We tried VOIP about 2 years ago. I think what you'll find is that everyone has a different experience, probably a bell curve.
I tried Sunrocket for 2 months (who went bust, naturally.) I liked them because they packaged you TWO numbers in any two area codes. I had one in Milwaukee, one number where the grandparents lived, so they would just place a local call and get us. Most voips charge $5/month for that.
Much of it depends on your ISP. I thought I had a great one, as it rarely went out, passed all the online tests with flying colors. Plus, even if it does go out, you can auto-failover to your cell phone.
However .. my results were mixed. I'd say 10% of the calls I made were completely garbled, enough that you'd have to hang up. 10% were bad, but had something wrong, like an echo or something garbled. 10% were mostly ok with some glitches. The other 70% were generally fine.
So. While it was cheaper than what I was paying with a landline+LDX (about $35 vs. $10/month) I determined that I just hated having a phone service that wasn't dead solid for 30% of the time. I was embarrassed when people called and I had to ask them to try again.
Now, if you're financially challenged, I'd totally go with VOIP in a heartbeat because of how cheap it can be, and put up with the failure rate.
That all being said, I've spoken to people who have had zero complaints and love it. Now that a couple years have passed, I might try it again too.
As a webmaster by trade .. I can tell you: The internet is just not that reliable from end to end.
My advice .. go with one of the big ones, Vonage is clearly the biggest .. Viatalk, maybe. Try them for a couple months, both outbound and inbound. Don't port your phone number. See what your failure rate is, and if it is acceptable to your family. You can always cancel. Usually, they give you 1 month money back, which may be enough time to figure out if you like it.
--Off that topic, webcams .. love em, but it's hard to find others with them. I use
www.ekko.tv which makes it brutally easy to start a webcam+audio session .. no software, no registration, just set up a "room" and go. That way, you don't need to walk gramma thru setting anything up.