by rising health costs are considering offering workers a new type of insurance, which couples a high-deductible policy with a savings account. Those accounts, partly funded by the employer, are meant to soften the blow as workers pay more toward their own health care. Firms such as Golden Rule are well positioned to manage such savings accounts.
''All trends point to greater individual involvement, and that's sparked the interest of health plans,'' says William McKeever, who follows the health insurance industry for UBS.
Humana edged into the individual policy market in mid-2002 in five states. But it added eight states this year and might add up to 12 more in 2004. If it does, Humana would be selling policies in 25 states, the same number as Golden Rule.
Neither United nor Golden Rule would disclose financial details of the purchase, which still faces regulatory approval. News reports have quoted Wall Street analysts as saying the deal is worth close to $800 million.
Unlike group policies offered through employers, the individual market requires applicants to give their medical history. Not everyone qualifies.
''Most people find it fairly easy, if they are not sick, to get an individual plan,'' says Jonathan Weiner, professor of health policy at Johns Hopkins. But it's a tough market for those with medical problems. ''Either it is easy for you or it is impossible; there is not a lot in between.''
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