Whether you’re one of the lucky folks who still have health insurance from your employer or you purchase insurance on your own, open enrollment is right around the corner. It’s a critical time in terms of choosing or renewing benefits, so approach with care and caution.
Here’s what it is:
An annual event, open enrollment gives you an opportunity to change your current health plan or benefit options, such as dental or vision care. Once open enrollment is over, you can’t make any changes to your plan design for an entire year, unless there’s an IRS qualifying event, such as marriage, divorce birth, adoption, or death.
During Open Enrollment, examine your plan choices for the following:
- The Network: Compare your doctors and specialists (along with your preferred hospital) with the plan’s list of network providers. Who’s in? Who’s not? Can you live with that? Are you allowed to use out-of-network providers and hospitals? If so, what are the costs and prerequisites?
- Cost Per Visit: Look at monthly charges, deductibles, and co-pay requirements for doctor and specialist visits. Do the math. If you see doctors often, you may want a higher monthly payment with lower co-pay; if you go occasionally, consider a lower payment and higher co-pay.
- Prescription Coverage: Basically, you want to compare plans in relation to the annual cost of all your prescriptions. Which plans have a separate prescription deductible? What about co-pays? How much will you save with generics or ordering by mail?
- Plan Features & Overall Coverage: Think about the services and supplies you normally use; now imagine the coming year and what you might need. Will you be traveling? Having surgery? Will you need short term rehabilitation and physical therapy? Does your plan require precertification? Are you covered anywhere in the U.S. or if you travel abroad? Are preventative care and immunizations covered? Of the plans you’re considering, which offers discounts for services like gym memberships? Is that important to you?
Choose your plan according to your needs — the ones you have now and the ones you envision for the coming year. You only get one chance each year to get it right. If you need help comparing plans and benefits, give Health Champion a call. We’re here to make Open Enrollment easy on you.