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Asked: Apr 24, 2010

Things to consider when buying family health care plan?

What is a family health care plan? How does it work? What should be considered when buying a family health care plan?

Categories: In California
Plan Types: In Other

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A family health care plan pays for your family’s medical epenses. You either buy this type of insurance plan as an individual policy, or you can get it through your employer. Family health care plans are offered by a Health Maintenance Organization (HMO), or a Preferred Provider Organization (PPO). This type of plan pays for doctors’ visits, medical tests, hospitalization epenses, and other medical services. However, you need to check the provisions of the plan because family health care plans offered by HMOs are different from those offered by PPOs. The plan offered by an HMO usually doesn’t have large deductible or out-of-pocket amounts. It also has standard co-pays for each medical service you use. The family health care plan offered by HMOs requires you to choose the primary care physician (PCP) who belongs to their network of accredited health care providers. Most of the time, HMOs do not pay for the services of health care providers that do not belong in their network. In case you have emergencies, wherein you used the services of a health care provider outside their network, you usually pay higher deductibles and co-pay. Like the HMO, the PPO also has an accredited network of health care providers. But unlike that of the HMO, you can choose a PCP who does not belong in their network. If this is the case, however, you usually pay more for the services of out-of-network health care providers as compared to the cost of the in-network healthcare providers. Most often, policy holders of PPO family health care plans have a ’no-deductible” policy if you use the services of their in-network healthcare providers. For eample, if you have a $300 out-of-network deductible, you will only pay this amount plus the co-pay. Afterwards, the insurance company will pay the rest of your medical claims. Another factor to consider when buying family health care plans is the drug prescriptions. You need to check if there is a provision for non-preferred drugs in the plan. If there is a provision for non-preferred drugs, check if you can afford the co-pay amount.  Most importantly, you need to check the health care coverage provisions of your children. You have to make sure that their basic medical services are covered. A plan that has a maimum of $300 per year for doctors’ visits is not ideal if your children are still young. Younger children often require doctors’ visits whenever they get sick, which is usually quite often. The provisions for maternity coverage are also important. Make sure to check these provisions and understand them well in case you might have to use the benefits in the future. When buying family health care plans, you might as well get the best coverage that you can since all of your family members are involved. If possible, try to prioritize the etent and quality of health care rather than cost. The cheapest family health care plan may not always be the most effective one when it comes to meeting the health care needs of you and your family. Answer by SRLifeAgent -- June 16, 2009 @ 3:32 pm

Answered: Apr 24, 2010

 

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