Group Health Insurance Can Reduce Overall Costs

Some of the best deals for health care coverage can be found with group health insurance plans, offered by employers and professional groups. Some medical service providers also offer plans for coverage that can save money on health care, but they may carry certain limitations that will have to be adhered to in order to realize the cost savings.

In most cases with group health insurance, the administrator of the plan has negotiated prices for specific services with providers who have agreed to accept lower fees for the services provided to group members. These fees are often substantially lower than that charged to patients who are not members of the group health insurance plan. By visiting health care providers who are members of the plan, the patients receive quality care while usually only paying a per-office visit co-payment.

They can also save if they visit a network physician for procedures not covered under their group health insurance, as many doctors will also offer similar discounts for uncovered services as they do for covered services. The difference is that the patients are required to pay the balance, usually up front when services are rendered.

Keeping Options And Choices Open

Most group health insurance plans will only pay the amount they negotiated with member service providers, and if a plan member visits a physician not in the plan, the difference between what the plan typically pays for the service and the cost by the physician will be the responsibility of the patient. For example, if the plan pays $100 for an office visit plus the patient’s $20 co-payment and the out of plan physician charges $200, the patient will be charged the $20 co-pay plus the difference of $100 per visit.

Patients can save money visiting physicians on the plan, but when employers switch group health insurance plans, there may be times when the family physician does not belong to the new plan. Instead of being forced to choose a new primary care physician, the patient continues to visit their previous doctor, incurring the additional costs out of pocket.

In most group health insurance plans prescription drugs are also included along with a co-payment being required for each prescription. Some allow up to a 90-day supply to be obtained from mail-order pharmacies at the same co-payment as the monthly supply from their regular pharmacy. This saves money from paying the coo-payment for each prescription once every three months instead of monthly on maintenance drugs.