7 Ways to Maximize Your Family’s Health Insurance Benefits

With a new year just around the corner, now is a great time to reprioritize your family’s health. From setting healthier habits, understanding and maximizing your family health insurance benefits, and preparing for potential challenges, there are plenty of opportunities to stay ahead of your loved ones’ health needs so you’re ready to take on any change that comes along.

Check out seven tips for creating a comprehensive health plan for your family:

1. Get up to date with vaccinations

While the COVID-19 vaccine and boosters continue to be top of mind for many, it’s important to stay on top of all vaccinations. Your annual physicals and routine checkups can be a good time to discuss with your doctor whether or not you’re up to date on your vaccines or if there are any you should consider getting. And for vaccines like the flu shot, it’s important to get vaccinated annually if you’re six months or older.

2. Consider choosing a plan that includes an HSA or FSA

Depending on your family’s health needs, a health financial account like an HSA (health savings account) or FSA (flexible spending account) could help make your money work harder for you. Both HSAs and FSAs are savings accounts that can be used for out-of-pocket medical expenses and health care needs, like prescription drugs and vision care.

It’s important to understand what type of savings account is available with your health plan coverage, and the differences between the two accounts. For example, with HSA accounts you own the account, so your balance can roll over annually, you can take the account with you if you switch jobs (as the money is yours). In addition, the funds within the account can be invested in mutual funds, stocks and bonds, and the account can even be used as a retirement savings vehicle. FSAs, on the other hand, have more restrictions. Because they’re owned by your employer, you can’t take an FSA with you if you leave your job, and any leftover money in the account is forfeited at the end of your insurance year.

When considering a plan with an HSA, it’s also important to think about how frequently you see your health care provider(s). HSAs can only be contributed to if you’re covered under a federally qualified high-deductible health plan, which often incur more out-of-pocket costs for care. Some employers that offer a health plan with an HSA will partially fund the account on behalf of their employee to help offset these out-of-pocket costs throughout the plan year. Check with your employer to see if this is an option for you.

3. Understand your employer's benefits before taking the job

Maybe you’re looking to switch up your career in the coming months or year. When comparing options between employers, many often forget to pull health benefits into the decision-making process. Out-of-pocket medical expenses can affect your overall compensation, so understanding the full picture of your benefits package is an important tool to use as leverage in your negotiation process and ultimately determine what’s best for your family.

Before accepting a new role, consider these tips:


Ask your prospective employer to share detailed information about their company’s health care options.

 

Pay attention to premiums (your per-paycheck coverage cost), deductibles (what you’ll need to spend before insurance kicks in) and coinsurance (the cost of each care visit).

 

Note cost increases with the addition of your spouse and/or children and any exclusions. For example, some plans don’t cover pre-existing conditions or long-term care.

 


Some employers will contribute to HSA and FSA accounts, so make sure to inquire.

4. Plan for any elective procedures you or your family will need

If you’re considering any elective procedures, be sure to consider all your plan options for coverage in the year ahead. When it comes to some medical care, the important details are in what’s covered, what isn’t and what you’ll actually pay in out-of-pocket costs.

Before getting that appointment on the books, take some time to research your options and prepare for what to expect financially. Harvard Pilgrim members can use the Estimate My Cost tool to compare the cost of the necessary service or treatment in your area. Members also have access to Reduce My Costs, a voluntary program that makes it easy to save money by finding care at a lower-cost facility for elective, outpatient medical procedures and diagnostic tests.

Maybe you’re already a parent, or maybe you’re planning on becoming one this year. While new parents can expect to need more robust coverage for their little one, parents of older children who are finally aging off of their coverage (or electing to take their employers coverage) may find it’s time to re-evaluate their plan selection. Here are a few things to keep in mind with family health insurance benefits depending on your family’s situation:

Maybe you’re already a parent, or maybe you’re planning on becoming one this year. While new parents can expect to need more robust coverage to save on costs, parents of older children may be able to hand over the reins and slim down their own offering. Here are a few things to keep in mind with family health insurance benefits depending on your family’s situation:


If you’re expecting a new addition…

 

  • Look into plans that support necessities like regular visits to your doctor, fetal ultrasounds and hospital stay for labor and delivery.
  • Pay attention to cost-sharing–plans may vary for maternity benefits.
  • Check to see if your current or potential insurer offers additional programs for new and expecting mothers. For example, Harvard Pilgrim Health Care offers their members access to the top health apps for women and families, Ovia Fertility, Ovia Pregnancy and Ovia Parenting, at no additional cost.


If your children are entering college…

 

  • While keeping them on your plan is still an option, many schools offer student health plans that make basic insurance coverage easy and affordable.
  • College students can also look into marketplace health plans that cover essential health benefits.


If your children are approaching 26…

 

  • Under the Affordable Care Act, dependents age off of their parents’ health plan when they turn 26.
  • Help your kids get ready for the transition and understand their options, which depending on their situation, could include enrolling in a plan through their employer, enrolling in a marketplace plan or enrolling in Medicaid or the Children’s Health Insurance Program (CHIP).

6. Improve everyday health habits

It’s never too late to find new ways to be healthy that the whole family can work toward together. Consider dedicating a few hours each week for a family walk to get everyone outside and moving, or implementing a “meatless Mondays” policy for delicious plant-based meals you can cook up together.

Just remember to be realistic when it comes to goal setting. With such busy schedules, it can take a lot of effort to make just one habit stick. Angelique Sobol, who is part of the health engagement team at Harvard Pilgrim, recommends starting small, being specific and striving for consistency to help everyone stay on track for the year. And for Harvard Pilgrim members, the Living WellSM Everyday program is here to support you with discounts and savings just for participating in health-related activities, including healthy eating, fitness, holistic wellness and alternative medicine.

7. Make time for mental health

The need for mental health support continues to be important vitally important to our whole health.

Sources: Mental Health America & American Psychological Association

Consider ways to check in on everyone’s mental health and what mental health benefits and services your plan might include. If you’re a Harvard Pilgrim member, you have access to dedicated 24/7 support lines, professional behavioral health treatment options (both in-person and virtually), online tools and discounts on wellness programs and care. Members can also access Sanvello, a mobile app that helps track your daily mood and provides coping tools, guided journeys and access to licensed therapists and support communities.

Keep a pulse on the health trends that matter today.

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