Making It Count: 5 Tips for Choosing a Health Plan

This fall millions have an important choice to make: their health care coverage for the coming year.

People will have the opportunity to select or switch their health insurance plans during “open” or “annual” enrollment.  The dates to keep in mind aren’t the same for everyone and vary depending on your situation:

• For the more than 175 million Americans with employer-provided coverage, many companies set aside a two-week period between September and December when employees can select health benefits for the following year.

• For the more than 60 million people enrolled in Medicare, Medicare Annual Enrollment runs from October 15 to December 7 each year.

• Health insurance marketplace or individual state exchange open enrollment ordinarily runs from November 1 to December 15, though individual states or the federal government could extend that enrollment time.

For most people, changes made during this time will take effect January 1.

Choosing health benefits can feel stressful, but it doesn’t have to be. Rebecca Madsen, chief consumer officer of UnitedHealthcare, shares five tips to help make the process easier and ensure you are choosing the right option for you:

Take time to review your options

Take the time to explore your options, and understand the benefits and costs of each plan so you can find the coverage that works best for you. Pay attention to more than just the monthly premium. You also should understand what out-of-pocket costs, including the deductible, copays and coinsurance, you may be responsible for. Also, consider any changes to your health over the last year or if you have any major health events planned for the next year – such as having a baby or surgery – to determine if your current coverage still fits your needs.

Prevent financial surprises

Before you select a plan, check to see if your doctor is in your health plan’s care provider network. Visiting doctors that are in-network is one way to help keep your costs lower. If you select a plan that would make your visit to a particular doctor or hospital outside the network, make sure you understand what the costs may be.

Also, see if your medications are covered by the plan. Even if you don’t expect to change plans, it’s important to make sure your drugs will still be covered in the coming year. People with Medicare should remember that Original Medicare doesn’t cover prescription drugs, so if you are looking for help covering the costs of your medications, choose either a Part D plan or a Medicare Advantage plan with prescription coverage.

Look for ways to save

Ask about incentive-based wellness programs that reward you for living a healthier lifestyle. Some health plans offer incentives for their members to participate in activities that may help improve their health, such as completing a health assessment, visiting a gym, lowering their cholesterol, participating in a wellness-coaching or tobacco-cessation program, or even just walking.

Also, check to see if your plan includes 24/7 telehealth services. Telehealth services can be especially convenient for consultations on minor health issues that occur.  Often, telehealth is available to members of employer-sponsored, individual and Medicare Advantage plans.

Don’t forget about additional benefits and features

Open or annual enrollment is the ideal time to select benefit plans that can help protect you and your family from head to toe, so consider adding vision, dental and financial protection plans such as life, accident or critical illness coverage. For people on Medicare, many are surprised to find that Original Medicare doesn’t cover most dental, vision and hearing services. But many Medicare Advantage plans do and often include additional perks like gym memberships or discounts on hearing aids.

Learn the lingo

Do you have a full understanding of health care terms, such as premium, deductible, coinsurance and out-of-pocket maximum? If not, there are resources online, including UnitedHealth Group’s Just Plain Clear Glossary (in English, Spanish, and Portuguese) to help you learn and understand health care terms.