Healthcare insurance coverage can be a confusing topic even for individuals within the medical field. With the changes in healthcare coverage due to the Affordable Care Act, a lot of information has been released, making it overwhelming for some to make an educated decision on health insurance providers. Below are tips and pointers to make the most out of the current open enrollment period.
What is Open Enrollment?
Open Enrollment is the period in which individuals are eligible to select a health insurance plan or change insurance plans. Open enrollment for the 2016 year will run from November 1, 2015 through January 31, 2016. The dates might be different for employer provided healthcare, so be sure to check in with your Human Resources team if applicable. Open enrollment not only affects individuals purchasing their own insurance, but it is also important to individuals who sign up through their employer’s insurance.
Reassess and Research
The common misconception when it comes to open enrollment is that if you are already on a health insurance plan, you don’t have to change it, or you shouldn’t change it. Providers make changes and adjustments to plans which means, while your plan might have been good for you last year, it might not be the best choice for your situation this upcoming year.
Another thing to keep in mind, are your own lifestyle changes and needs. If you’ve recently married or had children, you might want to change your plan for increased coverage for the whole family. The importance of assessing your healthcare needs from the previous year and predicting what will likely be coming up in the following year is paramount to making an informed decision for health insurance coverage.
Visiting the Health Insurance Marketplace will provide a breakdown of the available plans in your area with coverage information along with the associated cost of the choices.
What is a deductible? How does it work?
A deductible is the amount you have to pay for services before your insurer starts to share costs. For example, if your plan has a $2,000 deductible, you will need to pay for the first $2,000 of health care services you receive. Once you have paid this amount, your insurance will begin to pay a portion or all of your health care costs, depending on the plan. When shopping for a health plan, be sure to ask how much the deductible is, and which services it applies to.
Since plans with high deductibles tend to have lower monthly payments, individuals often overlook the cost and conditions of deductibles when choosing their health plans resulting in people skipping doctor’s visits because they can’t afford the out-of-pocket cost.
For families and individuals who anticipate or expect multiple doctor’s visits, it can be smart to look into a plan where you pay a set dollar amount for the services you need most, like doctor's appointments and prescription drugs. With a high deductible plan, you’d have to pay the full cost of care for these services until you reach your maximum deductible for your health insurance company to begin sharing the cost.
The Benefits of Enrolling
Aside from the opportunity to receive improved health care and more coverage, enrolling during open enrollment is a financially smart decision. This year there is a hefty financial penalty for individuals who forego signing up by the deadline: $695 per adult and $347.50 per child or 2.5% of your income – whichever is more.
Aside from the penalty, which is not a negligible amount of money, another unavoidable reason enrolling in health insurance is increasingly beneficial is that insurance policies have negotiated rates with doctors and healthcare providers. Without insurance, you will have to pay full price for your health care. With health insurance, your healthcare cost will be a discounted amount as negotiated between your insurance and your doctor.
Visit HealthCare.gov today to prepare for open enrollment and make the best decision for your individual care.