How to Choose a Family Health Insurance Plan

Finding a health insurance plan may not be at the top of your to-do list, but rushing to buy a plan can be costly. Here’s a step-by-step guide to choosing a great healthcare plan for you and your family.

Step 1: Choose A Healthcare Marketplace

Many Americans get employer health insurance that provides coverage for the whole family. But if you don’t have employer health insurance or you’re looking for a plan with different benefits, you can shop for a family health insurance plan in the marketplace.

The health insurance marketplace helps individuals and families compare and shop for insurance plans. There is a federal marketplace as well as state marketplaces. When you apply for coverage through the federal marketplace, you’ll also find out if you’re eligible for tax credits, savings, or coverage through Medicaid.

You can also enroll in a healthcare plan directly with an insurance provider. For family health insurance plans in Maryland, Washington D.C., and Virginia, visit the CareFirst marketplace. Enter your zip code to get started, then add your family size to see all plans available in your area.

Step 2: Choose a Plan Type

After you select a marketplace, the next step is choosing a plan type. CareFirst offers HMO and PPO family health insurance plans so you can get coverage that works for you.

Health Maintenance Organization (HMO) plans offer low monthly premiums and close collaboration with your primary care provider. HMO plans have

  • Lower costs
  • Less flexibility
  • Healthcare services coordinated by your primary care provider
  • Referrals to see a specialist
  • In-network care coverage

Preferred Provider Organization (PPO) plans give you greater flexibility and the choice to see out-of-network providers.

  • Higher cost
  • Greater flexibility
  • No need to work with a primary care provider
  • No referrals to see a specialist
  • In-network and out-of-network care coverage

Catastrophic plans, like HMO Young Adult plans, have low premiums and high out-of-pocket costs. This plan can lower your yearly healthcare costs and still offer coverage for any worst-case scenarios. You must be under 30 years old or qualify for a hardship exemption to purchase a catastrophic plan.

Step 3: Compare Plan Costs and Benefits

Comparing plans will help you choose the right plan for your family. Take a close look at your family’s healthcare needs and spending. Make a list of all healthcare services you accessed in the last year. Compare plan coverage options to find a plan that matches your healthcare needs and budget.

Family health insurance plan costs include out-of-pocket costs. This is just as important as your coverage options. Check each plan’s summary of benefits to find out exactly how much you’ll pay each time you and your family see a healthcare provider.

Then make a list of any doctors, specialists, pharmacies, and other providers you and your family accessed. Each healthcare plan has a network of providers who offer coverage at a lower cost. If you have preferred providers, make sure they’re in the health plan network. If you don’t have a preferred provider, look for a plan with a large network of care providers in your area.

Open Enrollment Period for Family Health Insurance Plans

Open enrollment happens every fall, and it’s the perfect time to evaluate your healthcare needs and coverage options. You may also qualify for a Special Enrollment Period if you get married, have a baby, moved to a new zip code, or lose other healthcare coverage.

All CareFirst health insurance plans are compliant with the Affordable Care Act.  Each plan also offers core benefits including office visits, maternity care, prescription medication, and dental and vision care. For comprehensive, affordable family health insurance plans in Maryland, Washington D.C., and Virginia, explore CareFirst plans in your area.