Group Plans/Employer-Sponsored Plans
Many individuals get health coverage through their employer or are covered by a family member who has employer-sponsored insurance. In many cases, the employer pays for part or all of the cost for the employee.
Some small businesses do not provide group health plans and many companies do not cover part-time employees. In this case, your best choice may be group coverage obtained through a labor union, professional organization, club or an alumni association.
If you are covered by a group plan, ask for a copy of the summary plan description, which outlines your benefits under your employer-sponsored group health plan and your legal rights under the Employee Retirement Income Security Act (ERISA), the federal law that protects your health benefits under such plans. The summary plan description should describe the following benefits.
- Coverage for dependents.
- What services require a co-payment, coinsurance or a deductible.
- The circumstances under which your employer can change or end a health benefits plan.
- What coverage, if any, is provided once you retire.
Individual Plans
An individual health insurance plan may be your only option if you are between jobs, in school, self-employed or work for an employer who does not provide health insurance. Typically, individual plans are more expensive, but you have the advantage of tailoring coverage that will fit your needs from the company of your choice.
Check Out The Company
Before purchasing any plan, make sure the company has a strong financial rating. Standard & Poor’s, Weiss Ratings, A.M. Best and Moody’s are independent agencies which evaluate the financial strength of health insurance companies.
You should also read the plan’s coverage contract, which may be called a “certificate of coverage” or “evidence of coverage.” It explains which services are covered and which are excluded in more detail than the summary of benefits.
No matter which health insurance plan you choose, you want to be sure you will receive quality care. To learn more about health care research and quality visit the Agency for Healthcare Research and Quality at www.ahrq.gov or the National Committee for Quality Assurance at www.ncqa.org.
Is the managed care organization accredited? Many managed care organizations choose to become accredited by one of several independent agencies. Accreditation provides a “seal of approval” and assurance that the organization meets a set of standards.
To find information on your state, call the National Association of Insurance Commissioners at (816) 842-3600 or visit www.naic.org.
Before choosing any health plan, make sure that it is convenient for you and your family.
- Where are the physicians’ offices located?
- How easy is it to get an appointment and how quickly can you get an appointment?
- Does the physician reserve some time each day for emergencies or walk-in patients?
- Are the hospitals or other facilities convenient and easily accessible?
- Do you have the option of going to an outpatient facility for certain tests or treatments?
Just because plans offered by different insurance companies provide standard benefits, do not assume that they cost the same. Compare all the costs, including deductibles, co-payments and the benefits provided.
Use the Comparing Health Insurance Plans work sheet and the Comparing Health Insurance Plans Costs work sheet to compare health insurance plans and to identify your out-of-pocket costs for the plan you are considering.
|
Auto
Insurance
Auto
Insurance