Shouldn’t everyone in the family be on the same plan? The answer is: sometimes.

 

The standard we hear about most often are family plans when it comes to health insurance. However, in many cases families can save thousands of dollars per year by enrolling in individual plans that meet their health needs. This ensures each person in the family gets the coverage they need and no one is supplementing the cost for coverage they don’t need. 

 

It seems logical to get a family plan. It is convenient and provides a nice feeling to know all family members are united and covered under one health plan and premium. Often though, compromises for one or more family members mean higher out-of-pocket expenses and in a worst case scenario not receiving the healthcare necessary/needed.

 

TRM founder, Judith, recently had the pleasure of working with a family of five to meet their healthcare needs. Both parents are self-employed. Initially, she signed them up for two different health plans, instead of one family plan. When Judith checked in with them a few months later, she reviewed their situation with regard to health, out-of-pocket expenses, and financial exposure. She proposed a change that would save them money and meet their insurance needs more comprehensively by splitting the coverage into different policies. Together, Judith and her clients came to the conclusion that for another family member to get the care needed, while keeping the annual costs at a minimum, a separate plan would be the way to go. This family is now covered by three health plans instead of one, resulting in better coverage for each family member and thousands of dollars saved each year in premiums and out-of-pocket expenses.

 

“As a licensed health insurance agent, I find great joy in finding the coverage best suited for my clients. There is no “one size fits all” plan. Health coverage should always be based on the needs and budget of the individual and my job is to ensure that. Situations in life change, health-wise, financially, socially and business-wise and so do health insurance needs. A health plan might be good today but not suitable months or a year later, so having someone you trust review your options and make the necessary changes to your health coverage if needed…I love being that someone.” –Judith Richter-Murphy, Founder, Licensed Agent

Health insurance is one of those things that keeps us at jobs we don’t like and careers that don’t fulfill our dreams, simply because we don’t know what our options are outside of employer-provided health insurance coverage. We are here to let you know there are options for your health insurance; whether you are self-employed, between jobs or simply want to know what other options you have to protect you and your family. Here is the TRM Health process:

 

Basic Information

In order to run some numbers for you, we will need the following information: 

• • Zip Code (premiums vary depending where you live)

• • Age

• • Gender

• • Tobacco use

 

Get to Know Your Preferences

Next, we want to make sure we are quoting the appropriate coverage for your needs and preferences. In order to do that accurately, we will want to know:

• • Name of preferred or current doctors

• • Current prescriptions

• • Medical history and current health

• • Lifestyle and work (ex. If you travel often, you will need a more versatile plan to make sure you have coverage when you need it)

• • Budget for health insurance

• • Eligibility for government subsidies (we can help you evaluate your eligibility)

• • Preference to high deductible/low premium or high premium/low deductible

• • Desired effective date of coverage (when you would like your coverage to start)

• • In addition to medical insurance, is there a desire for vision and dental as well

 

Evaluating Eligibility

Based on the information we receive from you, we will get to work on the best options for your preferences, budget and health status.

 

Education

Once we are ready to make our recommendations, we want to make sure you understand what we are recommending. We will explain every term that you do not know in detail. We provide a glossary of common and important terms that might make it easier to navigate through your health coverage options on our website, www.trmhealth.online. Here are few common terms, although we encourage you to visit our website for more!

 

• • Health Insurance Premium: The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance. (https://www.healthcare.gov/glossary/premium/)

• • Health Maintenance Organization (HMO): A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. (https://www.healthcare.gov/glossary/health-maintenance-organization-hmo/)

• • Preferred Provider Organization (PPO): A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. (https://www.healthcare.gov/glossary/preferred-provider-organization-ppo/)

• • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency). (https://www.healthcare.gov/glossary/exclusive-provider-organization-epo-plan/)

• • Vision Insurance: A health benefit that at least partially covers vision care, like eye exams and glasses. All plans in the Health Insurance Marketplace ^® include vision coverage for children. Only some plans include vision coverage for adults. (https://www.healthcare.gov/glossary/vision-or-vision-coverage/)

• • Dental Coverage: Benefits that help pay for the cost of visits to a dentist for basic or preventive services, like teeth cleaning, X-rays, and fillings. (https://www.healthcare.gov/glossary/dental-coverage/) 

• • Dependent: A child or other individual for whom a parent, relative, or other person may claim a personal exemption tax deduction. (https://www.healthcare.gov/glossary/dependent/)

• • Emergency Care: “Emergency Care” means inpatient and outpatient hospital services necessary to prevent the death or serious impairment of the health of the recipient. (https://publichealth.gwu.edu/departments/healthpolicy/CHPR/nnhs4/PCCM/subheads/pccm116.html)

 

Selecting a Plan

We work closely with you to select a plan that meets your needs. Once we get quotes back, we sit down and discuss the pros, cons, and details of each plan. We provide plans details and materials for further review so that you can make an informed decision. Once you feel comfortable about a coverage option, we set to work on signing you up and activating that plan!

 

Ongoing Communication

It is important to us to be available to you throughout the term of your coverage. If you have questions or need resources, you can count on us to pick up the phone or answer an email to make sure we provide excellent ongoing customer service. This includes, plan change options, cancellations or selecting a new plan.

 

A Message from TRM Health 

We know how important it is to work with an agent you can trust and with whom you feel comfortable. If you have any questions, contact Judith at jrmurphy@trmhealth.online.