Advantages of a Group Health Plan

There are many reasons why when given the choice people prefer getting their health insurance coverage through a group plan from their employer. The premiums are less expensive monthly since the employer pays a portion and takes the employee’s portion from their paycheck weekly. Additionally, there is less paperwork and they don’t have to deal with an insurance agent. Human Resources takes care of setting up the plan with the insurance agent and then educates employees on the group plan’s coverage and costs. It is an inexpensive no fuss, no muss way of getting the health insurance coverage that you need.

Group health insurance plans are known as many things including, indemnity plans, fee-for-service plans or managed health care plans. To determine which you are involved in you would look at how your benefits are provided. The main differences are the choice of providers offered, out-of-pocket expenses for covered services and how claims get paid. Individuals who have indemnity plans get a wider choice of doctors including, specialists, hospitals and other health care providers. People on managed care insurance plans have less out-of-pocket costs and paperwork.

Managed care plans are the most common type of group health insurance plans. The three basic types of managed health care plans include, HMO, PPO and POS. HMO or Health Maintenance Organization plans provide lower costs to members, but they limit their choice of doctors and hospitals. They usually have to select a primary care physician and ask them for a referral to any specialists that are needed. Patients on an HMO may be required to pay out a deductible amount before insurance payments will start to apply, however, co-payments are usually lower with an HMO than other plans. You have to see in network providers though or it will not be covered by your insurance.

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People who have a PPO or Preferred Provider Organization plan have to use the plans list of in network doctors and hospitals. They will also have co-payments to pay for services rendered. You can see physicians that are out of network but payments for providers who are outside the plan’s network will result in more out of pocket expenses for the member. Still, many people prefer the flexibility these plans provide them. In most cases, a patient can see a specialists without a referral on a PPO.

Although there may appear to be certain disadvantages such as plans that limit your choice of providers or having deductibles, being in a group plan is the most economical way to get comprehensive health insurance. The cost of health insurance goes up each year and being involved in a group plan reduces your expenses while still giving you access to the level of care you deserve. Without insurance one cannot afford to properly take care of their health and group insurance ensures that individuals can do what is necessary to ensure health long-term.

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