Shopping for family health insurance plans can be a daunting process. You want to ensure your family has the coverage you need to protect your health, but health insurance plans for family participants can be expensive. Ideally, you need a plan that balances the services you need with prices you can afford.

To help you out, we’ve put together a guide on everything you need to know when looking for comprehensive and affordable family health insurance. In this post, we answer basic questions such as what is family health insurance, but we also dive into specifics on how family plans work and what to expect.

What is family health insurance?

The first question most people have is what is family health insurance? To put it simply, family health insurance is a plan that covers your family rather than just you individually. Think of a family health insurance plan as an individual plan only with dependents added to the policy. But what does family mean in health insurance? In most cases, family includes you, your spouse, and your children under the age of 26. As of 2020, the U.S. Census reported 91.4% of families having health insurance coverage, with 8.6% of families uninsured.

For example, if you’re married with no children, family health insurance is essentially couple insurance. If you’re single with two children, your family health insurance covers you and your children. Similarly, if you’re married with six children, your family health insurance covers you, your spouse, and your children.

If you’re getting family insurance through your employer, you will hear the phrase “employee plus family”. So, what does employee plus family mean? It just means that the plan covers you plus your family as explained above.

How do family health insurance plans work?

At this point, you’re probably wondering, how does a family plan work for health insurance? You pay a single premium for everyone in the family. The premium typically changes when you add or remove people from the plan. Then, just like individual insurance, the plan may require you to pay co-pays for different services and reach a deductible.

How are family health insurance plans different from other plans?

Shopping for family health insurance coverage may be daunting. However, family plans are very similar to individual health insurance plans.

The main difference between family plans and individual plans is who they cover. As indicated above, a family plan covers everyone in your family who you add to the plan. Generally, this includes you, your spouse, and your children up to age 26.

Another notable difference between family health insurance vs individual plans is how they deal with out-of-pocket maximums. In some cases, family health insurance plans have an out-of-pocket maximum for the whole family, but in other cases, each individual on the plan has their own out-of-pocket maximum.

Additionally, there are differences between individual vs family health insurance costs. Generally, you pay more for a family health plan because it covers more people, but you may end up paying less per person than you do on an individual plan.

What you should know about the typical costs for family coverage

As with all insurance policies, there are a few different kinds of costs to consider while shopping:

• Premiums: Premiums are the monthly payments you make in order to stay enrolled in your family plan. In 2018, the average cost per month for family coverage was $1,168.
• Deductibles: Your deductible is the amount of money you have to pay out-of-pocket before your health insurance takes over payment. After you’ve reached this amount of money, your family health insurance will pay for any other health care you receive that year.
  With family health insurance you generally have two types of deductibles: family and individual. You must reach either the individual or family deductible before your family health insurance kicks in.
  On average, family health insurance plans had a deductible of about $8,232 in 2018, according to eHealth.
• Other various costs: There are a few other costs – like copayments, coinsurance, and out-of-pocket maximums – associated with family coverage that you need to consider when looking for a policy.
  A copayment is a fixed amount of money you pay for a covered service which either come into effect before or after you’ve reached your deductible. Coinsurance is a percentage you pay for covered services after you’ve reached your deductible until you’ve reached your out-of-pocket maximum.
  After you hit your out-of-pocket limit, your family health insurance will pay for 100% of the cost of your covered benefits for the rest of the year.

What to keep in mind while shopping for coverage for your family

When you shop for coverage, you have more to consider than if you were shopping for individual coverage.

While a plan with a low premium and a high deductible might seem appealing at first, you must consider that you’re shopping for health insurance for your children or other dependents. When it comes to buying health insurance for kids, you may want to consider looking for a family plan with a higher monthly premium and a lower deductible since you have several people’s healthcare needs being covered under one plan.

If you have a larger family than a four-person household, you can expect your insurance to be more expensive overall, however you may end up paying less per person. You’re also likely to pay less per person if the members of your family are in good health. In this case, it’s smart to get an insurance policy that covers preventative care to keep your family healthy and costs lower in the long run. Additionally, you’re likely to pay less if you’re getting your insurance through an employer.

While family coverage may seem expensive, your finances can be impacted by unexpected medical expenses if you do not have health insurance for you and your family. If you have trouble affording health insurance there are programs and incentives that help you keep your family covered.

• ACA Subsidies: The Patient Protection and Affordable Care Act, also known as Obamacare, provides tax credits for those who have difficulty affording health insurance. In general, the lower your income and the larger your family the greater tax credit you’ll qualify for.
• CHIP Plans: The Children’s Health Insurance Program, also known as CHIP, is a federal-state collaborative effort to provide free or inexpensive health insurance for families with children. Requirements are different in every state, however you will usually qualify for CHIP if you make too much money to qualify for Medicaid but have an income 200% below the poverty line.
• Other coverage options: There are other state programs that are specifically for families that have a difficult time affording health insurance. If you are at least a family of four, with an income of less than $99,000 a year you should qualify for some state or federal assistance.
  If you need coverage for a short amount of time or quickly, there are short-term health insurance plans available. While you will not be receiving the same level of coverage as major medical plans, you will have some coverage at a low cost and fairly quickly with some applicants getting approved next-day.

Choosing the right health insurance plan for your family

Now that you understand what is family health insurance, you’re probably wondering what plan is right for your situation. The best family health insurance plans vary based on your unique needs.

If you don’t anticipate using a lot of services, you may want to opt for a low premium and a high deductible. However, if you don’t have savings and someone in your family gets ill, this strategy can end up costing you more in the long run. If you use a lot of medical care, you may want to look for a family health insurance plan that has higher premiums in exchange for fewer co-pays and lower deductibles.

As you shop for family health plans, keep in mind that there are different answers to the question of which health insurance plan is best for your family. Ultimately, the answer varies based on your situation. Again, you need to take into account how much family health insurance plans cost and what they offer. There are also a variety of different family health insurance options by state.

Why family health insurance is important

Family health insurance is critical because it helps to ensure that your family can obtain medical care. By law, emergency rooms must treat you even if you are not insured, but going to the emergency room without insurance can lead to very expensive bills. Additionally, once you’ve been treated for the emergency, the health care providers are not legally obligated to provide you with any additional treatment.

Without health insurance, you may not be able to access essential health care for you and your family. You will also struggle to obtain preventative care, which is critical for your health. Family health insurance plans cost money upfront, but they help to protect your family’s health and compared to the financial risk of being uninsured, they also help to protect your budget.

eHealth offers wide access to many health insurance plans for families. Take a look at family health insurance plans today to find what coverage is right for you.