Choosing the right healthcare plan is a big decision for almost everyone and the health reform law makes things more complicated, especially for those who are looking at plan options provided by their employers. Unlike the earlier days where people had only one type of service, we now have a wide variety of options to choose from. This means that in addition to sorting through the differences in deductibles, premiums and copayments, you now need to take into account the recent provisions in the law, as they could have an impact on your (and your family’s) health coverage for the coming year.
While there is no “right way” for any individual to choose a healthcare plan, there are a few tips that you could consider during the open enrollment season:
Look for “grandfather” exemptions
In case your employer has made no substantial change in your insurance plan, it could have been “grandfathered in”, are they are not subject to certain provisions in the health reform law. These usually comprise free coverage for preventive services such as depression screening, blood pressure checks, immunization and smoking cessation programs.
Identify the plan that meets “your” needs
In general, there are three types of plans you can choose from:
Before choosing any plan, check if your preferred primary care physicians and specialists are a part of the provider’s network.
Recognize Changes Before Re-enrolling
Sometimes changing plans may be more beneficial, especially of the coverage of a specific service has disappeared. Go through your plan for any changes carefully, as it could save you to trouble of dealing with any unexpected costs later. This could also make you realize that your healthcare needs have changed.
Beware of New Freebies
Several new plans now need you to pay nothing for certain preventive care measures; however, it may not be necessary that you switch off your old plan, just to reap this benefit. Randall Abbott, Senior Healthcare Consultant, Towers Watson (New York based global consulting firm) claims that several plans were offering preventive services for free, or at minimal costs even before the health reform was passed.
Think about Opening a Healthcare Account
You could save on your premiums by setting up a healthcare savings account, through which you can pay for your contact lenses, prescriptions and other small medical expenses. The biggest advantage of taking this step is that contributions to health savings accounts are deducted from your pretax income. The drawback of the health savings account is that it has to be paired with a high-deductible plan, which has an annual deductible of US$ 1,200 for an individual and higher for a family.
Check the Prescription Coverage
Medicines that were covered by your insurance plan last year may have been dropped this year. Therefore, make sure that the drugs you take on a regular basis are still a part of your insurance coverage. Also check if there are any additional discounts on generic drugs or if you have the option to save more money by receiving prescriptions by mail.
Make use of Wellness Incentives
Many companies offer their employees cash incentives for completing lifestyle questionnaires, covering topics such as smoking, eating and exercise habits. These assessments enable employers encourage their workers to participate in wellness activities, which may include fitness programs or smoking cessation. Such programs reverse poor habits and may reduce health costs for employees as well as the company.
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