Insuring the Whole Family: Factors to Consider
Buying insurance for your whole family makes an already difficult process even more complicated! Many of the same factors apply as when buying health insurance for yourself, but there are additional logistics to take into account when you’re buying for a family. Here are a few things to consider before choosing a health plan:
1. Think about what kind of premium you can afford.
A health insurance premium is a monthly amount you pay to be enrolled in a health plan. Most frequently, health plans with higher monthly premiums will have lower deductibles. A deductible is the amount of money you pay out-of-pocket before your insurance picks up the rest of the bill. When you’re buying insurance for your family, consider your monthly expenses and how much you can afford to comfortably to spend on a premium.
2. Estimate your family’s medical expenses.
It’s hard to predict who will get sick (and when), but take out your crystal ball and do your best to estimate how much you might spend on healthcare next year. You should ask yourself how much your family has previously used insurance for sick visits, specialty care, and prescription medications. Are you planning on having a baby in the coming year? This is a medical expense that should be factored into your insurance decision.
You should also inquire about the copays and deductibles that apply to your family’s anticipated health needs. For instance, if your child uses an asthma inhaler, you should see what share of the cost you would be responsible for under the health plan you’re considering. In short, if your family tends to consume a lot of medical care, you may want to consider a plan with a lower deductible to save on costs (but make sure you are comfortable with the premium that comes with many of these plans).
3. Educate yourself on different health plan types.
There are many different flavors of health plans. It’s important to know the lingo so you can understand what might work best for your family:
HMO (Health Maintenance Organization): You have a primary care provider who you will refer you to a specialist if necessary but you must always see your primary care provider first. These plans typically have lower premiums and lower cost-sharing.
PPO (Preferred Provider Organization): You can see any provider you choose, but keep in mind that not everything will be covered if you go out of network and it will be more expensive. These plans typically have higher premiums and higher cost-sharing.
EPO (Exclusive Provider Organization): In an EPO plan you can see anyone in-network without needing a referral, but if you go out-of-network you will have to pay full cost. This plan typically has a lower premium and higher deductible.
POS (Point of Sale): With this plan, you are allowed to get out-of-network care under special circumstances but you will need a referral from your primary care provider. Cost of this plan is typically lower in-network and higher out-of-network.
4. Make sure your health plan covers your family’s preferred medical providers.
Does anyone in your family have special healthcare providers that they would like to continue seeing? If you’re changing health plans this Open Enrollment, check to see that you family’s visits will continue to be covered.
There are many factors that go into choosing a health plan for your family, and no single plan works for everyone. It may help to speak with a licensed health insurance broker or another insurance professional who will be able to walk you through all your options prior to making this big decision.
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