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Last Updated on 24 February 2019

Help With Health Funds: How to Choose the Right One

There are concerns with many people over the coverage they have with their health funds, sparking debate as to whether a public plan will cover all of their costs when they visit the doctor or have to be in the hospital. It is a fact in life today that the co-pays that are charged sometimes prevent people from seeking medical assistance when they should, or visiting a doctor for preventive medical advice to prevent major medical catastrophes, such as strokes and heart attacks.

So where is a person to go to be sure their medical health needs are met as well as reducing their out-of-pocket costs? The answer to this question is dependent on a person’s budget as well as their current health condition.

Who is Covered Under the Plan?

The first consideration in choosing any health funds plan in addition to a national insurance is who will be covered under the plan you purchase. The number of children in the household and their ages are important to consider when purchasing a private health funds plan. For example, if one child is over the age of eighteen, has completed basic education, but is continuing to college, you may want to include him or her in your plan for their protection in their health care needs. On the other hand, if the child has become an adult that is working but still living in the home, it may be an idea to let him or her purchase their own health funds plan. Young children should automatically be included in a family plan purchase to be sure they can remain healthy as well as be treated for emergency medical care that may be required from time to time. After all, children will be children, and they tend to get themselves into a spot every now and then that causes injury or illness.

Budgeting is the Key

There is a term that says a person or family can be “insurance poor.” The term simply means that the monthly income in the home goes to pay for insurance plans of different types that do not benefit them at all. The cost of a health funds insurance policy is no different. If the co-pay amount is too high to pay with routine medical care, the person or family members will not seek medical assistance in order to save on the costs, rendering the policy they have as useless. At times, it is best to pay the higher premiums in order to reduce the routine co-pay costs to enable the routine medical exams or continued treatment for pre-existing medical conditions.

The general health of each member that will be included on the plan should be considered, since some people with major health problems will cost more on the plan or be denied altogether depending on the company policies. It should be noted that any denial of coverage can be disputed with the insurer, but costs for coverage may increase due to existing and ongoing health problems. The purchaser of any health funds insurance policy should check several companies to be sure the costs are in line with their budget, so as not to drain the household of funds needed for ordinary living.

Choose Only What You Need

In choosing a health funds insurance plan, choose only the coverage you need. For example, if you are single and healthy, choose only the coverage that will allow you to remain healthy as well as coverage of fees to your doctor when you do feel ill. If you have chronic health conditions, such as high blood pressure or heart disease, the costs may be higher due to health risk factors, but can be worth the extra cost in getting needed medications and exams to keep your health issues under control to prevent more dangerous conditions.

If there are children included on the health funds plan, it may be worth the cost of including wellness checkups with your doctor to prevent conditions that develop in childhood, such as some allergies, asthma and obesity. But if your budget is such that you cannot afford the cost of the premiums, be sure to have at least an emergency medical care plan for the mishaps of childhood as well as adulthood. All health fund insurance plans offer a different deductible amount that must be paid first as well as different co-pay amounts that are paid in addition on a per-service basis. For example, some will require you to pay the first $250 of the cost of your medical care, and then a portion of the cost of doctor office calls and prescription costs. Keep these costs in mind when choosing only the coverage you need.

Do Your Research

There are many companies that can provide the health fund coverage you need within your budget, but be cautious of exactly what they do cover and what they don’t. It is important to read the fine print on any policy you are about to purchase so that you know exactly what will happen when they are billed for a service you receive. In some cases, policies do not cover what they consider to be self-inflicted injuries, such as extreme sport injuries or cuts while cooking. Some plans are negligent in covering everyday injuries such as these while they still collect the premium costs, costing you money not only in paying them for the lack of coverage but also in the co-pays or outright costs of emergency treatment.

The lesson here is to research any company before purchasing a health funds insurance plan to be sure you are actually getting the coverage you are paying for. No matter what the level of coverage you are choosing, the fine print will always tell you exactly what you get, and how it will be paid. Some plans work on a reimbursement process, forcing you to pay the funds up front for treatment, and then sending it back to you if they feel it is within their guidelines. Most will choose the plans that pay up front so there are no out-of-pocket costs that compromise the family budget.

Private health funds insurance plans are great for some people, providing the peace of mind of knowing they can get good quality health care without draining their bank accounts. However, due diligence should be adhered to in order to have exactly and only what you need.

Disclaimer: The above information is correct and current at the time of publication

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