Every year, businesses offer open enrollment opportunities for their employees, which can have a big impact on their family.
Ask questions. Talk to your Human Resources representative and find out when your open enrollment deadline is. Ask what changes have been made to your options in the past year, including changes in health care plans and changes in cost to you.
Compare, compare, compare! Look at the plan choices you have and compare the out of pocket costs; the deductibles; the coverage; and the in-network physicians.
Prioritize. Determine what is most important to you. Your priority may be keeping your doctor or having access to a certain hospital or keeping your cost low. Once you know your priorities, making your choices will be easier.
Plan ahead. Many people choose a health insurance plan for where their life is right now. However, it is important to plan ahead and try to anticipate what your family’s medical needs may be in the coming year. Elective surgeries, pregnancies, vision or dental needs can all have an impact on your health care choices. All of these considerations can affect which plan you choose (including whether you need a PPO or HMO) and also how much money you need to set aside in a flexible spending account, if that is an option for you.
Consider life changes. A lot can happen in 12 months, so consider what will be happening in your life in the coming year before you make your healthcare choices. Are you getting married? Having a baby? Changing careers? Is your child moving out of your house and onto his or her own insurance coverage? All of these life changes can have a big impact on what type of health insurance you need. Plan ahead!
Understand what you are signing up for. It can be overwhelming trying to figure out insurance paperwork. Figuring out co-pays, deductibles, premiums – it can feel like a different language. Take a moment to familiarize yourself with the terminology so that you can compare your choices appropriately. Again, time spent now can save you money down the road and ensure that the coverage you need is available to you.
Open Enrollment is a time of year when you can sign up for health insurance. The dates depend on your employer but are generally offered in November. Additionally, you may qualify to enroll if you have a qualifying life event, like losing coverage through your employer.
A primary care doctor helps you to manage your health. Common services include regular physical exams, prescribing medications, treating minor illness and injuries, managing chronic conditions, and screenings for common health problems.
Should you need specialized care, your primary care doctor can expertly guide your next steps, and connect you to the right specialist. There are five main types of primary care doctors: Family medicine doctors for the whole family; internal medicine-pediatric doctors for preventing and treating diseases, pediatricians who specialize in children, internal medicine doctors who care for adults, and OB-GYNs for adult women.
Choosing and building a relationship with one of these doctors can help you live a healthy lifestyle based on your individual needs.
One type of health insurance is not better than the other, but there are differences. With an HMO plan you will choose a Primary Care Provider (PCP), who will coordinate the care you need for any specialists. Services are all provided through physicians and facilities in the health plan's HMO network. With a PPO you may also choose a PCP, but you will not need a referral to see another physician. It will usually cost less to see in-network physicians than an out-of-network physician. Whether you are considering an HMO or a PPO, you can check which doctors, medical groups, hospitals, etc. are in the network before you enroll.
A health insurance broker or agent is a person who can help you apply for help to pay for your health insurance and enroll in a health plan. They can make specific recommendations about which plan to enroll in based on your health care needs. They are licensed and regulated by states and typically get payments, or commissions, from health insurers and therefore, consumers do not pay for their services. Dignity Health offers a list of brokers here who provide enrollment assistance over the phone and in person.
