Amid higher inflation, you may be looking at ways to adjust your lifestyle and spending habits. But when it comes to health care, it’s important to keep your well-being and budget in mind.
Annual or open enrollment season is here – a time when more than 4.5 million people in Louisiana and millions of Americans across the country will have the opportunity to select or switch their health insurance plan for the coming year.
Open enrollment is a good chance to review how often you’re using health services and decide whether you’ll stick with the plan you’ve got or switch to another being offered. It’s also an opportunity to assess your overall care costs to ensure you’re choosing a plan that will work best for next year’s budget.
Enrollment timing: For people with coverage from their employer, open enrollment typically happens for two weeks sometime between September and December. Medicare members can enroll or make changes to coverage from Oct. 15-Dec. 7. Most selections made will take effect on Jan. 1, 2023.
Here are seven tips to help in choosing a health plan through work, the Exchange Marketplace or Medicare:
1. Consider all your options. Take time to understand and compare the benefits, services and costs of each plan, so you can figure out which will work best for you. A good first step may be to refresh yourself on health insurance lingo, including premiums, deductibles, copays, coinsurance and out-of-pocket maximums.
· Medicare members: As you weigh your options, ensure you’re familiar with the difference between Original Medicare ad Medicare Advantage. If you need a review, visit MedicareEducation.com — an online resource with answers to questions about eligibility, plan choices, cost basics, prescription coverage and more.
2. Check your prescription benefits. Knowing how to get the most out of your prescription benefits may help you manage costs. For example, check into discounts and lower-cost alternatives, including generics, which may be available. You may also be able to fill your prescriptions at a participating network pharmacy or with home delivery by mail — two more money-saving options.
· Medicare members: You may be surprised to learn Original Medicare doesn’t generally cover prescription drugs. Consider adding Part D or a Medicare Advantage plan with prescription drug coverage to help keep your medication costs in check.
3. Check for mental health coverage. In addition to in-person mental health care, you may have access to a large virtual network of therapists and psychiatrists. Some health insurers also offer advocacy services to help you find the right type of behavioral health care.
· Medicare members: Some plans offer virtual mental health care with a $0 copay, including UnitedHealthcare Medicare Advantage.
4. Don’t forget about specialty benefits. Additional benefits, such as dental, vision, hearing or critical illness insurance, are often available and may contribute to overall well-being.
· Medicare members: You may be surprised that Original Medicare doesn’t cover most dental, vision and hearing services, but many Medicare Advantage plans do.
5. Look into wellness programs. Many health plans offer incentives that reward you for taking healthier actions, such as completing a health survey, exercising or avoiding nicotine.
· Medicare members: Many Medicare Advantage plans also offer gym memberships and wellness programs for members at no additional cost.
6. Anticipate next year’s health expenses. If you’re expecting a significant health event in the next year, such as surgery or the birth of a child, compare the differences in plan designs for that specific situation, including any out-of-pocket costs.
7. Consider a plan with virtual care services. If you’re busy or just prefer connecting with a doctor from the convenience of your home, consider choosing a plan that includes 24/7 virtual care. You may have access to virtual wellness visits, urgent care and chronic condition management.
· Medicare members: Most Medicare Advantage plans provide access to virtual care, which can be an easier, more affordable way to talk with doctors about common health issues on a smartphone, tablet or computer.
Christine O’Brien is executive director of United Healthcare