Once a year, your company has an open enrollment period in which you select your health insurance plan for the coming year. This time can be stressful for many people as figuring out how to balance premiums, deductibles, and copays can be tricky.
Professionals can often make the wrong decision about choosing their healthcare plan. Even if you do everything right by researching different plans, confirming that your doctors are in-network, and reviewing prescription limitations; something may still go awry. For example, some plans have a tiered network of providers: tier 1, tier 2, tier 3, etc. In this case, you'd have to make sure that your doctors were in an appropriate tier that matches your budget.
Health insurance can be stressful to understand, and many worry they are not making the right decision on which plan to choose. Here are five tips to help you find the right health insurance plan.
Make Sure to Read Through All the Changes
Even if you are comfortable with the plan you were on the past year, it is important to consider other possible plans with a better value for your money.
It may be tempting to skip the open enrollment process but know that there may be changes to the plan you were on. Even if your household income hasn't changed, your plan will likely update automatically. Policies and premiums are not guaranteed to stay the same forever.
The beginning of the year is known to shake things up for consumers, and the insurance industry is no exception. In fact, this year the amount of new insurers entering the market is driving down the cost of premiums in some states; yet another good reason why you should check back in and see what plans are available.
Look at the Estimated Yearly Expenses, Not Just Monthly Premiums
When looking at the estimated yearly cost you also have to take the deductible and copayment amounts into account.
The premium is usually put front and center when looking at plans, but there are some online tools to help you calculate the estimated yearly expenses. You can look at HealthCare.gov or certain state marketplaces. The estimated yearly expenses are calculated based on all the different factors, including copays, deductibles, and the amount of healthcare you expect to receive in the upcoming year.
These kinds of tools can be extremely useful when choosing a plan. The math can be tricky to work out with all the different variables involved.
Determine How Much You Typically Spend on Healthcare
The amount of healthcare you expect to receive can be difficult to determine. The amount will indeed affect the price and is a prime factor in choosing the right health insurance plan near you. While age is a useful thing to consider, you must also account for the possibility of accidents (auto, workplace injury, unexpected diagnosis, etc). Think through all the ways you consume healthcare – from specialists to prescriptions – and which plans best support those use cases.
Decide What Your Priorities Are
What it really comes down to:
- Do you want to pay a slightly higher monthly premium and have a decreased out-of-pocket expense limit?
- Or do you want to pay a lower monthly premium with higher out-of-pocket expenses? In this case, incidents can be quite costly but there is still the peace of mind of staying insured.
Besides these general considerations, you should also take your specific health needs into account. Are your current prescriptions and favorite doctors covered under the potential plan? Many companies have a search tool for doctors and prescriptions they cover and providers often list what insurance carries they accept.
Health Navigators are Available to Help You
Your employer may offer a healthcare navigation platform – such as Rightway. Navigators are clinicians with expertise in healthcare policy to help you with all decisions you need to make around your health and wellness. Not only can Navigators help you find providers and schedule appointments, but they can also explain the plan options to you and help determine which plan is best for your needs.
The main benefit of working with a health navigator is impartial advice. They look for the plan that's best for you.
Rightway Navigators are available to members through phone or chat in the Rightway app to answer your open enrollment questions. Not sure if you have access to Rightway? Ask your company’s HR director if Rightway is included in your benefits package.