Wouldn't it be great if we could pick a plan based solely on our family's needs without a thought to cost? Unfortunately, most families don't have this luxury, and health insurance is no exception to their tight budget. Once you've decided what you want in a plan, rank each item as a want or need. Are there wants you would be willing to compromise for a better price?
The next thing to do is start pricing out plans. If you're employed by a company that provides a group employee plan, this will most likely be your best option. Not only does the insurer provide a discounted rate for the group of employees, your employer will usually pay a portion of the cost. Even with employee plans there are usually a few choices such as PPO versus HMO, each with different costs and coverage options.
If you and your spouse both have access to an employee plan, it may be best to choose one for the entire family. On the other hand, it might also be more affordable or give you better coverage for each spouse to keep his or her own employer's plan. It all depends on the options available to you and what is best for your family. Don't forget to ask your trusted coworkers for advice, especially if they've had more experience with the plan than you.
If you're seeking an individual plan, you should get multiple quotes from providers, and get several quotes from each provider to compare your best- and worst-case scenarios. Even if you're self-employed, you may still be eligible for a group plan that would provide a discounted rate. Unions, trade groups and other associations may offer group insurance plans [source: Reuters]. Although you won't have the added bonus of an employer paying a portion of the cost, you can still benefit from the group discount.
No matter what plan you choose, you should look at the plan in its entirety, not just the monthly fee. Every plan will have deductibles you must meet, copays you owe for each appointment and varying monthly fees. Some plans may even require coinsurance, where you are always responsible for a percentage of your health care costs. Take a look at how often your family uses the doctor and average out how much the plan will cost you in a year. Do you have a child with a condition that requires constant appointments? If so, a plan with a lower copay may be the best option. Is your family generally healthy and rarely visits the doctor? If so, a plan with a low monthly rate, but a high deductible might work for you.
If you are in a tight spot and can't afford the plan you want, you might want to consider catastrophic insurance, which is designed to cover emergency situations only. For a low monthly fee, you will receive a high deductible to meet. Compared to HMO deductibles of perhaps $250, a catastrophic insurance deductible might be closer to $2,500. The difference is you will be completely covered at 100 percent once this deductible is met. This way, if you are in a car accident, you won't have to go into severe debt to cover your bills. You'll have a plan to fall back on.
As you can see, finding the right family health plan is a complicated task. So what happens when the government gets involved? We'll discuss health care reform on the next page.