Advertisement
Top Tips to Consider When Buying Family Health Insurance
Top Mistakes to Avoid When Purchasing Family Health Insurance
1. Not Comparing Various Insurance Plans
When it comes to purchasing health insurance for your family, one common mistake that people often make is not taking the time to compare different plans. You see, every health insurance plan is unique with its own set of coverage details, specifications, costs and benefits. If you simply choose the first plan you come across, you could be missing out on a better deal.
In addition to this, it’s important to look beyond just the monthly premium. Other factors to consider include the deductible, the co-payments, the maximum out-of-pocket costs, and exactly what is covered. The aim is to find a balanced plan that provides adequate cover at an affordable price.
Remember, it’s very possible to pay too much for health insurance, but it’s also possible to pay too little and end up with inadequate cover. A detailed comparison will go a long way in avoiding both these scenarios.
For instance, before choosing a health insurance plan, Mrs. K took the time to compare different plans from various providers. She not only looked at the monthly premiums, but she also considered other features such as the deductible, the co-payments, and the maximum out-of-pocket costs. This helped her find the best plan for her family’s needs.
- Understand the specifics of each plan.
- Compare more than just the premiums, consider all features.
- Look for hidden fees or requirements in the fine print.
- Take note of any exclusions or limitations in coverage.
- Be aware of the provider network: are your preferred doctors and hospitals included?
- Consider the reputation and customer service track record of the insurance company.
2. Choosing a Plan Based Solely on Cost
Yes, cost is an important factor when choosing a health insurance plan, but it must not be the only factor considered. Sometimes, cheaper plans may end up costing more in the long run if they don’t provide adequate cover. The goal is to find a plan that strikes the right balance between cost and value.
In particular, don’t solely focus on the monthly premium costs. Take into account other costs such as the deductible amount, co-pays for doctor visits or prescriptions, out-of-pocket maximums, and expenses for non-covered healthcare services.
No two families are alike, so the best insurance plan will depend heavily on your specific family’s needs and situation. It’s important to assess all aspects of a potential plan before making a decision.
Take for instance, Mr. P decided to go with the cheapest plan he found because he wanted to minimize his monthly expenses. However, when one of his kids broke an arm at soccer practice, he discovered that his plan barely covered the necessary medical care — resulting in thousands of dollars in medical bills. Had he considered more than just cost when choosing his plan, he might have prevented this financial burden.
- Don’t be swayed only by affordable premiums; consider what you get in return.
- Be aware of the trade-off between high deductibles and low premiums.
- Understand co-insurances and co-payments & their impact.
- Factor in the costs of uninsured medical events under the plan.
- Weigh high-paying coverage with your medical history and foreseeable healthcare needs.
- Analyze if the low-cost plan provides flexibility of doctors, hospitals, etc.
3. Overlooking Family Health History
Health insurance should cover more than just routine check-ups and small illnesses. It should also provide support for those unexpected, major incidents. This is where family history comes into play. If your family has a history of certain health issues, it’s crucial to make sure your plan covers these things.
Here’s why – existing family health problems may likely transpire in the future. By overlooking this when purchasing a plan, you could be setting yourself up for potential high medical bills down the line.
Moreover, should anyone in your family develop such specific conditions, ensure they are covered by your health plan or consider obtaining additional coverage specifically for those conditions.
Consider the example of Mrs. L – she knew that heart disease ran in her family, so when choosing her family’s health insurance plan, she made sure to opt for one that offered comprehensive coverage for cardiac-related procedures and treatments.
- Analyze your family history for recurring health issues.
- Maintain complete health records of all family members.
- Ensure your plan provides sufficient coverage for prevalent health concerns.
- Consider supplemental insurance if your regular plan does not cover certain illnesses prevalent in your family.
- Look for plans with wellness programs focused on managing prevalent health concerns.
- Re-evaluate your circumstances periodically & adjust your cover accordingly.
4. Not Reading the Fine Print
Health insurance policies have a reputation for legal jargon and fine print. Do not assume that you are familiar with all terms and regulations of a policy. Spending some time reading and understanding the policy can save plenty of trouble down the line.
The fine print often contains important details about your coverage, which may include provisions on pre-existing conditions, waiting periods, exclusions etc. It also encompasses how much you will have to pay out-of-pocket for different types of care and services and what is not covered.
Furthermore, comprehending the various elements such as copayments, deductibles, coinsurances and premiums is crucial and these are typically explained in the ‘fine print.’
As an instance, Mr. J assumed that his family health insurance plan would cover any hospitalization costs. However, after a minor surgical procedure, he was surprised with a medical bill that stated otherwise. Since he hadn’t read the fine print of his policy thoroughly, he wasn’t aware of this exclusion.
- Thoroughly read the policy terms & conditions before you sign up.
- Familiarize yourself with healthcare terminologies such as co-payment, deductible, premium, etc.
- Look out for clauses related to pre-existing conditions and exclusions.
- Ascertain there are no conditional clauses concerning change in your personal situation.
- Understand what particular conditions or treatments have longer waiting periods.
- Inquire about hidden fees or penalties within the policy’s provisions.
5. Not Accounting for Routine Health Care Needs
While one hopes never to need insurance coverage for major medical events or emergencies, routine care is something virtually every family requires. If your family health insurance doesn’t account for basic medical care such as annual check-ups, immunizations, blood tests etc., it will put an unnecessary strain on your finances.
Routine healthcare needs may also include regular appointments for chronic illnesses or scheduled therapies. It’s crucial to factor in the average number of doctor’s visits and recurring prescription medications for each family member throughout the year.
Check if your plan covers the needed prescriptions, physician visits and the likes. Underinsurance in these areas can result in significant unplanned expenses yearly.
For instance, when selecting her family’s health insurance, Mrs. N made it a point to choose one that catered sufficiently to her family’s widespread healthcare needs – right from her teenage daughter’s allergy medications to her husband’s biannual doctor’s visit.
- Consider routine health needs like annual check-ups, vaccinations, screenings, etc.
- Think through the recurring medicine costs for your family members.
- Choose a plan that covers everyday healthcare needs efficiently.
- Calculate the number of scheduled doctors’ visits in a year and their impact on cost.
- Consider the need for any particular therapies or day-to-day medical equipment.
- Check if procedures like labs and x-rays come under regular health expense coverage.
6. Failing to Review Healthcare Providers in the Plan’s Network
Health Insurance companies usually enter into agreements with select providers who form part of their ‘network.’ They do this mainly to control healthcare costs. If you have favorite doctors or hospitals, it’s important to check if they are included in the network of health care providers approved by your insurance company.
Failure to do this may not only force you to switch healthcare providers but also result in higher out-of-pocket expenses should you decide to continue with out-of-network providers.
Remember, networks can change from year to year, so even if you’re renewing an existing plan, it is essential to verify that your preferred providers are still in-network.
For instance, Mr. B found his primary care doctor was no longer in the network of approved providers for his insurance plan when he renewed. Fortunately, he noticed this before committing to the renewal and was able to choose an alternative policy where his doctor was a network provider.
- Ensure your preferred health facilities and physicians are within the coverage network.
- Find out if services from out-of-network providers are covered and at what additional costs.
- Evaluate the quality of doctors, professionals and hospital facilities in your network.
- Ponder over network restrictions viz-a-viz your family’s specific health requirements.
- Keep up to date with changing network arrangements in case of renewals.
- Gauge the geographical availability and accessibility of network providers.
7. Ignoring the Perks or Additional Benefits
Health Insurance plans often include additional health benefits that may not be core to health coverage but add value to your plan by promoting and supporting overall wellbeing of insured members. These can range from wellness programs, free health check-ups, disease management programs, mental health support, to gym memberships.
Ignoring these perks could mean you are missing out on some valuable health benefits and services that can improve healthcare outcomes for your family both in terms of preventive care as well as disease management.
Set aside some time to understand any such additional benefits to ensure you make full use of what you have paid for.
For instance, Mrs. H availed a diet counselling session for her entire family, without any out-of-pocket expenditure, as part of her family’s health insurance plan.
- Be aware of the extra offerings that come with the policy.
- Considering taking advantage of wellness programs if available.
- Find out if there are free preventative or routine check-ups included in the plan.
- Check if the insurer has special arrangements for disease management, drug substitution, etc.
- Consider additional coverages such as, maternity, dental, mental health provisions and others.
- Determine if these perks provide substantial value for your family’s health requirements.
8. Neglecting How Prescription Medicines Are Covered
Prescription drugs are a crucial part of healthcare services, especially with growing incidences of chronic diseases, allergies, infections etc. across different age groups. When choosing an insurance plan for your family, it is essential to pay close attention to how prescription drugs are covered.
Prescriptions are usually placed into ‘tiers’ in many health plans and they attract different co-payment amounts. Some plans might also exclude some drugs or require prior authorization for others.
Neglecting to understand these factors can lead to surprise medical bills when you go to refill your prescriptions.
Consider this example, Mr. and Mrs. G had two children that required monthly medication for asthma. When deciding on their family health insurance, they made sure to consider the cost and coverage for those specific medications under the plan.
- Understand how prescription medicines are covered in your plan.
- Consider costs associated with prescription drugs – both generic & branded.
- Check if the plan needs prior approval for certain prescribed medications.
- Be aware of medicine tiers and the costs associated with them.
- Assess whether over the counter drugs, if needed regularly, are covered by the policy.
- If you have chronic illnesses requiring routine medications, take that into account.
9. Not Considering Future Family Planning
Deciding on a health insurance plan without considering future family planning could be a potential mistake. You may not have a newborn now, but do you plan to have one? Or are your current kids soon going to age out of your plan as dependents?
Considering where your family is heading can make a huge difference in the long-term financial impact and usefulness of your plan. Remember, once selected, most insurance plans allow changes only during specified enrollment periods.
For instance, while deciding on their health insurance plan, the Bell family realized that their firstborn would be heading off to college soon, and their second child had plans to study abroad. They chose a plan considering these eventualities, thus ensuring they were not paying unnecessarily for individuals who would not be covered under the plan in the near future.
- Consider where your family will be in terms of size and health care needs in a few years.
- Take into account potential family expansion plans, if any, while choosing the plan.
- If you plan to have a child, examine the prenatal, childbirth, and newborn coverage options.
- If your children are soon aging out, consider what that means for your healthcare costs.
- Factor in switching financial aspects when teenaged children leave the home or start working.
- Adjust coverage as per aging parents if they are under your care.
10. Not Reviewing Plan Annually
The last mistake people often make when it comes to health insurance is not reviewing their plan periodically. Health insurance needs can change from year to year based on changes in your family size, aging, health conditions of family members, income level, employment status etc.
Keeping up with these changes and adjusting your plan accordingly will ensure you are not overpaying for unnecessary coverage or underinsured risking high medical bills.
Additionally, even if your situation remains unchanged, insurance companies may make changes to plans including premiums, deductibles, network hospitals etc. Hence, it becomes important to review your plan annually at the time of renewal.
As an example, Mr. S’s father moved in with him permanently after being diagnosed with dementia. At this point, Mr. S reviewed his original health insurance plan, understood it was inadequate to cover his father’s needs, and switched to another comprehensive one that catered to them.
- Schedule annual reviews around the date of policy renewal.
- Consider changes in your family composition – births, deaths, marriage, diverging dependants etc.
- Factor in major health-related changes for anyone covered under the plan.
- Pay attention to changes made by your insurance company to the given plan.
- Consider if your income or job changes make you eligible for other health insurance options.
- Adjustments may be needed if your preferred healthcare provider is no longer in the network.
Summary Table
Mistake | Solution |
---|---|
Not Comparing Various Insurance Plans | Analyze various plans considering more than just the monthly Premiums. |
Choosing a Plan Based Solely on Cost | Strive for a balance between cost and value based on individual family need. |
Overlooking Family Health History | Ensure prevalent family illnesses are appropriately covered in the plan. |
Not Reading the Fine Print | Understand all the terms, conditions & provisions of the policy. |
Not Accounting for Routine Health Care Needs | Verify that basic healthcare needs like check-ups, prescriptions etc. are covered. |
Failing to Review Healthcare Providers in the Plan’s Network | Confirm your preferred healthcare providers are within the plan’s approved network. |
Ignoring the Perks or Additional Benefits | Maximize use of additional benefits & services offered in the plan. |
Neglecting How Prescription Medicines Are Covered | Check coverage details for Prescription drugs as per your family’s requirement. |
Not Considering Future Family Planning | Choose a plan based on expected changes in your family size or demographics. |
Not Reviewing Plan Annually | Update your plan annually to match changing family needs. |
Purchasing family health insurance is no minor task. By taking into consideration these common mistakes and ensuring you do not fall prey to them, you can make an informed decision that best protects you and your loved ones from unexpected medical costs. Remember, when it comes to selecting the right health insurance, diligence is always better than regret. Happy Planning!