Top Five Health Insurance Plan Issues for Parents
As a parent, you want the best for your children and that includes health insurance. Picking the right health coverage has become more complex, and it isn’t as easy to determine what is the “best” policy for your loved ones. If you are on a budget, you also need to factor in the costs which can make the decision considerably more complicated.
That is why you should keep in mind the following issues when you are considering a health plan for your family.
1. Deductibles and out-of-pocket expenses:
If you are like most parents trying to stretch your budget to get the most comprehensive policy you can, then you should closely examine the amount of money you will pay for deductibles and other out-of-pocket expenses. The annual deductible is the amount you must shell out prior to your insurer contributing. In recent years, this amount has grown on average as more policyholders and employers opt for lower premium plans that often require a more substantial deductible. The average American worker must now pay $1,318 a year before insurers will start paying out, up from $584 ten years ago.
You should also keep in mind that you will also have to make copayments and/or coinsurance when you see a medical professional. While copayments are a fixed fee, coinsurance is a percentage of the medical expense. If your child is frequently ill, these out-of-pocket expenses can quickly add up—and they must be paid even if you have already paid out your annual deductible.
2. Physician network:
It is vitally important that you consider what kind of physician network your new family plan includes because the type of network often determines how restricted you are in seeing specialists. The most restrictive network are HMOs, but they are often the least expensive; however, you may need to get approval from your primary care doctor to see a specialist, and these plans will usually refuse to cover physicians outside of your network.
On the other end of the spectrum are PPO network plans that may cost quite a bit more but offer more freedom to see specialists and out-of-network doctors. Many PPO plans also offer more robust benefits that cover more and a broader range of medical services, including tests, therapies and office visits.
Once again, it is important to consider the health of your family before you choose a network. If your children require more specialized care, it may be a better idea to spend a bit more for the PPO plan.
3. Employer or private coverage:
If you or your spouse works, then your family may have the option of getting health coverage through an employer. In the past, it was almost unthinkable of passing up on an employer subsidized health plan, but circumstances have changed enough that you may want to closely examine your private insurance options. There are a wide variety of health plans on the Obamacare health insurance exchanges that may allow you to use tax breaks to pay for them which may make them a cheaper option if your employee plan is not fully subsidized.
You may also wish to consider a private plan if your employee coverage will only offer 60 percent of medical expenses, the minimum legal requirement; you may find that paying a bit more up front in premiums may save you thousands of dollars down the road if your family encounters a medical emergency. Finally, you may prefer a private plan with yearlong protection if you are unsure of your future employment plans. It is probably wiser to have full-time coverage than go without while you are transitioning between jobs.
4. Government-sponsored plans:
You may already know that the Affordable Care Act created private health insurance marketplaces with plans that the federal government subsidizes, but you may not realize that the same law also expanded Medicaid, another government insurance program that covers low-income families, pregnant women and people with disabilities. If you haven’t applied for Medicaid, or you did so before 2010, you should investigate the current application process because many states expanded their eligibility requirements in recent years. If you are unsure if you are eligible, you can visit gov and apply online; the online service should be able to tell you if you qualify for an Obamacare subsidized health plan or Medicaid in your state.
If you don’t meet eligibility standards for Medicaid, your child may still qualify for Children’s Health Insurance Program (CHIP). CHIP offers health coverage to children up to age 19 in families with income too great to qualify for Medicaid. Most states allow families with income up to 200 percent of the federal poverty level to enroll their children in CHIP.
5. Young adults:
If your child is older than 18 but younger than 26, then you may still insure them through your health plan, but there are still some issues you should consider carefully. First of all, you should make sure that your network will cover them wherever they are. If they are away at school in another state, ask your insurer if there is an affiliated network in that region. Otherwise, your child may lack access to in-network providers which may force you to change plans or even insurers.
If switching plans is too expensive or difficult, you may wish to consider enrolling your child in a college health plan. While this option is a bit more expensive, most college plans are relatively modest in cost due to the large student population that enrolls in them. These plans will often grant access to campus health services but may limit the number of claims or office visits per year. Parents should also examine these policies closely to learn what other restrictions they may come with.
If you are considering a health insurance policy for your family, then you should speak with one of the insurance experts at Boost Health Insurance.
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