Section 1The Personal/Family Health Plan

 The Personal/Family Health Plan

Your guide to Develop Tour Personal/Family Plan

Introduction

Healthcare consumers rarely think  or plan about their healthcare.  Consumers spend more time planning for a family vacation than they do healthcare.  The Personal/Family Health Plan is a document that guides the healthcare consumer to develop an annual medical and financial plan.  The plan is designed to start by asking the healthcare consumer to determine their “Healthcare Must Haves”. “Healthcare Must Haves”  can be medical, financial and likely both.  Once identified,  “Healthcare Must Haves” plan items become the foundation of the health plan.

Healthcare medical and financial events, planned or not planned,  can be devastating to an individual or family.  At a minimum, your Personal/Family Health Plan can plan for expected healthcare events, such a new baby, surgical procedure to fix your hip, etc….  In addition, your Personal/Family Health Plan can take into account any chronic health conditions that currently exist and your age.  The older you are, the likelihood exists you will have more medical problems.

Planning for your healthcare annually can be very daunting.  As the healthcare landscape changes, this process will become very important.  Today’s healthcare consumer has been delegated the responsibility to manage their healthcare.  The goal is to help the consumer with a practical approach to plan for their healthcare. The following steps will start the process.

Step I:  Basic Healthcare Questions

The first step is to determine you and your families current health status.  Current health status is based on previous health conditions, any current chronic conditions, your age and any other  medical condition that exists.  For those healthcare consumers that have children, in addition to the above, add any pediatric care needed if appropriate.  This section is very subjective.  The healthcare consumer should be as honest as possible to determine their health risk.  If the healthcare consumer makes a mistake, the mistake should be aggressive versus conservative.

The following is a guide/checklist to assist the healthcare consumer:

The above is clearly just a snap shot for health risk factors. By typing into your web browser “Personal Health Risk Factors” a number of web sites are available to help you understand your health risk.  We would suggest locating and completing an assessment.

Step II:  Determining your “Healthcare Must Haves”

“Healthcare Must Haves” are the foundation for your annual Personal/Family Health Plan.  “Healthcare Must Haves” are defined in two general categories;  Medical and Financial.  The following guide will start with the basics.

Medical

If you have answered yes to any of the above, start to plan for these medical events.  Planning starts with reviewing your current health insurance plan to determine the coverage.  If you are in a new health insurance selection period, review all plans available to determine coverage compared to monthly premiums.  Out of pocket expense is a very big consideration.  Make sure you understand your financial responsibilities.  Step III will help with this process

Financial

Financial consideration are based on your current health insurance plan or the health insurance plan you have selected.  Step III will help with this process

STEP III: SELECTING YOUR HEALTH INSURANCE PLAN

Selecting the correct health insurance plan is dependent upon what are your “Healthcare Must Haves” for the year.  Remember, most employers ask employees to select a new health insurance plan annually.  Depending on your circumstances, you may select a “Richer” plan one year to leverage coverage and minimize expanse and a “Less Rich” the next year to leverage health maintenance coverage and reduce expenses.  Create a guide as shown below and populate with the appropriate information you need to make your healthcare decisions.

1. List the “Healthcare Must Haves”…if appropriate create another guide showing out of network costs
2. Based on the coverage benefits for each plan, populate the out of pocket costs you will be required to pay
3. List Preventive Services covered at 100%…no out of pocket costs
4. Enter the monthly premium

There are many different health insurance plans and selecting the correct insurance plan is very important.  In the Consumer Navigator Section of this Web Site, we have outlined the process and types of plans available.

Step IV:  SELECTING A HEALTHCARE SPENDING(HAS) OR FLEX SPENDING ACCOUNT(FSA)

Informed consumers have several options to help them offset their out of pocket healthcare expense.  Selecting the correct health benefit can be confusing and requires the consumer to understand the differences before making a decision.  Employers who offer health insurance allow them to set up either a FSA or a HSA to cover “qualified expenses” to include deductibles, co pays, co-insurance and prescriptions expenses. Some employers will either contribute monies or match employee contributions to FSA or HSA. Both health benefits have tax benefits, although they are not the same.

In the Consumer Navigator Section of this Web Site, we have outlined the process and types of plans available.

Step V: SELECTING YOUR HEALTHCARE PROVIDERS

Selecting your healthcare providers is a very important because they along with you manage your healthcare.

In the Consumer Navigator Section of this Web Site, we have outlined the process.

Step VI: YOUR HEALTH PLAN BUDGET

Budgeting for healthcare expense is a new process for the healthcare consumer to understand and complete.  This process is becoming more critical since the management of healthcare and associated costs have shifted to the consumer.  The following is a guide to assist the healthcare consumer in the budgeting process.

ANNUAL HEALTHCARE BUDGET TEMPLATE

By now, you clearly have an idea on how complex healthcare planning  is and how important it is to you and your family. This process should be an annual event.  The first year is the worst because of the learning curve.  Subsequent years will be easier.