Wednesday
How to Pick the Right Family Health Insurance Plan
Our first recommendation would be to follow common guidelines on how to cut health insurance costs. By following these guidelines, it is almost certain one can reduce his and his family's health care costs. Perhaps most importantly, as one of the tips suggests, it is shop around for various health plans and receive multiple family health care plan quotes. This gives a good starting point for considering plans, as getting the best plan for the lower amount of money provides one with the liberty to take other special considerations into mind.
One challenge that exists for getting family health insurance plans is that it depends on each member's medical history. This is referred to as 'pre-existing condition'. A pre-existing condition is an illness or injury that the family member has been treated for in the past, before applying to the current insurance plan. Although certain providers have different rules, normally there is a waiting period before becoming eligible to receiving treatment for this condition. However, this also depends on the previous type of coverage one held before.
Pre-existing conditions are a major factor in determining whether an insurance company will agree to cover one's family, as well for the final cost, which depends on the risk the insurance company assigns to one's family.
Useful tips:
- Most importantly, one must select the plan according to his family's current and future expected needs. For example, if a family member may need to see specialists often, it might be advisable to go with a PPO plan that gives the liberty to go to a specialist without requiring a referral. Being covered in a plan which has a primary care physician (a 'gatekeeper'), such as POS plans, can be a real problem at times, as the doctor might not agree that the issue requires seeing a specialist. Speaking from personal experience, this can be a very frustrating experience.
- An additional point is receiving second opinions: clearly when one requires approval to see a specialist, he may not get it twice unless he has a very good reason (just saying "I don't trust that doctor's opinion" is probably not good enough to convince the primary care physician). Going with a PPO gives the liberty to receive multiple opinions by specialists. However, if one does not expect to face this issue, then going with a different plan may be a better - and certainly cheaper option.
- Preventative care: this can be an issue at times. For example, if a family is expecting to have children, and the plan offers maternity classes, then it is important to keep in mind. Normally HMOs are far better than PPOs in their preventative care offerings, so this is yet another issue to keep in mind.
- Dental plans: some providers offer dental plans in addition to the 'standard' health plan: this could be very useful in saving money, but it is important to take it only if one believes this may actually be used (though of course, certain things are out of control and cannot be predicted). Note that these plans normally offer very limited coverage, so if facing numerous dental issues, the plans won't be of much help.
- Since insurance plans periodically change, it is important to make sure to follow up on these changes and the coverage that is being received in order to know that you are getting the most at the best rates; perhaps at times it might be a good idea to switch plans.
- Finally, it is important to remember that a cheap plan that does not protect you or a family member from major illnesses may not be worth it. Life is precious, and to face a horrible disease without the ability to pay for treatments is a terrible scenario to be in.
In conclusion, it can be said that it all comes down to the delicate balance between cost, flexibility and availability. If one predicts having to see multiple specialists, and can afford to take a PPO, that may be the best choice. However, if for a small, young, family that is generally healthy, a basic HMO plan may be the best one for you. An additional issue is preventative care: since HMOs are better at this aspect, this should also be taken into consideration.
Tom_Harkenshire
