When a Family Health Plan May Not Be the Right Choice

  • February 23, 2016
  • |Quartz
|
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It generally makes sense for all the members of a family to be on the same health plan. However, under certain circumstances, it may not be the best choice.

It generally makes sense for all the members of a family to be on the same health plan. However, under certain circumstances, it may not be the best choice.

Scenario #1 – Spouses on different employer-sponsored health plans

Many companies pay part or all of their employee’s health insurance premiums. It’s also common for employers to offer family health plan coverage as well – but at a cost to the employee.  For example, it’s common to have Spouses employed at different companies. Both companies may offer free coverage for the employee, but require contributions toward the premium when family members are added to the health plan. Often, the costs increase as family members are added. A spouse will be one amount, dependents will cost more and spouse and dependents will cost the most.

At this point, it’s a matter of deciding which health plan offers the best benefits at the lowest cost.

When making the decision as to which health plan is best for a family, it’s important to consider more than just the payroll deduction for the coverage. Other factors include –

  • The plan’s provider network of doctors, hospitals and clinics
  • The deductible amount and whether each person in the family has a separate deductible or it is a single deductible for the entire family
  • Copays and coinsurance
  • Cost of prescriptions

Scenario #2 – The employer-sponsored family health plan is too costly or inadequate

As health care costs have increased over the past decade, many employers have reduced their family health plan benefits so that employees shoulder most of the cost of the premium if their family is included. In these cases, having two plans might be the right choice. This is especially true if the employee health plan existed before 2010. That means that it may not offer all of the benefits required by the Affordable Care Act (ACA).

ACA-compliant plans must offer a range of preventive care services at no out-of-pocket cost and provide coverage of essential health benefits. If you’ve had the same employer for many years, it’s probably worthwhile to explore family health plans that include all of the ACA-required benefits, especially if you have a growing family.

It’s also good to know that you can buy ACA-compliant child only policies that may be less expensive than adding children to your employer-sponsored health plan.  Unity offers a range of such plans.

Scenario #3 – A family member has extensive health issues

At times, families may purchase a separate health plan for a member who uses a lot of health care services. This way, the family member can have a plan that fits his or her needs, while the rest of the family has a health plan that works for them.

If you have specific questions about finding a plan that’s right for your family, have a look at our plans or give our knowledgeable customer service representatives a call at 800.362.3310.

See If You Qualify and Get a Quote

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