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Family Health

Family Health Insurance Plans

How to shop for family health insurance and Things to Think About:

  1. First you need to find coverage that balances both your family’s financial and medical needs.  So give some thought to what your minimum medical needs are and the maximum you can afford before you begin.  But be prepared to adjust expectations as you go.
  2. Next, review your medical history, ie: doctor visits, prescriptions, hospital stays.  For any medical visits - what was the diagnosis and is condition ongoing or has it been taken care of. You’ll need to provide this information when applying for a plan.
  3. Find out what plans does your doctor and hospital participate in. If you plan on obtaining quotes from a particular provider, and if it’s essential you keep the same doctors, you’d better give them a call and make sure they participate with the carrier.
  4. Determine how much of a deductible and copay can you afford as a family. There is generally a deductible for individuals and a higher amount that you have to meet as a family.
  5. Be aware: Pre-existing conditions may have a higher premium or a rider that would exclude certain coverages for a specified length of time. In other words you may be able to obtain coverage, but it might exclude the pre-existing condition.
  6. If there are several carriers to choose from, they all have different underwriting criteria. If you do have pre-existing conditions, it might be best to chat with a qualified, independent agent who knows the various carriers and can tell you which ones are more likely to accept your application.
  7. Some plans offer a Preferred Provider Organization (PPO).  The doctors that participate in this agree to the terms of service and payment according to the organization.

How to compare:

  • Compare deductibles, coinsurance rates, and copays — sometimes paying a higher premium you will have a lower deductible, coinsurance, or copay.  A lower premium will usually have a higher deductible, higher coinsurance, or copays.  This is where your financial and medical needs come into consideration. If you go to the doctor frequently a lower deductible and copay may work better for you.  Look at your estimate yearly cost: yearly cost = premium + deductible + copays.

  • Does the plan include prescriptions? If so, is it generic only or also preferred and nonpreferred brand drugs?  Does it have a prescription drug deductible or a capitation of what it will pay in prescription benefits per year?

  • Does the plan have no cost to you for annual check ups, or a specified number of doctor visits that the copay does not apply to?

  • What are the restriction/requirements for hospitalization, outpatient care and emergency visits?

If you’d like our assistance in your shopping efforts, start with our family health insurance plans introductory page.