A Closer Look at Group Health Insurance

Here’s where the services of a good insurance agent can be invaluable, but you’ll still have to do your homework. It’s important that both you and your employees understand exactly what your Group Health Insurance will and will not do for you. To do that you’ll have to understand some basics that are typically found in most Group Health Insurance plans.

Deductibles

A deductible is generally considered to be the amount of expenses the employee must cover from his or her own pocket before the plan begins to pay. This can vary widely, from nothing to thousands of dollars. Over the course of the last few years, as medical expenses have increased, deductibles tend to be going up. There is a trend toward routine medical bills being paid out of pocket, or in the form of increased premiums. This doesn’t mean you can’t get a plan that will help lower overall costs, but expect to pay more for better coverage.

HMO or PPO

HMO’s or Health Maintenance Organizations, are one form of Group Health Insurance. In general, an HMO will use a primary care doctor as a sort of filter or gatekeeper, to manage coverage. This doctor will be the first one you see and he will then decide whether referral to a specialist is needed. This helps to keep costs down and discourages unnecessary use of the plan. A PPO, or Preferred Provider Organization, will offer a list of doctors and hospitals for you to use. This can save money, as these doctors and clinics have agreed to offer lower costs in order to be included. It does however, offer fewer choices. While most plans will allow use of an out of network provider, it may come at a higher cost.

Limits

Here’s where you’ll have to ask the right questions. Limits can come in the form of treatments available, and expenses. Group Health Insurance can vary widely. Some may cover things like needed medical equipment (ex. Breathing Machines for Asthma sufferers) while others won’t. You’ll find some cover mental health problems, transplant coverage, and vision, while others will leave these out. Most policies will also have some sort of lifetime coverage limit for expenses so be sure to ask about that.

Insurance for Every Concern

Insurance for Families Insurance for Singles Insurance for the new addition Insurance for Life