Inspired living

A guide to picking the right health insurance plan for your family

Health Partners

Credit: Kelly Sikkema

While we all do our best to keep our families happy and healthy year-round, some accidents and illnesses are simply an unavoidable part of life.

When that unfortunate accident or illness does strike, we want to make sure our families are protected and the best way to do this is by selecting the right family health insurance policy that will ensure you’re in good hands when you need it the most. However, if you’ve considered getting health insurance before, you’ll know just how confusing it can be.

To make the process a little easier, here are some key things to consider that will ensure you select a policy that covers you for the things you need, without wasting money on the things you don’t need.

Assess your current situation

Because every family is unique, a one-size-fits-all approach to health insurance simply doesn’t work; that’s largely why selecting health insurance has become so confusing. Most health insurers offer policy options with varying levels of cover for a range of pre-selected inclusions and exclusions that they think customers at a particular stage in their lives may want.

The key here is to make sure your policy provides sufficient coverage for the things you’re likely to need, without making you pay for a seemingly endless list of other items you most likely won’t.

To work out what you do need, a good place to start is by considering whether you have a family history of any hereditary or genetic conditions such as diabetes, heart conditions or certain types of cancers. While there are no certainties, your family history should give you an indication of your own risk for certain conditions.

You should also consider your family’s stage of life. For example, if you’re a young couple or family that’s just starting out, you’ll most likely want cover for pregnancy/obstetrics or even fertility services, but if you already have children and don’t plan to have any more, there’s no point in paying extra for these.

While most health insurers offer policies with a list of inclusions that can’t be altered, some providers give you the option to “make your own” policy, developed around the specific items you want coverage for. However, make sure you shop around a little before signing on the dotted line; some other providers may cover you for the same things but with a few added items thrown in for the same price.

Before selecting a policy, you should also investigate what the insurer’s position on pre-existing conditions is. If you do suffer from a pre-existing condition, there’s a good chance you won’t be covered if you need to make a claim, so doing some prior research is critical.

Consider what excess or co-payment option you can afford

Most health insurance providers offer you a choice between various excess or co-payment options (the amount you’ll need to pay yourself if you are admitted to hospital), which are designed to reduce the amount of your premium.

If you opt for a policy with a co-payment option, you’ll need to pay a specified rate for each day you are admitted to hospital, whereas with an excess, you’ll need to pay the entire fixed amount regardless of the number of days you spend in hospital.

Generally, the higher the excess or co-payment option you choose, the lower your premiums will be. However, you’ll need to remember to keep some extra money set aside to cover the excess or co-payment in the event of being admitted to hospital.

Work out what extras what you’re likely to use

Price is always an important factor when selecting the right health insurance policy for your family. One area where you can minimise cost is by working out if you really need extras cover.

If you’re considering adding coverage for extras onto your policy, make sure you crunch the numbers first to calculate if it’s really worth it. Review how much you’ve forked out in the past 12 months for services or treatments that would be covered under an extras policy, then calculate how much you would’ve saved if you’d been able to claim them.

If you or other family members wear glasses, require orthodontic work or need regular physiotherapy or other similar treatments, it’s going to be worth your while to pay the additional sum for extras cover. However, if you’ve only attended the odd dental or other appointment here and there, the amount you’ll be able to claim back may not justify the upfront expense.

When selecting an extras policy, it’s also important to take note of any waiting periods before you’ll be able to make a claim, how the claim amount is calculated (is it a percentage or flat rate payment?) and any personal or membership limits.

Ultimately, the only way to find the right policy for your family is by shopping around to see what various providers can offer you. Once you sign up for a policy, it’s helpful to remember that most providers offer a cooling off period. This allows you to cancel your policy within a few days if you change your mind or find a better deal.

Visit the Health Partners website to find out more.