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Family Health Insurance Plans

A good family health insurance plan is a protection for your family against any unpredicted devastating financial effect, resulting from unexpected health problems. However, with the multiplicity of family health insurance plans that are available, choosing the best option is a daunting task.

Moreover, laws and policies related to family health insurance also often change, hence it is required that you have all the latest information. Knowing the various types of family health plans that are available will help you choose the plan that is right for you.

Use our free family health insurance quote finder to get started finding the health insurance plan that your family needs today!

Family Health Insurance Plans: Traditional & Managed Care Coverage

The broad coverage options are traditional health insurance option and a managed care option. When you are planning to buy a family health insurance plan, your first task is to choose any one option between traditional health insurance and a managed care option.

In traditional health insurance you, the buyer of the policy, choose your own healthcare provider, maybe a doctor or a hospital, you have used for years. In this case, you visit the doctor or hospital, pay for the services availed and submit the bills to the health insurance company to get reimbursement of the portion that the company agreed to pay as per the policy terms.

With a traditional health insurance plan, you go to your doctor/hospital, pay for services and then get the reimbursement from the insurer. However, in the case of a managed care system, the insurers manage the service provider i.e., the doctor and the hospital, provides you services and settles the bill between them.

Typical Family Health Insurance Coverage Options

Traditional Health Insurance

  • You choose your doctor/hospital/healthcare service provider
  • Get the services and pay for the services availed
  • Submit bills to insurer to get reimbursements
  • Your Choice of doctors/Hospitals
  • Costly Coverage

Managed Care

  • Insurer has its own network of service providers
  • Get the service and no need of any payment
  • to the service provider
  • Insurer pays to service provider, as per
  • your terms of policy
  • You have limited choice of healthcare providers
  • Cheaper Coverage

Types of Coverage Available

  • Basic medical insurance
  • Major medical insurance
  • Health Maintenance Organizations (HMO's)
  • Exclusive Provider Organizations (EPO's)
  • Preferred Provider Organizations (PPO's)
  • Point-of-Service Plans (POS)

Types of Traditional Family Health Care

Basic Medical Insurance (hospital/medical/surgical) - This is the initial or bare minimum of health insurance that pays for a portion of your expenses as well as for some hospital/clinical services such as expenses towards operations, laboratory tests and X-rays. The medical/ surgical insurance covers expenses towards surgical and related costs (either in the hospital or doctor’s office), and may pay for anesthesiology. Depending upon the terms of policy, this insurance may also pay for doctor fees for medical visits when you receive hospital care other than surgery. This type of family health insurance plan can often have very limited benefits so read your policy carefully.

Major Medical Insurance - This coverage is meant for the high costs of hospitalization, injuries and serious prolonged illness. Major medical insurance coverage may also cover the cost of blood transfusions, drugs and out-of hospital costs, such as doctor visits. Most group health policies fall under the category of major medical policies. Since this insurance covers the high cost healthcare services and offers more benefits; it comes at a higher cost. Usually, major medical insurance pays 80 per cent of covered expenses after you pay the deductibles.

Types of Managed Care

Health Maintenance Organizations (HMO's) - Like with an insurance premium, HMO members pay a fixed monthly amount for accessing wide range of healthcare services. In several cases, there is a pre fixed amount that members pay for each doctor, emergency room, prescription drugs etc instead of paying the service provider in full and later getting reimbursement of a portion of the payment from the insurer. HMOs, now also offer with deductibles and coinsurance. The best feature of HMO is that its members have little to no paperwork to process since there is no submission of bill of reimbursement involved.

Preferred Provider Organizations (PPO's) - PPOs also have their own network of services providers like HMOs. However, in this case, the insurer ties-up with a group of service providers, who charge less than the standard charges in exchange of prompt payment and greater number of patients. The advantage for consumers is that they themselves choose the service provider but pay less in coinsurance with a preferred-provider than with a permanent-provider.

Other managed care options are Exclusive Provider Organizations (EPOs) and Point-of-Service Plans (POS).

Other Major/Supplemental Family Medical Coverage

  • Group Plans
  • Individual Plans
  • Single-employer plans
  • Hospital confinement indemnity insurance
  • Disability income insurance
  • Accident insurance
  • Limited benefit insurance
  • Long-term care insurance
  • Home health care policy
  • Nursing home care policy

 How Should You Compare Family Medical Insurance Plans?

Healthcare insurance coverage has the potential of making or breaking your financial potion, if any healthcare issue occurs. Therefore, choosing not the good health insurance option but only the best option should be your objective when you plan to purchase any family health insurance coverage.

Any family health coverage should be based on your needs as well as your ability to pay routine costs. Therefore, first of all, you should calculate your needs, the amount that you can pay anytime and a tentative level of cost for which you need financial protection. You should also note the fact that the greater the cost you share the lower the premium you will have to pay.

Here are some common health insurance terms that you must understand in order to be informed about your family health insurance policy:

  • Premium - This is the monthly or annual amount that you pay for the insurance coverage.
  • Maximum out-of-pocket - This is the maximum amount that you pay out-of-pocket for covered claims.
  • UCR (Usual, Customary and Reasonable) - This is the limit of the amount that the insurer will pay to you on the basis of average fee for given procedures, geographic areas, etc. This is one of the most important features that you should carefully look at.
  • Coordination of benefits - This provision prohibits you from receiving more benefits than your actual expenses in spite of your having additional policies.
  • Renewal and premium increases - Based on this, your insurance company renews your policy or increases the premium.
  • Conversion privileges - This makes you eligible to convert your coverage to another insurance plan when you lose eligibility, without a medical exam to prove good health.

How to Select A Family Health Insurance Company

By now, you must have fair idea of the role a good healthcare insurance coverage and the insurance provider play in your life. Therefore, you must check that you are purchasing health insurance coverage for your family from properly licensed, registered and reputed healthcare insurance provider and its agent.

You may be aware that there are various organizations that rate these insurance companies on various parameters including average cost of their policies, their record of successful claim settlements, level of customer satisfaction, their financial position, asset & liabilities, company history etc. Therefore, you should consider verifying the ratings of the potential family health insurance providers. A few of the recognized agencies that rate these insurance companies are:

  • A.M. Best Company,
  • Standard & Poor’s,
  • Weiss Ratings Inc.,
  • Moody’s Investors Service and
  • Duff & Phelps

Find The Best Family Health Insurance Plan Now!

Shopping around is key for finding an affordable family health insurance plan. Use our free family health insurance quote tool to compare the best in family health insurance plans.

Search quotes from top companies to find a cheap family health insurance plan that will keep your family protected while staying within your budget. Find the family health insurance plan that is best for you and your family today!

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