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Basic Tips To Consider During Your Health Plan Open Enrollment Period

It's that time of year when employers are beginning annual open enrollment for employee group health insurance plans. Even if you think your status has not changed recently or since the last enrollment period, it is recommended you follow these simple steps to ensure you are getting the most from your coverage. If anything, you will be informed in the event you want to go out and generate your own private health insurance quotes just to test the market.

Although your health coverage enrollment packet may appear complicated, the information inside can be broken down into simple parts. Most will provide a summary page that helps you compare the main points of each plan side by side.

Basic Changes or Additions You Can Make During Enrollment

If you're not currently enrolled in a health insurance plan at work, then open enrollment is for you. If you are enrolled, you may switch plans (if this an option), correct inaccurate information, or add eligible dependents, such as a spouse and children not previously covered.

Cheaper Monthly Premiums or Lower Co-Payments; Which to Choose?

It depends on your situation. If you're young and healthy, you can go for lower premiums and higher co-pays. But if you're older, have a chronic health condition, or have young children who make frequent visits to the doctor, you're better off with higher premiums and lower co-pays. You also have to weigh the value of your health plan against what you pay yearly. If you go with a cheap health plan but it doesn't pay for the benefits you need, you are not getting good value for your health insurance dollars.

Examine the Maximum Lifetime Benefit

A lifetime benefit maximum is a cap on the amount of benefits available to you. In other words, it’s the point where you max out your coverage. Many health plans cap lifetime benefits at $1 million. A health plan with a high deductible and a low lifetime maximum benefit is typically less expensive than a low-deductible plan without any maximum-benefit limits.

If a plan has a relatively low lifetime maximum cap, think carefully about how much risk you're willing to assume. These plans are attractive because they cost very little per month compared to other plans, but you should consider what would happen in the event of a major hospitalization or injury. Those "cheap" benefits may end up costing you more in the long run.

What's better, an HMO, POS or PPO? And what are they?

There are several health plan choices, including traditional indemnity fee-for-service plans (FFS), health maintenance organizations (HMO), point of service plans (POS), and preferred provider organizations (PPO). Each plan has its own features to consider before making your choice. The key here is to ensure your doctor that you currently use in "in-network." Otherwise, you may have to find a new primary care physician.

Be sure to study your packet and think through scenarios that might be akin to your own situation and ensure you will be properly covered. The main thing is to not leave yourself open or uncovered in the event you do need to cash in on those benefits. Take some time and talk to others in your organization and see what health plans they have chosen and why. Just remember, 12 months from now, you’ll be doing this all over again; like taxes!

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  1. 2 Comment(s)

  2. By Clarisa Odell on Nov 29, 2008 | Reply

    For seniors who are using Medicare Part D insurance for prescriptions, now is the time to review your coverage and make sure you have what you need. Understanding Medicare Part D is quite difficult. If you go to the Medicare website, you can find tools to help you navigate the many options. If this remains difficult, you might consider working with a medical claims professional with Medicare part D training. If you need assistance, you can visit my website http://www.claimsrelief.com .

  3. By Jacob on Aug 3, 2009 | Reply

    I would like to know if you think there should be more open enrollment dates for Medicare? There is a growing movement towards this happening.
    Jacob´s last blog ..Getting Approved for Medicaid is Getting Tougher My ComLuv Profile

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  2. Oct 27, 2008: Ppo Health Insurance

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