In a recent blog post, I addressed the regulations around mid-year benefits plan changes. Since the IRS controls when and how you can make plan changes, the obvious solution would be to make sure you choose the right benefits for you while you have the opportunity.
Because our healthcare needs and the needs of our families change over time, our benefits needs may change as well. Open enrollment is an opportunity to review the changes that have taken place in your life, anticipate changes to come and adjust your benefits plan accordingly.
Here are some questions to ask yourself when choosing your medical insurance during your employer’s next open enrollment period.
What are your cost priorities?
Many employees begin and end the process of plan selection with cost. Some choose the plan with the most expensive premium, believing that the high cost ensures them of great coverage. Others choose the plan with the least expensive premium because they don’t want to pay for insurance if they don’t frequently utilize health care services. Both ends of the spectrum may apply to you but the trick is to determine which approach is best. It may well be that you are somewhere in the middle.
If you are going to use cost as a basis for your choice, keep these additional items in mind:
Cost isn’t just about premiums. It’s about copays and co-insurance and deductibles. You can refer to my previous post on choosing a medical plan for more information on what these terms mean. Make sure you factor all costs into your calculations when you consider what plan to elect. Consider using your medical expenses from previous years as a guide to determine how well a plan may work out for you in the coming year.
The plan with the best price may still be the wrong plan for you. Is your doctor participating in the plan? Is the hospital you prefer in-network? Have you checked to see that the medications you take are covered? These factors will also contribute to your satisfaction with your choice.
Are there any additional benefits? Some plans provide gym memberships. Some include pricing tools. Some provide 24-hour nurse lines to discuss an illness before running to the doctor. These extras have the potential to help save you money and make your experience with the plan more valuable.
What does your doctor think of the plan?
If you have a doctor whom you like and respect, their opinion could be invaluable to you as you make this important decision. No insurance carrier is perfect but many doctors or billing offices can be a guide to the plans that provide the best service or give the doctor the least amount of trouble when ordering tests. It doesn’t hurt to have some guidance from people who deal with insurance every day.
Failure to plan is planning to fail
Even after you’ve chosen a plan you believe will be amazing for you and your family, your responsibility does not end. Make sure you fully understand the plan rules, including the requirements for referrals, precertification of certain services and any limitations. Shopping around for services is a good idea too. Your doctor may send you to a facility that is easy for them but a wallet-grabber for you. Be a great healthcare consumer and shop around for the best deal - just as you would do when making any other major purchase.
Open enrollment is every year. It is a great opportunity to re-evaluate your life circumstances and make wise choices for the coming year. Complacency or inertia can lead to dissatisfaction with your coverage and unanticipated out-of-pocket expenses. Remember, medical plan elections cannot be changed at will. Choose wisely during open enrollment to avoid buyer’s regret.
This communication is for informational purposes only; it is not legal, tax or accounting advice; and is not an offer to sell, buy or procure insurance.
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