Even though it isn't always easy, you can find affordable health insurance for your family. It’s simply a matter of looking in the right places for the plan that will fit both your family’s needs AND budget.

Affordable Family Health Insurance: Getting Started

First, you need to take a moment to consider your family’s health insurance needs:

• How often do you or your children visit doctors?
• Is having the freedom to visit any doctor, hospital, or specialist a priority?
• Whether you’re a parent already or not, are you planning on having children soon?
• How much can you afford to pay out of pocket for health expenses?

Affordable Family Health Insurance: Types of Coverage

Individual Health Insurance: Just because it’s called “Individual Health Insurance” doesn’t mean it’s not for families. The term simply refers to the fact that this is insurance you shop for individually, unlike group coverage that you generally buy through your employer.

If you’re self employed or unemployed (and want an alternative to often costly COBRA rates) then this is the type of health insurance you should consider. With an "individual plan," you choose every aspect of your coverage, from deductibles to co-pays, and you can easily shop around and compare rates and polices offered by different companies. Check out an insurance comparison site like InsWeb.com to look at multiple rates from different providers.

Group Coverage: If you’re trying to choose between plans offered by your employer or that of your spouse –- don’t just look at the amount of money being taken out of your check every pay period. Sit down with both plan options and take a look at the following:

• Co-pays
• Deductibles
• In-network vs. out-of-network options
• Reimbursement levels (coinsurance)
• Is visual and/or dental insurance offered?
• Prescription coverage

And get familiar with COBRA –- the Consolidated Omnibus Budget Reconciliation Act. If you lose or change your job or decide to start your own business you’ll be clear on how your family will be covered when your situation changes.

Affordable Family Health Insurance: Benefit Plans

If you’re confused about the differences between health plans, you're not alone.

Plan types (and the endless acronyms that come along with them) can be intimidating, but the differences aren't difficult to understand when you look at them one by one.

Health Maintenance Organizations (HMOs): HMOs are usually the least expensive way to get medical care. HMOs offer a range of benefits, including preventive care, for a set monthly fee. HMO plans generally don’t have deductibles. Instead, you make a co-payment for the services performed.

For example, doctor visits may cost $20. However, HMO plans require you to get a referral from your Primary Care Physician before the plan will cover treatment by a specialist. You choose a primary care physician from a list of participating doctors and he or she must give authorization for additional services to be covered by your HMO. For example, if you need to see a specialist, need to be hospitalized, or have lab or X-ray work, your doctor will refer you to a provider or facility.

You also might have to pay some portion of the cost, called a co-payment, for each office or hospital visit, such as $15 per doctor visit, regardless of what the services cost. Some services such as emergency room care, mental health and chemical dependency services may also require extra fees.

Preferred Provider Organizations (PPOs): PPO plans let you use any physician when medically necessary. But if you use a “Preferred Provider” from the list of participating providers, the company will pay for a higher percentage of the costs.

For example, a PPO plan may pay for 80% of the medical expenses if you get treatment from a Preferred Provider, but only 60% if you go to a Non-Preferred Provider. When you use a Non-Preferred Provider, you may also be responsible for any amount billed over customary and reasonable charges.

When you enroll you'll receive a list of participating medical professionals which you can use to find health care. Or you may continue to see anyone you already use.

You may have to pay a portion of the cost for each office or hospital visit, regardless of how much the visit costs. Also, you may have to pay extra for some services like the emergency room, mental health and chemical dependency services.

Point-Of-Service: These plans combine characteristics of HMOs and PPOs. You choose a primary care physician who controls all aspects of care, including referrals to specialists.

All care received under that physician's guidance, including referrals, is fully covered. Care received by out-of-plan providers is reimbursed, but you have to pay a significant co-payment or deductible.

So basically, you decide each time you need medical care whether you want to use your plan as an HMO or a PPO.

Indemnity Plans: These are the least restrictive options of the main health insurance plan types. You’re allowed to see any licensed health care professional for anything covered by the plan. You choose a deductible and other options when you enroll, and those apply to you and any dependents covered by the plan.

The deductibles you choose apply to each person enrolled in the plan. So if you and a spouse enroll and select a $250 deductible, you each must pay $250 in medical expenses before your plan starts paying further costs each year. But companies typically set a maximum of two or three deductibles per family.
Costs that exceed your deductible are covered by a coinsurance plan, so you and the insurance company share the cost for services covered by the policy.

For example, with an 85/15 provision, the insurance company pays 85% and you pay 15%. After you meet your deductibles, coinsurance maximums apply that protect you from skyrocketing bills. You may have to pay extra for some services such as emergency room care, mental health and chemical dependency services.

Now that you know the basics of how to find affordable family health insurance, it's time to shop around for coverage. Check out your group plan options, and it they don't work for you, compare quotes for individual health insurance at a site like InsWeb.com.