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Group Health Insurance

With the cost of living on the rise, it makes sense to take the time to review your health care coverage. In the case of families with two working spouses working for employers that offer group health insurance coverage, it makes even more sense to compare policies.

Most health insurance policies offered by employers have an open enrollment period, in which dependents may be added or dropped. To make sure that you're getting the best coverage for your family's health care needs, you'll need to make an accurate comparison of what each plan offers. Have a copy of your current policy on hand, and when the next open enrollment period rolls around, get ready to perform a side-by-side comparison. You may find that when it comes to selecting the best family health insurance plan, one policy doesn't fit all.

Get the basics: What are the costs of premiums, yearly deductibles, benefits or services, and annual maximum benefit of each policy? What is the difference between the different service co-pays for each policy?

Take stock of your family's needs: Does your family have certain recurring yearly medical expenses, such as regular wellness checkups, physical therapy, chiropractic services, eye examinations, and eyeglasses? What is the difference between policies for this coverage, including co-pays?

Prescriptions: What provisions do your policies make for prescription drugs? Compare prescription co-pays. Do you have a choice between filling prescriptions with generic, formulary or non-formulary drugs, and if so, what is the difference in costs?

Mental health: Does your policy offer mental health coverage, and if so, what services are covered? Does your policy require a referral from a medical professional for counseling or therapy? Is there a limit to the number of appointments that may be made in a single fiscal year? How much does a co-pay cost for a visit to a mental health professional's office?

Women's health: What is the cost and provided coverage for yearly women's wellness exams such as mammograms and pap smears? Also, what are the coverage details for infertility treatments, hysterectomy, birth control, and other gynecological concerns?

Adding to the family: Be sure to consider what your covered health care conditions are and remember that services during pregnancy and childbirth vary from policy to policy. Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) health care plans cannot consider pregnancy a pre-existing condition during the open enrollment period. Changes in your family, such as the birth or adoption of a child, may prompt a new enrollment period in which you may add your new family member to your plan.

Older children: Most family health insurance plans will cover a full-time student under the age of 22, or until college graduation, although some plans may not cover dependent children after reaching their 18th or 21st birthday, regardless of student status. Should your child no longer be considered your dependent, he or she may be eligible to purchase Consolidated Omnibus Budget Reconciliation Act (COBRA) insurance coverage for a period of 18 to 36 months.


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