Group insurance is one of the most inexpensive health insurance schemes available in the market. It accounts for over 50 percent of the non-governmental sponsored health insurance market. For most people, buying insurance can be overwhelming. Definitions, coverages, conditions, endorsements, and exclusions can be overwhelming and possibly give you a headache. Today, most employees are looking for organizations that offer group health insurance plans. Since individual insurance is expensive, these individuals rely on group plans to provide better insurance at affordable rates. If you choose a group plan, you’ll need to make very critical choices. These choices will affect not only the quality of your medical care coverage but also your wallet. So, what do you look for? Which factors carry more weight? Here are a few simple factors you should keep in mind when choosing suitable group insurance.
1. Seek More Coverage Limits
Healthcare costs are skyrocketing by the day. Unfortunately, this isn’t something that is coming down anytime soon. Based on a past report released in 2013 by AHIP (America’s Health Insurance Plans), hospital care costs had risen by a margin of 8.2% between 2008-to-2010. While general practitioner bills are cheaper than healthcare cover, they’re still part of the increasing healthcare prices. Additionally, physician care costs have also increased. Such increased healthcare costs make having applicable coverage limits necessary. As an individual, you want high policy limits, so you’re not left on the road even when something devastating happens.
Referred to as a PPO (Preferred Provider Organization), they contain the managed care aspect of an HMO (Health Maintenance Organization). This means you have the added flexibility of venturing outside the healthcare practitioners’ network and facilities to any healthcare provider of your choice when you feel so. However, if you venture outside the network, the benefits are less. This means you pay more than you would if you had stayed within the network. However, you will still receive some coverage, unlike an HMO where you won’t. If choice and flexibility are vital to you, a PPO may be a suitable choice if it’s available to you. The only downside of PPO is that it’s more difficult to predict your out-of-pocket costs.
3. Avoid Shopping By Price
We get it; you might be tempted to pick the group insurance plan that is cheaper for you and your family; This is primarily attributed to the rising costs of health insurance. Price is the last thing you want to consider when shopping for a new group insurance scheme. Why? This is because coverage is more important than price. For instance, if you get a plan with a low lifetime maximum care limit, you could be liable for a considerable sum of money if you run out of coverage. This is because of picking the cheapest possible plan.
4. Evaluate the Dollar Maximum per Claim
A cheaper plan has a lower dollar maximum per claim. In short, this is the amount of money an insurer will payout for a specific health insurance claim. For instance, if you’re involved in a car accident and need surgery, medication costs, and physical therapy totaling $500,000, and your dollar maximum per claim is only $300,000, you could be on the hook for the remaining $200,000. You need to evaluate your financial capacity and risk tolerance. So, can you invest in a more costly plan for more coverage limits? If you’re in good health, it might not be the case. However, if you expect to run into some severe health issues soon, it’s worth paying more for a premium plan.
5. Assess Limitations
Some policies impose limits on specific procedures. These are known as internal policy limits. Avoid this at all costs. For instance, things like room and board at health institutions may be limited to specific dollar amounts per diem. Additionally, some also impose strict limits on certain surgeries. As a patient, this can put you in a difficult situation. Do your research carefully and assess if there are any impediments.
6. Consider International Coverage Requirements
If you travel internationally for work-related activities, you may need to pick a plan that includes global coverage. Be sure to look for both emergency and non-emergency coverage. This means if something happens to you while traveling for work, you will be covered.
As an employee, consult the HR department in your company if you require additional information about all the benefits offered to you. This also includes health insurance. Additionally, there are some cons of group insurance you need to keep in mind. For instance, if you’re self-employed, you might be limited when it comes to deducting your healthcare sharing amount. This is different from how you would deduct health insurance premiums when you pay out of your pocket.