Choosing Between Employee Health Programs
Updated March 26, 2015.
Question: Choosing Between Employee Health Programs
I recently graduated college and began my first job as a professional. I negotiated my salary, paid time off, and office space successfully, however when it came to choosing an employee health program I was stumped. How do I know what plan to choose?
Answer:
The interview is over and you've successfully negotiated a reasonable salary and your dream job.
The journey through human resources is not over yet – you still need to choose an employee health program. If you are given the option, request to take the company's health plan information home so you can review it at your leisure. Picking a plan should not be taken lightly, as your insurance coverage choice may appoint more than just how much you have to pay out-of-pocket for screening exams.
As a perfectly healthy adult, you might be tempted to breeze through the choice of health insurance plans and coverage. However, these plans can determine what wellness and preventive medicine you receive and could impact more than just your pocket book. According to the American Cancer Society, colorectal cancer is most treatable in its earliest stages with a five year survival rate of 90 percent – but only four out of 10 colorectal cancers are found early despite the myriad screening tools at our disposal.
Although small employers are not legally bound to provide you with health insurance program options, this coverage can be a valuable benefit when offered.
There are many different types of plans available, from comprehensive insurance coverage plans to flexible and health spending accounts meant to reimburse you financially for medical care costs. Of the more comprehensive managed care plans, there are two basic types:
When comparing and contrasting your employee's health insurance plans it's beneficial to use Medicare coverage guidelines as the golden standard for preventive and wellness screening. Some private insurance companies already cover preventive screening exams for colorectal cancer, such as the colonoscopy or sigmoidoscopy, but many others do not. As of September, 2010, thanks to the Affordable Care Act, new private insurance health programs must cover – although possibly with a copayment – the recommended exams and screening encouraged by the United States Preventive Services Task Force. However, many older plans have not incorporated these wellness and screening exams under their allotted coverage, which means you might have to pay out of pocket for the tests should you want them, even though they are encouraged under the Medicare guidelines.
Private health insurance coverage is mandated by state. For example, you may not receive the same benefit covering a fecal occult blood test if you live in Florida versus North Carolina. Your human resources department should be able to provide you with a copy of the coverages, copayments and deductibles for each medical consideration under their provided health care plans. Within the United States, 22 states still do not require, under written policy, individual or group insurance companies to cover all screening exams for colorectal cancer including the:
Having said that, regardless of where you live, Medicare covers these exams based on predetermined screening guidelines. Anyone over the age of 50 is eligible for these screening exams to detect colorectal cancer under the Medicare guidelines. Early detection of colon cancer can save lives, treatment time and cost of care. The 22 states who currently do not have a policy mandating this coverage include:
Some of these states offer and encourage insurance companies to provide comprehensive wellness and screening for beneficiaries, but they are included in this list because they do not mandate or have written policy to this effect.
Some of the newer screening exams for colorectal cancer are not covered by the Medicare screening guidelines, nor by many privatized health insurance companies. The virtual colonoscopy, which is a non-invasive colon exam performed with the use of computed tomography (CT). Similarly, the newer DNA stool tests, which may detect shed amounts of DNA associated with cancer in the stool sample, are not yet covered nor are they FDA approved at this time.
Sources:
American Cancer Society. (n.d.). Colorectal Cancer Early Detection.. Accessed March 30, 2013.
Centers for Disease Control and Prevention. (n.d.). Insurance and Medicare. Accessed March 22, 2013.
Government Accountability Office. (n.d.). Coverage of Key Colorectal Cancer Screening Tests is Common But Not Universal. Accessed online March 31, 2013.
National Women’s Law Center. (n.d.). Colorectal Cancer Screening, Health Care Report Card. Accessed March 23, 2012.
Question: Choosing Between Employee Health Programs
I recently graduated college and began my first job as a professional. I negotiated my salary, paid time off, and office space successfully, however when it came to choosing an employee health program I was stumped. How do I know what plan to choose?
Answer:
The interview is over and you've successfully negotiated a reasonable salary and your dream job.
The journey through human resources is not over yet – you still need to choose an employee health program. If you are given the option, request to take the company's health plan information home so you can review it at your leisure. Picking a plan should not be taken lightly, as your insurance coverage choice may appoint more than just how much you have to pay out-of-pocket for screening exams.
As a perfectly healthy adult, you might be tempted to breeze through the choice of health insurance plans and coverage. However, these plans can determine what wellness and preventive medicine you receive and could impact more than just your pocket book. According to the American Cancer Society, colorectal cancer is most treatable in its earliest stages with a five year survival rate of 90 percent – but only four out of 10 colorectal cancers are found early despite the myriad screening tools at our disposal.
Learn About the Plans
Although small employers are not legally bound to provide you with health insurance program options, this coverage can be a valuable benefit when offered.
There are many different types of plans available, from comprehensive insurance coverage plans to flexible and health spending accounts meant to reimburse you financially for medical care costs. Of the more comprehensive managed care plans, there are two basic types:
- Health Maintenance Organizations (HMO)
- Preferred Provider Organizations (PPO)
When comparing and contrasting your employee's health insurance plans it's beneficial to use Medicare coverage guidelines as the golden standard for preventive and wellness screening. Some private insurance companies already cover preventive screening exams for colorectal cancer, such as the colonoscopy or sigmoidoscopy, but many others do not. As of September, 2010, thanks to the Affordable Care Act, new private insurance health programs must cover – although possibly with a copayment – the recommended exams and screening encouraged by the United States Preventive Services Task Force. However, many older plans have not incorporated these wellness and screening exams under their allotted coverage, which means you might have to pay out of pocket for the tests should you want them, even though they are encouraged under the Medicare guidelines.
Private health insurance coverage is mandated by state. For example, you may not receive the same benefit covering a fecal occult blood test if you live in Florida versus North Carolina. Your human resources department should be able to provide you with a copy of the coverages, copayments and deductibles for each medical consideration under their provided health care plans. Within the United States, 22 states still do not require, under written policy, individual or group insurance companies to cover all screening exams for colorectal cancer including the:
- Colonoscopy
- Fecal occult blood test
- Double contrast barium enema
- Sigmoidoscopy
Having said that, regardless of where you live, Medicare covers these exams based on predetermined screening guidelines. Anyone over the age of 50 is eligible for these screening exams to detect colorectal cancer under the Medicare guidelines. Early detection of colon cancer can save lives, treatment time and cost of care. The 22 states who currently do not have a policy mandating this coverage include:
- Alabama
- Arizona
- California
- Florida
- Hawaii
- Idaho
- Iowa
- Kansas
- Missouri
- Michigan
- Minnesota
- New Hampshire
- Mississippi
- Montana
- North Dakota
- Utah
- South Dakota
- New York
- Wisconsin
- Ohio
- Oklahoma
- Tennessee
Some of these states offer and encourage insurance companies to provide comprehensive wellness and screening for beneficiaries, but they are included in this list because they do not mandate or have written policy to this effect.
No Coverage
Some of the newer screening exams for colorectal cancer are not covered by the Medicare screening guidelines, nor by many privatized health insurance companies. The virtual colonoscopy, which is a non-invasive colon exam performed with the use of computed tomography (CT). Similarly, the newer DNA stool tests, which may detect shed amounts of DNA associated with cancer in the stool sample, are not yet covered nor are they FDA approved at this time.
Sources:
American Cancer Society. (n.d.). Colorectal Cancer Early Detection.. Accessed March 30, 2013.
Centers for Disease Control and Prevention. (n.d.). Insurance and Medicare. Accessed March 22, 2013.
Government Accountability Office. (n.d.). Coverage of Key Colorectal Cancer Screening Tests is Common But Not Universal. Accessed online March 31, 2013.
National Women’s Law Center. (n.d.). Colorectal Cancer Screening, Health Care Report Card. Accessed March 23, 2012.
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