Family Insurance
Are you trying to choose between an individual, family, or no health insurance plan? You must know there is a lot to consider. Even if you get insurance as a perk from work, you have to pay a hefty fee if you want to include your spouse.
As a mother, you want to do what’s best for your family. We understand that chronic decision fatigue can catch up on you. Will you save money by not paying a premium? Do veterans’ families get free healthcare? How do I save money while getting quality healthcare? Let’s dive in and figure this out.
Health Insurance Terms
Before we begin, let’s get some health insurance-related terms straight. That will help you better understand what you’re getting into.
Premium
Your insurance premium is your monthly insurance payment. Think of it like your car or house payment.
Deductible
The deductible is the amount a policyholder must pay by themselves before their insurance kicks in.
Out-Of-Pocket Expenses
These include deductibles, copays, and anything the policy holder must pay themselves.
Copays
Copays are a flat fee you pay from your end whenever you get a medical service. They may apply before and after you hit your deductible.
Coinsurance
Coinsurance is a percentage of the insurance received after the deductible that the policyholder must pay.
Types of Health Insurance Plans
To understand more about insurance and family insurance, let’s first go over the four types of insurance. Insurance is classified based on flexibility and expense.
Health Maintenance Organizations
Health maintenance organizations or HMOs give you a limited selection of healthcare providers within a local network. They require you to have a primary care practitioner or PCP. You can only visit a specialist within the local network once your PCP refers you.
HMOs are the least flexible plan but have the lowest premiums and sometimes no copay.
Preferred Provider Organizations
Preferred provider organizations or PPOs are more flexible than HMOs. It would help if you had a PCP but a much more extensive medical network. You can get treatment outside that network, but it is much cheaper to remain within it. PPOs are inexpensive like HMOs but still have more options that could charge more. You do not need a referral from your PCP to see a specialist.
Fee for Service
A fee-for-service or indemnity type plan offers you the most flexibility but is also the most expensive.
You have your choice of medical providers and services. You will not need referrals to be covered. However, your out-of-pocket expenses and deductibles are sky high as a result.
Point of Service Plan
Point of service plans is like HMOs and PPOs combined. You need to have your own PCP and get referrals to visit specialists in your limited medical network. However, you can get treatment outside the network and write referrals to specialists. It costs a little more than staying within the network.
Child Health Insurance Program
CHIP, or child human insurance program, is a comprehensive medical plan for which only children can be eligible. The criteria are different for each state. With CHIP, child wellness visits to the doctor and dentist become free. There is no specific enrollment time for this, so find out about eligibility now!
Family or Individual Healthcare Insurance
WE understand this is a hard decision. Read about this mom of 10 on the blog. Family insurance is the way to go for most situations, and here are some reasons why:
Makes Visits Cheaper
Insurance makes going to the doctor cheaper. It is estimated that you will end up paying a total of 30% of your medical expenses. Getting an insurance plan is much better than going to the hospital without it.
You do not have time to shop for a cheap hospital in an emergency. Healthcare quality for your children is paramount and must not be compromised for money.
Preventative Care
Knowing that you will not have to pay as much lets you go to the doctor more readily. You get the chance to chat about any diseases spreading to different family members. God forbid one of your family members gets diagnosed with a terminal illness that has little time to cure. You may dodge bullets by getting yourself and your children into the hospital on time. Read more about dental insurance on eightymphmom.
Family Out-Of-Pocket Maximum
One of the biggest perks of family insurance is the out-of-pocket maximum. There is a certain fixed number that you pay in a year. After that amount has been reached, all treatment and services become 100% free. It is easier for a family to reach the family out-of-pocket maximum than individuals on individual health plans since the cumulative individual out-of-pocket maximums are greater than the family plan maximum.
Penalties
In exceptional circumstances, you or a family member may be eligible for health benefits. Some states and health benefit programs have penalties for not availing of these plans on time.
For example, if people get Medicare too late, they pay the penalty with every payment.
Some states also have penalties for not getting basic health insurance for yourself or your family, for example, California.
To avoid any hefty fines or ensure you won’t have a higher premium than you need to, you should check with the local authorities to see if you or your family is eligible.
Generally, you can use Medicare if you are disabled or over 65. There is a specific enrollment time, so don’t miss it.
Conclusion
As you may have learned, insurance is essential for a growing family of vulnerable kids. It would help if you were prepared for every possibility to ensure their safety and protection. Choosing the right plan may be difficult, but with PHP Agency reviews it doesn’t have to be. Be sure to do your research as having a plan is better than having nothing.
Do not be late and secure the right plan for your family so you can take advantage of reaching the out-of-pocket maximum and enjoy 100% free medical care afterwards.
Get a family insurance plan or bump up your current group plan from work to include your spouse and child so that you can put your mind at ease today!
Eighty Mph Mom says
There is some great information here and really cleared up a lot of questions. Thank you!