Choosing a plan during open enrollment is stressful for many people, especially if their life circumstances have changed. Fortunately, there are steps you can take to minimize the stress and also help you choose a plan that is best for your personal situation. Here are some circumstances that illustrate the typical decision-making process to take the headache out of open enrollment.
1. Choosing a plan
Start by looking at the slate of options you have, and review them to make an educated choice. If you are relatively healthy and don’t visit the doctor often, you should consider low-cost options (high-deductible plans). This is because you have a low chance of reaching your plan’s out-of-pocket maximums with a little more cost-sharing. You can also choose a plan with lower cost-sharing and expect to pay just a little more in monthly premiums.
Take a close look at the plans offered, evaluate coverages, and select the one that suits you and your family best. You can get information from the health plans’ websites or contact each health plan directly for assistance locating providers, covered medications and for any other specific questions you may have. Carefully review the costs of each plan – including your payroll deduction amounts, plus your out-of-pocket costs – and what you pay when you receive care (for example, deductibles and copayments).
2. Chronic disease
If you are living with any type of disease, you already know that you’ll be accessing health care. Judge from the current year how close you got to reaching your out-of-pocket maximum. If it’s close and lower than your deductible, the overall outlay should only be slightly different. It is also imperative you check that your doctors are in the network of the plan you choose.
3. Healthy adults with a family
If you have kids and nobody in the family has a health condition, you shouldn’t gravitate toward an expensive plan to achieve “added protection,” as the extra cost may not be worth it. Sit down with your spouse and predict, based on this year and last, how much you expect to pay out in health care expenses during the year for all of your family members. Compare your expected health care expenses to each prospective plan’s out-of-pocket maximums. Then make sure that the plans you are considering have your family doctors in their networks. This exercise can help you avoid a plan that saddles you with many up-front expenses for services you will not use and/or one that will foist too many out-of-pocket costs on you.
4. Happy with last year’s plan
If you’re like most people, you are happy with your plan and don’t want to change much. But even if you’re content with what you’re spending and what you’re laying out in out-of-pocket costs, you should still take the time to peruse the offerings. Sometimes new plans that may be more suitable for you become available. Also, if there are changes to your plan, you should compare and contrast the next year’s offering with your current plan (check deductibles, out-of-pocket costs, copays, drug copays and premium). Check to make sure you’re still comfortable with the costs – and that your doctor is still in the network.
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