What Is a Family Health Insurance Plan?

A family health insurance plan covers you, your spouse, and your children in the event of injury and illness. Enrolling in a family health insurance plan ensures that your family won’t get stung with massive healthcare fees and can help guide you and your loved ones through tough times. 

The introduction of the Affordable Care Act made it possible for every person and family to have access to health care. 

While it is no longer mandatory, and there are no penalizations for not having health care insurance, the Affordable Care Act has brought many benefits. Guaranteed coverage for anyone, no matter their health, guaranteed coverage for mental health issues, and guaranteed pediatric dental coverage, to name a few. 

When exploring health insurance plans for family, it is crucial to sort through all possibilities to find the one that fits your family best. Depending on your family’s specific needs, there are various health plans to choose from.

How Do Family Health Insurance Plans Differ From Others?

With a family health insurance plan, you can add immediate family members onto your coverage, including children up to the age of 26. The plans are an extension of individual coverage, just with more dependents on the policy. 

Each time a new individual is added to the plan, whether it be a spouse or a child, the monthly premium increases. 

What Are the Typical Coverage Costs for Family Health Plan

Premiums

Premiums are the monthly payments for your health insurance coverage. In 2019, the average annual cost for family coverage was $20,576.

Deductible

The deductible is the amount of money you have to pay in out-of-pocket costs before the insurer starts to pay toward covered care you receive for the rest of the year. 

Other Costs

A copayment is a fixed amount of money you pay before receiving certain services. 

Coinsurance is the percentage of costs you pay for a healthcare service after you’ve paid your deductible.

The out-of-pocket maximum is the most a family will have to spend on deductibles, copayments, and coinsurance before the health plan pays 100% of the costs. 

What Are Your Family Health Insurance Options?

Of course, you want the best family health insurance plan for your family at an affordable price. Thankfully, there are several possible health insurance plans available to ensure you get a plan best-suited to your family’s needs.

The most commonly discussed option is the healthcare marketplace offered through healthcare.gov. The marketplace provides a range of insurance options for your family from well-known companies at various price points. 

Another option is employer-based insurance. Those with a job that offers family health insurance plans may be able to enroll in a health plan for a fraction of the price. Most employers must offer employees insurance at a competitive premium, especially if the employer has 10 or more employees. 

The final option is private insurance. Those with the means can purchase health insurance for their family directly from their preferred provider. The coverage offered in this arena is typically a premium coverage at a premium cost.

What to Keep in Mind While Shopping for Coverage for Your Family

When you shop for coverage, you have more to consider than if you were shopping for individual coverage.

While a plan with a low premium and a high deductible might seem appealing, you must first consider that you’re shopping for health insurance for your children or other dependents. When it comes to buying health insurance for kids, you may want to consider looking for a family plan with a higher monthly premium and a lower deductible since you have several people’s healthcare needs being covered under one plan.

If you Have Trouble Affording Health Insurance

While family coverage can save families thousands of dollars in healthcare costs, the cost of a suitable family plan can seem out of reach for many. To help, there are subsidies and programs available that could help cover your family if you are unable to afford family health insurance.

ACA Subsidies

The Affordable Care Act provides tax credits for households unable to afford health insurance. The lower your income and the larger your family, the greater the tax credit.

CHIP Plans

The Children’s Health Insurance Program provides free or inexpensive health insurance for families with children. Requirements vary by state. 

Other Coverage Options

There are likely other programs in your state that can help support your family. Families of four or more with an income of less than $99,000 should qualify for some assistance.

Individual Versus Family Plans

While an individual health plan covers one person, a family plan covers two or more people. This can include a spouse and children under the age of 26 (naturally born, legally adopted, or fostered). 

A family health insurance plan is simply an extension of an individual plan with more dependents on the policy. Each time a new individual is added to the plan, whether it be a spouse or a child, the monthly premium is increased. 

When calculating the deductible and out-of-pocket maximum, family plans are usually twice as much. So, if the deductible for an individual plan is $500, it will be $1,000 for a family. If the out-of-pocket maximum for an individual plan is $4,000, it will be $8,000 for a family – no matter how many individuals are on the plan.

Benefits Under The New Laws for The Family

The Affordable Care Act means families can no longer be denied coverage or charged an exorbitant rate as a result of a diagnosis – giving families like yours a better standard of healthcare.

This means if you have a child with a health issue, your child will receive the same coverage as any other child at the same rate for the plan you have chosen. 

Another benefit is free wellness checks for the entire family. These appointments and all wellness checks (including gynecological exams, mammograms, prostate screenings, and physicals) are covered into adulthood. In addition, family health insurance covers preventative medical measures such as flu shots, immunizations, and birth control pills. 

It is reassuring that health care plans must now also cover mental health care. Finally, pediatric dental coverage is also mandated to be part of every health insurance plan.

Do Not Go Without Family Care

The Affordable Care Act may not be the perfect answer to the epidemic affecting health care in the US. Still, it is a much better alternative than going completely without insurance. It helps those who truly need coverage not to be singled out or denied and left to handle the bills on their own, while potentially claiming bankruptcy. 

It ensures the necessary coverages are available to all people because, while it may seem unnecessary, you never know when you may need the likes of mental health coverage or free immunizations. No family should ever have to go without a family health insurance plan in the United States. 

Whether you are a family of two or a family of 10, you are entitled to have the means to pay for necessary life-saving measures and the right to protect your overall health. The Affordable Care Act has recognized this basic human right and provided an answer to the problem of underinsurance and uninsured families. 

We all would do anything possible to give our child medical help when they need it. Now, all you have to do is present your insurance card.

Average Cost of Family Health Insurance

Average Cost of Health Insurance for a Family of Three

The 2019 Milliman Medical Index uses a male aged 47 and a female aged 37 as the typical age for parents. A couple with a child under two years old can expect to pay around $25,000 annually, but if the child is over two years old, the annual costs will be closer to $19,000. 

Average Cost of Health Insurance for a Family of Four

Using the same aged parents for a family of four, the average cost of health insurance will again fluctuate depending on the children’s age. If one child is over two years old and the other is a newborn (aged 0-1), the annual cost of a family health insurance plan will be around $28,000. But if both are over two, it will be $22,000. 

Average Cost of Health Insurance for a Family of Five

For a larger family of five, the average health insurance cost will be higher than premiums for a smaller family. For the same aged couple with two children over two years old and a newborn (aged 0-1), an annual family health insurance plan will be upwards of $30,000. However, if all three children are above two years old, you can expect to pay closer to $25,000. 

FAQ

How Does The Size of My Family Impact My Insurance Cost?

You are charged for each person covered in your family health plan. So, when you add a spouse or child onto a family health plan, the monthly premium increases. Typically, the average child adds $3,000 to the family healthcare plan ($9,000 for children below two years old).

However, once a family reaches three or more children under the age of 21, the plan-holder only pays premiums for the three oldest.