Businesses and employers across the country offer health insurance plans to their employees. Most often, these are group plans, with aspects and costs managed by both employer and employee. Employees often find these plans convenient for their needs through the fact that they offer competitive medical care costs for entire families. However, in most cases, an employee will have to pay something out of pocket for the plan and its eventual services.
How Group Plans Work
In a workplace setting, an employer agrees to buy a health insurance plan that it extends to employees within the business. Those who choose to enroll can receive health insurance not only for themselves, but also for their families.
By providing health insurance as part of its benefits package, the employer can ensure that employees have access to medical care when they need it. That can ensure that employees are better able to maintain their own health, and continue to work for the business. It often works as a great way to attract employees to the business.
For employees, group plans have benefits beyond just the access to care. There are often cost benefits. In the case of most plans, the employer pays a portion of the premium, while the employee pays the remainder.
That often reduces the out-of-pocket cost to employees, and it allows them to get coverage for a cost that they might not be able to afford alone. Additionally, employees can usually add more participants than just themselves to the plan. Therefore, their entire family can get covered, and reap the cost benefits.
What You Will Pay
Group health plans are not free health insurance. Usually, employees must pay a portion of their premium through a deduction from their paycheck. However, there are other costs that you might have to pay when you go to receive your care. These might include:
Co-payments: These are nominal fees that you might have to pay your doctor at the time you go for your appointment.
Deductibles: Most health plans have deductibles, which are a cost you agree to pay first, before your plan pays. For example, the plan might have a $1,000 deductible. You therefore will pay $1,000 out-of-pocket before your plan pays for the costs of your care.
Coinsurance: When your plan pays for certain care, you might have to pay for a percentage of the care. For example, the plan might pay 80% of the cost of an MRI, while you will pay the remaining 20%
The thing to remember is that different types of care have different cost obligations. For example, you often can receive routine wellness care, like immunizations, that aren’t subject to your deductibles. Don’t hesitate to speak to your insurer to determine the costs of your care.