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Importance Of Health Benefits In Job Offer Package

Last night I was told a horror story by one of my friends about the health insurance package his employer has in place. Before accepting this position he did not carefully check out the details about the package and not he is in a position where he is paying a lot of money out of his pockets than the salary raise he got by changing the job. This incident got me thinking how important health benefits are in job offer package offered by employer.

I will try to discuss some of the important parts of the health benefit package that you should be aware of. And based on your individual and family needs you need to weight them very carefully.

HMO and PPO

Always check if the health insurance offers HMO and/or PPO plans or not. PPO plans costs a little more but it offers the flexibility of not having to get referals from your primary doctor. You can pick and choose the doctors and specialists that you like as long as they are in-network. You can still choose out-of-network provider but you will be paying little extra based on the plan you have. So attention to the part where they tell you how much extra you will be paying for choosing out-of-network provider.

Prescription Drugs

This is the most important part of the package. Things happen in life, you or your family members will need doctor's care from time to time. The doctor will write prescription for the care and thats where the prescription drug benefits come into play. This is where you will really find out how good your health benefits are. Almost all the health insurance companies will cover generic drugs and you will be paying standard prescription rates as mentioned in your plan. God forbid if you or any of your family member need non-generic drugs, then insurance company will play devil with you. No matter what health insurance company you are with, their first reaction is to deny non-generic drug coverage. If your health insurance company is good and willing to listen, then they will ask your doctor to justify the need of non-generic drugs. And most of the time they will approve it based on their recommendations. But if you have health insurance company like United Health Care then you are so out of luck. My friend happen to be victim of United Health Care.

I think its worth the time time for me to describe the horrors of United Health Care insurance plans as far as the drug prescription go because there are some underlying facts that most of the people do not know. First of all United Health Care out sources drug prescription to another company named Medco. So when you call United Health Care about it, they will push you to Medco. Surprise surprise. Then you talk to Medco about the prescription plan and they will tell you that Medco/UnitedHEalthCare does not cover any non-generic drugs. When you tell them that there is need for that drug in your case, they will tell you to write appeal to United Heath Care and would not even bother for doctor's letter. So you better have very good appeal writign skills because insurance company is going to make decision based on your appeal and not on doctor's letter or call. Don't you like it that Medco and United Health Care sets you up for denial from the word go. And in my friend's case, he was using Blue Cross Blue Shield insurance from last jobs and never had this kind of problem.

Before you accept a new job offer, do ask for drug prescription coverage. And if you or your family members need some non-generic or named brand prescription then ask that health provider if they cover those drugs or not. Otherwise you will be paying lot of money out of your pocket. Based on some investigation we have made on our end, we will strongly recommend not to go with United Health Care plans because these people are not helpful at all. And they definitely have a very bad track record or disappoving care that is normally covered by providers like Blue Cross Blue Shield.

Powder Form Drug

This is very important if you have small kids and they take compounded medication in suspension form. Ask the health provider if they cover pwder form prescriptions. We know that United Health Care does not cover powder form and they will force your 2-3 year old kids to swallow capsules or pills.

X-Ray, MRI

Always check if these facilities are covered under the plan or not. If they are covered then check on following things:

  • Are theere any deductibles?
  • Is it 100% covered or part of it?
  • Do you need pre-authorization for it or not?

Emergency Room Visit

Check how much co-pay you have to pay if ER visit is required.

Premium Payment

Gone are the days when most of the employers used to pay for 100% of the health benefits. Now a days almost all the employers wants you to pay some percentage of the premium. So check on how much you will be paying from your pocket. It is different for single person, married person and family. So check on all the rates carefully.

Use your judgement

I have tried to cover some of the important points of the health benefit package offered by your eomployer. Not all of these may apply to you based on you and your family. So use your judgement in making decision. A wrong decision can end up you in a situation where you will be paying lot of money out of your pocket than the salary gain you will get from your new job.

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