One question we get frequently is, “How do we know we are picking the right healthcare plan for our family?” Healthcare can be expensive, especially if you don't know what the different options are! Don't get caught up in decision paralysis when making a choice about your family's health. We're here to help so you can find what's best for you.
It's that time of year when health insurance open enrollment is coming around again. It's also the time we get flooded with questions from readers asking how to pick the right plan for your family.
This is SUCH a personal decision, and the solution will be different for each family. However, there are some general tips you should know that can help you make the best choice for your situation. Check out our advice below, it's full of great information!
KNOW YOUR STUFF TO PICK THE RIGHT HEALTHCARE PLAN
HSA? FSA? HRA? Premium versus out of pocket cost? Knowing the lingo for your healthcare options helps making the decision on which plan is best for you and your family so much less stressful!
- Insurance Categories – There are four general categories for health insurance plans corresponding to metals. Platinum, gold, silver, and bronze determine how costs are shared on your plan.
- Premium – Your premium is the monthly fee you pay for being enrolled in your health plan.
- Out of Pocket Cost – Out of pocket cost is the amount that you pay for the care and services you receive.
- HSA – This stands for Health Savings Account. It is just that. An HSA is a savings account set aside entirely for medical expenses.
- Copayment – A copayment is the set amount that you pay for specified doctor visits. Rather than paying for the entire visit out of pocket, you essentially pay a set fee amount for the visit.
These common terms are just scratching the surface with regard to health insurance. To learn more, check out this awesome resource from United Healthcare that helps explain allllllll the common health insurance terms.
WHICH HEALTH PLAN WORKS BEST FOR YOUR FAMILY FINANCIALLY?
When you pick your plan, think realistically about the medical expenses that you foresee for your family that year. Yes, we know that feels a little bit like looking into a crystal ball, but do your best. You typically know things about your general health, whether you'll be planning for a pregnancy, a scheduled surgery, or continuous care for an existing condition.
Once you decide on what your family realistically needs, then decide between the following options:
- Low Premium, High Deductible Plan – You will pay less every month on your premium but will pay a higher cost for services when they are incurred.
- High Premium, Low Deductible Plan – You agree to pay more each month on your premium in return for paying less of the cost of services when they are needed.
If your family is relatively healthy, then it probably makes sense to save on your monthly premiums and then pay a bit more when you need to visit the doctor on occasion.
CONSIDER THE HEALTH PLAN'S PROVIDER NETWORK
Do you have a pediatrician you love? Are you planning to have a baby soon? If there are specialists, or certain doctors you prefer visiting, make sure you choose a network that covers those physicians. Otherwise, you'll be paying out of pocket to visit them… and that can add up QUICKLY!
USE YOUR HEALTH PLAN WISELY
Okay. You've picked your plan and you're spending good money each month to pay for it. You better be taking advantage of every little thing you can with that plan and spending your money wisely. Here are a few things that we encourage you to do to take full advantage of your benefits:
- Estimate the Costs of Services Beforehand – It pays to check your costs before services and compare providers! A study done by one major insurance company showed that customers who estimate their costs beforehand saved an average of 35% over those who didn't.
- Go in for Routine Preventative Care – We all know that it's hard to get in for those routine checkups. But it's so important! Regular preventative care, such as mammograms, can help you detect conditions earlier on when they are more treatable. So, take care of yourself.
- Maximize Your Prescription Benefits – Check your regular medications against your plan benefits to see if they are the best option. Sometimes a doctor prescribes a name brand medication when there is a generic alternative available, so just be aware.
- Take Advantage of Plan Perks – Sometimes your health insurance plan includes perks just for being a member. Common ones we've seen are reimbursements for gym fees, health coaching, and weight loss support.
We know that health insurance can be confusing. However, managing your family finances well means being willing to teach yourself about difficult concepts so you can save money. You can do it!
WHY YOU SHOULD CONSIDER A HEALTH SAVINGS ACCOUNT
The last tip we want to share is a goodie. If possible, open a health savings account! The money you put into this account is tax-free! Many employers offer them along with healthcare plan options; or you can always look into getting one yourself!
If that isn't an option for you, then just open an additional savings account that you dedicate to medical savings. Then, when you need to visit the doctor, you will already have a slush fund of savings to pay for what you need! Read more in our Health Savings Accounts article!
What tips do you have when it comes to choosing the right healthcare plan? Share with us in the comments below!
Looking for more great ideas??
- Learn how we set financial goals and ways you can too!
- Get our best budgeting tips for families.
- Use our clipboard system for homework and kids chores.
thank you for all of your tips and tricks – no matter what the topic! helps so many of us at all different stages of our lives!
ps – love love love the floral sweatshirt! please do say it’s a yard sale or I may cry!
don’t say it’s a yard sale! oops!
Jordan, If we choose a Health Savings plan, does it allow to use on dental, and prescriptions too?
Dental is different from Health, unfortunately! Our family has health insurance, but not dental – we pay out of pocket for dental because insurance is so expensive. We save hundreds by just paying out of pocket. However, if you are employed (we are self-employed) maybe it’s a package deal that you could take advantage of!
I totally agree with you. Just to add up, you might want to find a doctor who is affiliated, or has privileges at different hospitals.
I can definitely see why you would want to buy health insurance based on your family’s financial situation. My son currently struggles with a serious illness which has really taken a toll on our family. I definitely think that we should find an insurance broker that could help us to find a plan that suits our son’s needs for treatment.
health insurance is must for everyone.