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Your Ultimate Guide to Family Health Insurance

As you may already know, health care coverage is at its all-time high! Often, families can’t afford to pay for health insurance, so they let it go because of costs.

Health care costs have increased by 740% since 1984. The average price for health insurance in 1984 was $2,474.85 annually. The average employer-based family health insurance cost about $20,576 in 2019.

Most American families’ income goes toward health insurance. So how can they survive to pay their bills when most of the money goes towards healthcare costs?

Our ultimate insurance guide will help you to choose the best policy for your family and save money.

Why Do You Need Health Insurance

Due to the high cost of chronic lifestyle diseases, health insurance is essential. The Covid-19 pandemic showed how a condition could have lasting effects on our society, proving how an illness can be challenging to recover from and costly.

Also, health issues and accidents can happen out of nowhere, especially with children within the home. Unfortunately, there’s no telling when your child may become ill or have a fatal accident.

It’s best to enroll in Texas  health insurance at the right time. An insurance policy for your family will remove surprises in health-related costs.

As a reminder, the open enrollment date is usually from November 1st to mid-December.

The rest of this insurance guide provides questions to consider when researching the right policy for your family. If you’d like to be well informed on your health care options, be sure to read this guide from beginning to end.

Know These Terms Before Buying Insurance

Terms used by insurance providers often confuse and intimidate people. Therefore, it’s best to learn the new vocabulary before open enrollment to understand the health care policy. Below are some of the critical terms you should know about your health care plan:

Premiums

These are regular payments you make to maintain your health insurance. It is essential to understand that higher premiums usually offer lower deductibles.

Deductibles

This is the amount of money you pay upfront until your insurance policy kicks in. So, for example, with a 3,500 deductible, you’ll have to pay that amount before your health care policy covers your medical expense. 

Coinsurances

Your coinsurance is the percentage you will pay after paying your deductible. For example, your coinsurance covers 25% for a doctor visit for $100. Once you paid your deductible, you’ll pay $25 for the doctor’s visit.

Copays

Your copay is how much you have to pay at the time of service. Let’s say you plan on visiting your family doctor for a checkup. As a standard copay, your visit will cost $50.

Flexible Saving Account

Employers offer these plans to help employees pay copays, deductibles, and prescriptions. You’ll also be able to purchase other medical expenses such as dental care, vision care, and disability treatments.

Health Saving Account

As with flexible saving accounts, you use these accounts for health expenses. You open a personal saving account and is used to help cover the high cost of health care. Also, the money you put into this account is not taxed. You must have a high-deductible health insurance plan to be eligible for an HSA.

You should be aware that some plans may need a referral to see a specialist, and others do not. Also, some programs may allow you to see doctors nationwide, while others have a local network.

You should be familiar with these acronyms below. They refer to different types of health care plans allowing you to access physicians and services.

HMO: Health Maintain Organization

Health Maintain Organization is a budget-friendly health insurance plan. It offers low deductibles, premiums, and fixed copays for doctor visits. You will have to choose a doctor within their network for regular checkups. If you need to see a specialist, the doctor can refer you to one. These plans are often best for people with low income and do not get sick often.

POS: Point of Service

The point of service plan covers doctors out of the network, but you will have to pay more for them. The plan requires you to have a referral from a primary doctor before seeing a specialist. You may need this option if you have a health condition and no local specialist can treat you.

PPO: Preferred Provider Organization

A Preferred Provider Organization is for people who want to see doctors outside their health plan’s network. If you see an in-network doctor, the copays and coinsurance are lower. The downside is that the premiums are higher within this plan.

EPO: Exclusive Provider Organization

An Exclusive Provider Organization is like HMOs but offers more extensive in-network care. You do not need a referral from a primary care physician to see a specialist. However, premiums are usually higher than HMOs.

HDHP: High Deductible Health Plan

High Deductible Health Plan offers low premiums but higher deductibles. Employer-based insurances often pair these plans with health savings accounts. Companies do this to help cover some or all your deductible.

Did these health care terms confuse you? If you have any questions about these terms, an insurance provider can assist. 

Choose the Right Health Care Policy for Your Family

Finding the right health care coverage for you and your family is a challenging task. To help you with the right policy for your family, consider these options.

Individual Health Plans

These plans only cover one person and pay hospitalization expenses made by them. Individual health care policy can be purchase privately or through an employer.

Family Floater Plans

These are health insurance policies that provide coverage for an entire family. A family floater plan is cheaper than picking individual plans for each member, especially if you have a young family.

Plans for Senior Citizens

Senior citizen health insurance covers people 60 and older. An elderly member of the family may benefit from this plan if you want to cover outpatient treatment and treatments for pre-existing conditions.

Critical Illness and Disease-Specific Health Plans

A disease-specific health plan covers specific diseases and their complications, such as heart problems or CO-VID. The insured is covered against many common conditions such as strokes, cancer, and heart attacks in a critical illness plan.

Super-Top-up and Top-up

These are supplementary health insurance plans that cover medical expenses above the deductible limit. You can increase your health insurance coverage for less by choosing one of these two options.

Therefore, if you and your spouse have children, a family floater plan is the best option. However, if you have an older family member within the house, you may want to consider a different plan for them.

Are You Expecting Any Changes Within the Next Year?

Are you currently pregnant or hoping to become pregnant? If so, then you may want to check for potential plans for their maternity and newborn coverage.

When searching for healthcare coverage for maternity and newborns, keep this in mind: Does your hospital or birthing center in-network? Will your health care carrier offer breastfeeding education and support? How much will the insurance company cover for the birth?

If you’re expecting any changes, such as pregnancy, keep these kinds of questions in mind within the next year when looking for new health care coverage.

Is Your Current Physician Covered by the Insurance Policy?

You may already have a family doctor or a specialist that you’d like to continue seeing. If you do, then make sure the health care plan you choose includes your doctor in their network.

It is still possible to continue seeing outside of your health insurance’s network. Just know that it will cost more to do this.

Does Your Health Care Coverage Offer Any Perks?

Some health care insurances offer certain perks than others. These perks often include gym membership, a medical hotline that’s open 24/7, digital tools, health coaching, and help with addiction.

You may even find an insurance provider that offers holistic health treatments such as yoga and massage to treat chronic pain and illness. To find these kinds of perks or discounts within a health plan, you will have to research.

Do you need help? Contact an insurance provider to help you with the research to reach your health goals and keep extra money in your pockets.

Is the Deductible High or Low?

It makes sense for individuals to select a high deductible plan, but it is not always the best option for families. In addition, a healthcare plan that covers more than one person increases the likelihood of visiting the hospital or a doctor.

There is a possibility of high costs if the visits are frequent or someone is constantly ill. Remember that the deductible is the amount you must pay out of pocket before your health plan kicks in, so you’ll have to consider how much you can afford.

The low deducible plans are generally more costly, but a family should still choose these plans to save money until their insurances start to pay.

Are You Still Looking for the Right Family Health Insurance in Texas ?

Hopefully, this article gave some valuable points to help you compare healthcare coverage for your family.

However, you’re still going to comb through some fine details to find the right family health insurance plan for everyone within your household.

For additional help, contact us today to find the plan most suitable for your family.

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