In today’s fast-paced world, the mantra is “expect the unexpected.” Hence, insurance. Group health insurance is an easy way to get coverage for the bumps in the road of life, but also for your everyday needs.
Group health insurance is usually offered through your employer, but you may also get coverage on a group health insurance plan through a trade union. You will pay an extra yearly “premium” for this benefit to the group on top of the yearly premium you pay for the coverage. This is one of the downsides of group health insurance among many upsides.
One of the major benefits of group health insurance is you don’t have to show “evidence of insurability.” Some individual health plans will require you to send off medical records, have a medical exam, or answer a questionnaire about their medical health. These companies may decline coverage based on health, lifestyle, habits, etc.
Group health insurance plans, on the other hand, give you the benefit of the “Law of Large Numbers.” As more people are covered in a group, they balance out the people the insurer covers with good health with the people they cover with bad health. This way a group health insurance plans can accept people with poorer health. Finally, that high school statistics class is working in your favor. Another benefit of the “Law of Large Numbers” in group health insurance is that because of the sheer number of people covered, the insurer may be able to lower the rates.
Unions have the option to buy into group health insurance. If you are a member of a labor union, you may be eligible for group health insurance. Check with your union. Some unions offer these plans, and this will give you an opportunity to take advantage of the benefits of group health insurance even if you work for several different employers throughout the year.
You may notice many acronyms when it comes to your group health insurance. Two of the main group health insurance plans you will run across will be the HMOs (Health Maintenance Organization) or the PPOs (Preferred Provider Organization). Read over your EOB (Explanation of Benefits) to clarify the type of group health insurance program you have and the type of coverage you qualify for.
An HMO is a program which gives you access to only the specified doctors through the HMO’s direction, except when in an emergency situation. You will chose a PCP (Preferred Care Provider), a doctor to whom you will go for your primary care, and who will need to refer you to specialists, if needed. This is a highly regulated system, but generally costs less for doctor visits, checkups, baby births, prescriptions, etc.
A PPO is a program which allows you to see any doctor in the provider network and you are allowed access to licensed physicians outside of the network, but it usually costs more. You usually don’t have to choose a PCP and can see any doctor in the network. Your costs are low as well for prescriptions, in-network visits, and covered services.
Just remember when you are thinking about joining a group health insurance plan, look over the benefits, make sure they fit your needs, your budget and lifestyle. And don’t forget, for once, it is not bad to be one of the group.
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