4 Factors to Consider When Looking at Your Employer’s Group Health Insurance

Posted in Group Health Insurance

If you’ve recently started a new job, congratulations! One of the first things you’re likely to do is get some information on employer provided health insurance. Small business health insurance offered through work can be a great opportunity to secure reliable coverage at an affordable price.

But, plans and coverage are often customized to meet employer needs. Should you opt in to your employer’s group plan? Here are four areas to consider when evaluating your company’s health insurance plan.

1. Coverage

The services that a group health insurance plan covers can vary significantly. Some Colorado plans provide comprehensive benefits for regular doctors visits, hospital stays, prescription drugs, dental and more. Others offer little more than coverage for preventive care.

Think about your needs and the type of coverage that would offer you the most value. Do you have a young family that will likely need regular check ups and frequent visits to the doctor? Are you single and looking for just a little coverage to protect you in the event of an emergency? Deciding on the appropriate amount of coverage first, and then looking into available plans will save you time. 

2. Out-of-Pocket-Expenses 

Cost is always a consideration, but sometimes it’s easy to overlook out-of-pocket expenses that are buried in the details of an insurance plan. Be sure to look at not only the cost of premiums, but also, deductibles and copays associated with coverage.

While a plan’s premium may look affordable, a large copay can dramatically increase the amount of money you need to pay out each month. The deductible is the amount of money you need to pay before your insurance coverage kicks in. In general, the higher your deductible, the less you will have to pay over the course of the year for care. 

3. Exclusions 

While we would like too think that just having health insurance means we are covered—or at least partially covered—for every possible medical treatment. But the truth is far different. Health insurance exclusions refer to anything the insurance policy will not cover, ranging from a specific drug to a certain type of surgery. The tricky little details that you somehow didn’t see when you were reading the policy can wreak havoc when it’s time for treatment.

The five most common exclusions include:

  1. Long term care – in home care and private nursing
  2. Cosmetic surgery – tummy tucks, nose jobs, etc.
  3. Dental and vision services – require separate policies
  4. Alternative medicine – yoga, acupuncture
  5. Behavioral or learning problems – ADHD, dyslexia

Of course, there are always exceptions. However, it pays to be prepared in the event you may want to pursue medical services that are not covered. Be sure to review every plan carefully that you are considering, and be crystal clear with what’s covered and what is not.

4. Network Restrictions 

One of the most important factors to consider when assessing group insurance is availability of care, or network restrictions in Colorado. Plan providers—the doctors, specialists and healthcare facilities that provide medical care as part of your group plan may be just fine.

However, in some cases, networks in Colorado can be limiting, and you may find that you need to travel great distances just to visit the doctor. The good news is, many plans have no restrictions on providers at all, and you are free to go to any hospital or see any doctor you choose.

Colorado Group health insurance may be the right choice for you and your family. An easy, convenient way to secure reliable coverage, the right plan can deliver the benefits you need to stay healthy and strong.

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