Navigating Healthcare Plans: A Guide for New Law Firm Partners

As you embark on this exciting chapter of your legal career, it’s crucial to make informed decisions regarding your healthcare plan. There are several important factors to consider when choosing the right healthcare plan and using healthcare services in a cost-effective manner.

Understanding Healthcare Costs

The rise in popularity of high deductible health plans has shed light on the way healthcare is provided in the United States and the associated costs. Our current fee-for-service model often leads to a belief that more is better – more tests, more medications, more visits. This, coupled with malpractice concerns and the opportunity for hospitals to charge more for the same procedures than independent doctors, can result in rapidly rising healthcare costs. As a law firm partner, it’s crucial to navigate these costs effectively.

Choosing the Right Healthcare Plan

When it comes to deciding which healthcare plan is best for you and your family, it is important to understand a variety of components. No two people are the same, and there is not a one-size-fits-all solution. Below are just a few factors to think about when you become partner and need to choose a healthcare plan that fits your needs.

Coordination with Firm Policies

Familiarize yourself with your law firm’s policies regarding healthcare plans. Understand any specific requirements, such as whether you’re expected to choose from a pre-approved list of plans or if there are restrictions on changing plans outside of the open enrollment period.

Provider Preferences

As a partner, you may have established relationships with specific healthcare providers or specialists. Ensure that the healthcare plan you choose provides access to the providers you prefer or that you have the flexibility to seek out-of-network care if needed.

Executive Health Programs

Some law firms offer executive health programs as a perk for partners and senior executives. These programs often provide comprehensive and personalized healthcare services, including dedicated medical teams, expedited appointments, and additional wellness benefits. Inquire about the availability and benefits of such programs.

Flexibility and Portability

Consider the flexibility and portability of your healthcare plan. If you anticipate changes in your career, such as transitioning to another law firm or starting your own practice, it’s important to evaluate whether the plan can be easily transferred or if it offers coverage options beyond the firm’s network.

Cost-Sharing Arrangements

Law firm partnership often involves unique compensation structures. Make sure that the healthcare plan you choose aligns with your specific compensation arrangement and considers tax implications, reimbursement methods, or profit-sharing agreements.

Dependent Coverage

Assess the options for dependent coverage under the healthcare plan. If you have a family or dependents, factor in their healthcare needs and ensure that the plan provides suitable coverage for them as well.

Additional Benefits

Inquire about any additional benefits or perks offered by the healthcare plans available to you. These may include wellness programs, gym memberships, mental health services, telemedicine options, or other value-added services that can contribute to your overall well-being.

Tax Implications

Understand the tax implications associated with your healthcare plan, including the deductibility of premiums and potential tax advantages regarding health savings accounts (HSAs) or flexible spending accounts (FSAs).

Using Healthcare Services Effectively

To make the most of your healthcare plan as a law firm partner, here are some helpful tips.

In-Network Providers

When making appointments with healthcare providers, ask if they are in-network rather than just covered under your plan. Being in-network means that the provider has a fee arrangement with your insurance provider, resulting in lower costs for you. Ensure that the providers you prefer are in-network or that the plan offers flexibility for out-of-network care when necessary.

Preparing for Doctor’s Appointments

Before each doctor’s appointment, write down relevant information such as symptoms, medications, and questions you have. Send a copy of this document to the doctor’s office a few days prior to your visit. Bring another copy to hand to the doctor during your appointment. This increases the likelihood of all your concerns getting addressed, and it helps facilitate effective communication with your healthcare provider.

Evaluating the Necessity of Tests and Procedures

If you are referred to a facility for testing, inquire if the facility and the doctors evaluating the results are in-network. Ask your doctor about the purpose and potential impact of the recommended tests on your treatment. If the necessity or relevance of a test is unclear, discuss alternatives or determine if the testing is truly necessary.

Cost Considerations for Prescriptions

When given a prescription, ask if the drug is covered under your plan and if there is a cheaper generic version available. Compare the cash price of the medication without insurance to the out-of-pocket cost with your insurance. Discuss the benefits, risks, duration of use, and potential alternatives with your doctor.

Conclusion

As a law firm partner, selecting the right healthcare plan and using healthcare services in a cost-effective manner is essential. By having a deep understanding of your healthcare needs, provider preferences, and plan flexibility, you can choose a plan that aligns best with your requirements. Moreover, by selecting in-network providers, preparing for doctor’s appointments, evaluating the necessity of tests, and considering cost-saving measures for prescriptions, you can make the most of your healthcare plan while effectively managing costs.

Remember to consult with your law firm’s benefits coordinator or human resources department for personalized guidance and to document important conversations throughout the process. Additionally, working with a financial advisor can provide valuable insights into managing healthcare costs and optimizing your overall financial well-being. A financial advisor can help you analyze the available healthcare plan options, review potential tax advantages, and develop a comprehensive financial strategy that aligns with your goals. As a law firm partner, being proactive and informed will empower you to navigate the healthcare system with confidence and make the best healthcare decisions for yourself and your family.

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Eric Dostal

About Eric Dostal, J.D., CFP®

Eric is a wealth advisor in our New York City office.

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