Family Health Insurance Policies

If you’ve got a family, one of your responsibilities is to provide sound health care-and you can’t do that without family health insurance policies. What do you need to know about family health insurance policies? How does President Obama’s new Patient Protection and Affordable Care Act affect you?

Let’s look at the second question first. Most of this new health care act will not go into effect until 2014-but a few provisions will kick in early. Here are some of the ones that will affect people early on:

• In the summer of 2010, if you have a pre-existing medical condition, you will have the option to join a high-risk pool. If you sign up for this coverage, it will be replaced by one of the plan’s new policies in 2014.

• In the fall of 2010, a variety of options becomes available. Children can remain on parents’ family health insurance policies until they are 26 years old. Covered children below age 19 cannot be discriminated against because of pre-existing conditions. New family insurance plans cannot charge you a deductible or a co-pay for Level A and Level B preventive care, used to prevent the development of or to diagnose a medical condition. Insured members of a plan cannot be terminated from coverage because they’re sick.

• Fall 2010 also mandates certain behaviors from insurance companies, such as controlling how much money is spent relative to how much comes in if they want to benefit from tax breaks. They’ll have to make public their executive and administrative costs. All companies must clearly reveal an appeals process for insured members to follow if they disagree with coverage denial.

• By January 2011, insurance companies must limit their profits to 15% (large group) or 20% (small group) unless they can prove they boosted the quality of health care. Otherwise, the extra profits will be rebated to customers.

While most of us are waiting to find out what all those changes will really mean to our pocketbooks, here are some tips for choosing family health insurance policies that best suit your needs:

• First, make a chart that shows each member of your family. For each person, write down if he or she will require immunizations, diagnostic tests, or prescriptions. Of course you cannot predict what will happen-that’s why we have family health insurance policies in the first place-but you’ve got to estimate what you expect your needs to be.

• Do take advantage of the internet to get quotes from several different companies. Prices and coverage guidelines can vary greatly from company to company, and it pays to compare.

• Call your doctor’s office to find out if he is in any of the family insurance plans that have quoted you. You’ll have to decide if you are willing to switch family doctors to save money on your family health insurance policies.

• While you have your doctor’s office on the phone, ask if they object to generic versions for any of the drugs you or your family members use.

• Whether you participate in a family insurance plan or buy one of your own, make sure you read your policy so you know what’s covered and what isn’t. If your company sends you updates, read them. It’s worth repeating: Read them!

• Control your costs by reviewing your providers’ fees. If you think you’ve been overcharged, you can ask your family insurance company to audit the provider’s claim. You can even request an item-by-item invoice from your local hospital. Don’t settle for a bill that just itemizes various categories of expenditures, such as medications $1,000, respiratory care $1,000, and so forth. You want to know exactly what they’re billing for.

One of the best ways to manage family insurance costs is to make informed decisions about the plan you buy. Participate in cost-saving measures suggested by your plan if they sound reasonable. Make the most of your health care dollars by always double-checking your bills before making your payments. Make sure you are not the victim of a careless bookkeeping or billing error. If there is an error work with your insurance provider to have the error corrected.