Family health insurance helps you pay for your expenses related to your family's health care. Many people get family health insurance from employers. Some purchase private family health insurance policies if necessary. You might be required to choose your physician from a specific medical provider network in order to receive coverage depending on what type of family health insurance you have.
Types
Families normally choose from PPO (preferred provider organization) and HMO (health maintenance organization) health insurance. Both of these family health plan types usually cover diagnostic testing, doctor visits, hospital stays and other kinds of medical services. Each plan type has its own specific provider and payment rules. Each family health insurance type is considered to be a "managed health care plan."
PPO Features
A PPO is a family health insurance plan that also has a specified medical provider network. PPO members, however, are not required to remain within this network (though there are fewer benefits to going outside the network). This means that PPO health insurance might require you to pay a higher co-payment for services rendered from physicians outside of the PPO provider network. You will also have to pay a higher deductible fee for out of network services.
HMO Features
An HMO health insurance plan is a prepaid one. Most HMO plans do not involve out of pocket expenses or large deductibles (except standard service co-payments). Many HMO plans require that you select a primary care physician (referred to as a "PCP"). As long as you stay within your insurance provider's network, you can choose to change your PCP. Most HMOs do not provide insurance coverage outside of their own network unless you have an emergency situation. Some HMOs do allow you to select a physician out of the network but you will have to make higher payments as a result. PCP representatives are often responsible for referring you to other health care providers or specialists.
Considerations
Select your family health insurance plan carefully. Make sure that the medical providers you prefer are within your potential insurance company's network. If not, ask your provider to join the network. If your physician refuses to do so, you must figure out how necessary it is for you to continue to see the same doctor. You can opt to provide higher insurance premiums to visit the same doctor.
Warning
If you have children, make sure that necessary health services are covered for them and that there is no cap on your family health insurance. You should not, for example, select an insurance program that caps your total doctor visits at $200 per year if you have small children, as they might need several sick visits per year. If you are pregnant or would like to become pregnant, it is also important to look at the maternity coverage provided by a potential family insurance plan even if you do not expect you will need it.
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