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Group Medical Insurance:
Knowing Your Options

For many people the main incentive in working a full-time job is being able to join a group medical insurance plan. Group medical insurance is often added as a benefit to employees after a certain term of service to the organization. However, when you are offered your group medical insurance, you will need to understand what type of insurance has and what impact it will have on your medical care.

Group medical insurance is very much life your individual insurance and functions in basically the same way. The nice part of having a group medical insurance plan is that you cannot be turned down for medical insurance, though there are sometimes waiting periods for certain types of medical conditions. Also, a group medical insurance plan is often less expensive, so if your employer does not fully cover the cost of your group medical insurance premium, you will still be getting a better deal on your insurance.

When considering whether or not to participate in your employers group medical insurance, you should weigh some important needs. If you are very attached to your doctor, you should make sure that your group medical insurance includes your physician in their plan. Also, check to see if your group medical insurance has an out-of-network plan so that your options are not necessarily cut off. Plus, you should make sure your group medical insurance covers routine check ups and that it has a drug benefit plan.

If you do decide to join your employer’s group medical insurance plan, you should consider what type of group medical insurance plan your employer is offering so that you know what your benefits and limitations are. For instance, if your employer’s group medical insurance plan is a PPO, or Preferred Provider Organization, then you know you will be able to choose your own doctor and do not necessarily need referrals for specialists. Though most PPOs do offer incentives for you to stay within the network of doctors they prefer.

Another type of group medical insurance your employer may offer is an HMO, or Health Maintenance Organization. HMOs are the least expensive of the group medical insurance plans, but they do limit your choices. You will have to choose a doctor in the group medical insurance network and may be required to obtain referrals from your primary care physician to other in network specialists. Your HMO may also require that you get permission before you go to the emergency room.

Point of Service plans are less common than PPOs and HMOs when it comes to group medical insurance, but some employers do offer them. The POS plans are similar to the PPO, but you will need a primary care physician from the network of doctors approved by the group medical insurance company. Plus you will need to get referrals from your primary care physician to see a specialist.

No matter what type of group medical insurance your employer offers, you should still be glad your employer is offering you the benefit. Many companies are now starting to move away from offering group medical insurance at all, or they no longer pay for any of the premium. If you are offered a group medical insurance, just make sure you read over the group medical insurance policy so that you know exactly what is covered and what fees are required so that you are prepared if you need medical care.

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