When you sign an employment agreement, you will be giving several health care options to choose from. These will have various features to consider. Outlined below are some of the factors, you may want to consider in your evaluation of which offer to accept.
- Your contribution amount- these will be described as a given dollar amount per month for different coverage situations; yourself, spouse, children. There could also be an extra fee for tobacco users.
- Coverage Eligibility- Spouse and family are almost always covered, but a number of plans will also cover non-married partners in a committed relationship including same sex partners.
- Annual Deductible- This will be described as an amount per year for you with an additional amount for a spouse and family. Typically higher deductibles will result in less expensive monthly payments into your health plan.
- Co-Pays- This will be described as a dollar amount for each visit to a doctor. You will also likely have a separate co-pay for each filled prescription.
- Prescription Drug Coverage- You will be given information on coverage. In most cases, you will be reimbursed more if you select generic drugs or drugs on an approved list (the formulary). You may be required to buy maintenance medicine from a specific mail-order pharmacy. You will also be given information of co-pays and the maximum amount that will be paid.
- Co-insurance- this will be described as a percentage you will need to pay for each billing after your deductible is paid. This amount could change once you reach a maximum amount you pay for your care.
- Wellness Benefits- You may be given a specific amount for such benefits as health club memberships, annual physical exams, and related prevention care practices.
- Flexible savings account- this will describe the availability of a flexible savings account and the amount you can contribute each year.
- Vision Care- This section will describe benefits for
- Eye exams
- Other eye care needs
- Coverage eligibility
- Dental care- This section will describe benefits for
- Dental hygiene
- Dental care
- Coverage eligibility
Now how do you decide what to plan to select?
- If you are in good health and are only likely to need just routine care, then select the plan with the minimal cost.
- If you decide to use the flexible savings account, be careful you don’t put more money into the account than you are likely to use.
- If you have a health condition that is likely to require frequent doctor’s visits and treatment, then select the plan that has a smaller deductible and a higher monthly payment. The monthly payment will come out of your paycheck where the deductible will come out-of-pocket which can create cash flow problems.
One more thing you might do when evaluating health care options is to talk with employees who are in a similar situation as you are in. There are often the “unstated” features of health plans that you would otherwise not know about..