The health insurance open enrollment period – which will take place from November 1 to December 15 this year – is still months away, but that doesn’t mean you can’t start preparing yourself now for making a decision about what coverage you might want when the time comes. Educating yourself and preparing before enrollment is critical, because once you make your decision, you’ll want to be sure it’s the right one. You will only be allowed to change your health insurance coverage if you qualify for a special enrollment period (typically triggered by a life event, such as a birth, death, divorce, change of job, etc.).
Rates and plan options won’t be released for a while, but there are some questions you should ask now to put yourself in a better position when open enrollment begins.
- Do you like your current plan? When considering your answer to this question, think about your deductible, any co-insurance, if you like the medical professionals or hospitals you have access to, and whether you feel like you’re covered for everything you need. Even if the answer is yes, keep moving through the questions on this list and still plan to research other health insurance options when open enrollment begins.
- Do you like your doctors? Many insurance plans limit you to a specific network of doctors, specialists, and hospitals. If you like your current providers, simply note them in the table below (or make your own list) along with the out of pocket cost for an office visit under your current plan. If you don’t like your options, make note of that as well. If you have a preferred provider who was available on a previous plan or who all your friends rave about, write down this individual’s name. This will come in handy when you’re reviewing coverage for the new year.
|Provider Name||Out of Pocket Office Visit Cost||Ranking (Like/Dislike)|
- Do you know what coinsurance is? How about a deductible? Now is a great time to educate yourself on common health insurance terms that you’ll find when you begin the enrollment process. CMS has a great glossary here. https://www.cms.gov/CCIIO/resources/files/downloads/uniform-glossary-final.pdf
- How much have you spent on health insurance so far this year? What about in 2016? How about in 2015? Gather as much information as far back as you can and compare your coverage and costs to determine whether your out of pocket payments are significantly increasing or decreasing, whether you’ve gained or lost coverage that you need/don’t need, etc. Use an average of as many years of information you have to develop a health care budget for 2018. It’s important that your list of health care expenses take into account all of your healthcare costs (including premiums, deductibles, copays, etc.).
|Health Insurance Item||Annual Cost|
|Primary care co-pay (multiplied by average number of visits per year)|
|Specialist co-pay (multiplied by average number of visits per year)|
|Emergency care co-pay (multiplied by average number of visits per year)|
- What prescriptions do you currently take? Below, I’ve created a small chart that you can use to track your current medications and the associated out-of-pocket costs. The second section of the table provides you space to think ahead to 2018. Do you have any reason to believe you medications will change? If you believe you’ll be taking new medications in 2018, write them down. And if you’re so inclined, call your current health insurance provider and ask for the out of pocket costs for those prescriptions, to give you a rough idea of how much your budget may need to increase.
|Current Medication||Out of Pocket Cost|
|New Medication||Out of Pocket Cost|
- Do you have any medical conditions that require consistent (i.e. more than annual, routine check-up) care? Does anyone covered by your plan have these needs? Make note of these conditions and what types of procedures or doctor visits are required, and how often they occur.
- What changes to your health or health insurance needs do you anticipate in 2018? The next of your lists should be full of any procedures you’ve deferred this year (perhaps in anticipation of better coverage in 2018) and any life changes that may impact your health or the health of someone on your plan. Are you welcoming a new baby? Was someone diagnosed this year with a chronic condition that requires additional care? Are you seeking treatment for a long-term injury? Does someone need glasses or braces? The answers to all of these questions will impact the type of coverage you’ll require.
If you’d like more information, check out the following sites and articles:
- OPM’s insurance page
- GovLoop’s Open Season Guide
- Tips to Get You Ready for Open Enrollment (GovLoop)
- Open Season Cheat Sheet (GovLoop)
- 8 Tips for Choosing the Right Health Insurance Coverage for You (GovLoop)
What do you think about while determining which health insurance plan to choose? Share with us in the comments below!