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What is a buy-up medical plan?

Keep in mind...
  • A buy-up medical plan is an addition to your current insurance coverage.
  • You will have the information to know whether investing in a buy-up medical plan is worth it during open enrollment
  • Buy-up medical plans are not for everyone. However, it will be explained the areas of research you will need to do to know if you may require the extra coverage
  • Not all doctors and specialists will take all buy-up medical plan policies
  • You will also get an idea of why premiums change when upping your health insurance policy outside of what is offered in a standard group plan

Workplaces offer general health insurance group plans if you meet their hourly standards. However, you can also opt for additional insurance policies. A buy-up medical plan is one of the additional insurance options.

In the case of group plans, your employer pays most, if not all, of your basic plans’ premiums. Although, if you opt into additional programs, you are likely responsible for the additional premiums and deductibles. The coverage of a buy-up health insurance policy is broader than a general group plan.

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Open Enrollment and Choices

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The human resource officer where you work is responsible for open enrollment. It is a yearly renewal of your insurances, including health, dental, and vision. During open enrollments, you also are given a choice to opt into a buy-up medical plan.

The health-related expenses from the year before are what you should consider when thinking about upping your coverage. You need to take into account your out of pocket expenses that the general group plan did not cover. Do not forget to factor your prescriptions into the decision.

You will also want to take into account any future health costs. Whether it is a dependent or yourself, specialist and medication may be changing or changed before open enrollment. You cannot predict every illness or injury, but you can still plan and take your lifestyle into consideration.

Evaluate the buy-up medical plan’s policy next to your general group policy. Each state treats specific treatments differently. Also, be aware of any aspects of your healthcare not covered by either policy. You want to address the issues with your insurer and human resource officer.

Buy-Up Medical Plan Network

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Not all policies are the same. They may differ from state to state. Your employer may have insurance through an insurance agency that varies in their options. Or, you have chosen to use private insurance or purchased a plan through the Marketplace. In all instances, asking questions and studying what is available with a buy-up medical plan keeps costs down and keeps you informed.

Health insurance works on networks. You want to ensure you can keep your doctor, specialists, and pharmacies. Be aware and ask questions so you do not find yourself having to change doctors because of an additional policy they may not take. You want to avoid unpaid claims, also.

Benefits Of Buy-Up Medical Plan

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Buy-up medical plans are meant to assist covering you in areas your primary coverage does not. It includes covering deductibles, copays, out-of-pocket expenses, unlimited lifetime caps and continues to cover your dependents to the age of 26. The age of your dependents may vary from state to state.

– Preventive Care Offered Through Buy-Up Medical Plans

Adult Preventative medicine is the goal of insurance agents and the policies they sell. However, when you decide on a buy-up medical plan, the care is more extensive. They cover more than one wellness visit a year. Rather, they include procedures, tests, and medications that prevent future catastrophic illnesses and injuries.

You are not the only one that a buy-up medical plan will use preventive methods to treat. Your dependents are also a priority with the addition of a broader plan. Wellness childcare and women’s care are also covered in the category of preventative medicine.

– Variety of Home And Out-patient Care Offered

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Office and home visits, maternity care, home health care, and hospice care are but a short list of extra coverage that comes with buy-up medical plans.

The policy’s coverage is broad enough to cover chemotherapy and radiation therapy, so you do not find yourself without the means to cover cancer treatments during an already stressful time.

Your family also benefits from the extra coverage. A buy-up medical plan covers a variety of therapies. Speech and language, occupational, developmental delays, and mental health are covered for you and your entire family if they under your insurance umbrella.

– In-patient Coverage With Buy-Up Medical Plans

Buy-up medical plans combined with your group insurance covers inpatient health crises such as hospital stays, anesthesia, and inpatient rehabilitation. Regardless of addiction or physical therapy, inpatient rehab is available through additional planning.

– Ambulatory And Medical Related Transportation

Primary insurance rarely covers sudden illnesses that require the use of an ambulance service. Catastrophic injuries are also a possibility in anyone’s life. The use of a medical helicopter service is also generally an unexpected expense that a buy-up medical plan will cover.

Final Evaluation of a Buy-Up Medical Plan

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You are your and your family’s health advocate. Both inside and outside of the doctor’s office, you make the decisions on who and what coverage you and your dependents will have.

Questions are never dumb when it comes to the health of you and your family. You need to take into account the coverage offered and if spouses and dependents are eligible.

You also need to evaluate as to whether you are expecting to use the plan to its fullest. It will depend on if you have ongoing medical expenses or they are in your foreseen future. Always question if you can afford deductibles, premiums, and fees, including copays.

Catastrophic events happen, and you should know whether or not you are underprepared while not being over prepared.

Study the doctors in your insurance network. Ensure your doctor and specialists are part of the insurance coverage. If they are not, it is up to you to make the decision as to whether or not you are willing to change doctors.

Use online tools to research your employer’s insurance before open enrollment. If you find that a group plan is not best for you and your family, options are still available. Private insurance agents and The Affordable Care Act’s Marketplace also have choices to cover you and your family completely.

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