There are times when splitting Individual Nevada Health Insurance policies within a family makes sense. There are even times when it may be forced by the carrier depending on the underwriting of individual family members. Usually, when a family of two or more in that family (say subscriber and spouse, or subscriber and child/children) applies for coverage, the family members assume everyone will be on the same plan together. Let's look at both the pro's and con's of a family policy versus split policies.
There are two main benefits to having family members all on one policy.
First, ease of use, but to us that is not a good enough reason to pay more money, simply because its convenient, remember we are here to save you money. With most individual Nevada health insurance plans, with two adults on the same plan (either family or subscriber/spouse), the rate is based on the age of older spouse. If the two adults are in the same age band (typically five year bands such as 35-39) the cost remains the same and its easy. If however the adult ages are spread out among different bands, this can be a significant cost increase for the younger spouse as a rate up entails.
The other benefit to having all family members (over two people on one policy), is that most plans in the Las Vegas Individual Health Insurance market have a two-member max. This means that if two family members in a family hit their deductible or max out-of-pocket, the other family members will not need to. The chances of this having an impact are small since you would need very large expenses for more than 2 family members but it can mean a lot of money for a larger family in such a situation.
Health Savings Account or HSA plans are different. The deductible and max out of pocket is cumulative with these plans which means that all the family members (2 or more people) are working towards one deductible (which is usually twice the deductible of a single person). Splitting an HSA plans can work in some cases and not others depending on how claims hit during the year. If one family member has very large bills, it's better to have an individual deductible. If multiple family members had big bills, the family deductible works better. It can also affect how much you can fund if choose to take advantage of the tax favored account associated with the HSA-qualified high deductible plan.
Of course, there is one billing and policy number to keep track of. Having all family members on one policy requires that everyone is on the same plan and the same rating tier. If these two situations do not apply, split policies may be the best if not only option.
When you apply for coverage, the underwriter can come back say that one or more family members were approved but at a higher separate rate. The rates you see when you run your instant Individual and Family health insurance quote for Nevada are Tier 1. The rates can go up by 25%, 50%, 75%, and greater depending on the carrier. If a family applies for coverage but one family member has health issues and can still qualify for coverage at a higher tier, the health insurance carrier will likely approve this one family member at a higher tier and the other family members at the best tier. Unless you have other and better options, we usually recommend accepting this split policy and trying to reduce the tier in the future if the underlying health issue improves or we have more time away from it.
There are times when it makes sense to have different plans for each family member. Certain family members may have different needs. Maternity is a perfect example. It might make sense for the female spouse on the policy to have a plan that covers maternity, but have the spouse and/or family on another plan. Since costs are significantly more for adults, the adults on the plan may opt for less expensive plans while children are on a richer plan that addresses their health care needs better.
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