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Open Enrollment Season: Consider This Before Changing Health Plans


With open enrollment for health insurance starting in November 2015, it’s important to evaluate your current benefits to decide whether or not your plan is working for you. Looking for another plan that better fits your budget? You may want to research other policies. Before changing your current health insurance coverage though, consider these factors below.

Do Your Research

You can’t just take a friend or family member’s word for it when it comes to selecting the right health insurance. Every health insurer is going to have a different policy, different prescription coverage, and different deductible.

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Get the details before you make any changes as the grass isn’t always greener. Photo courtesy of 2015 Get Out Enjoy Life campaign.

It’s crucial that when considering switching providers for you to conduct your own research. Look up information online, or call several providers to get a personalized quote. When you do this, you’re going to need to know what your deductible will be, as well as an idea about the kind of out-of-pocket expenses you would be looking at if you were to go with that company’s coverage plan.

pushrimEven if you don’t think you need to change providers, go back and review your current coverage and see what you spent money on in the previous year. It may surprise you, and encourage you to make changes for the upcoming year, especially if you’re expecting major life changes such as a new member of the family or a new job. When you have an idea about what your future costs may be, you’ll have a better idea of which plan is going to be most cost-effective for you.

Also, check your medical insurance premiums and combine them to determine whether or not the expense adds up to what you actually had in medical expenses the previous year. If you used medical services often, it may be a better decision to consider a plan that has a higher premium, and a lower out-of-pocket cost.

If you use monthly medical supplies, contact your current supplier and make sure they are in-network with your new plan BEFORE you change.  Failure to do so may cause an interruption or out-of-pocket expense for your medical supplies like catheters or continence care products.

Doing the research may be tedious, but once you have a better understanding of the current plans available, you’ll have a better idea of what questions to ask.

Ask The Right Questions

Many insurance companies have a cap on out-of-pocket expenses for the customer. Not all providers have an out-of-pocket cap, and not many providers will tell you this until you’re already in debt. In most cases, the lower the cost of the policy, the higher the cap will be.

If you develop a disease or more advanced condition later on that requires a costly medication, then you’re going to want to be prepared. In order to be prepared, consult providers about their prescription coverage both for any current medications you’re on as well as for any you may have to use in the future, and talk to them about long-term coverage, in case you were to develop any symptoms that required an expensive medication.

Be sure to take your family’s needs into account when you are looking in new insurance coverage.

People often forget that just because they have insurance, it doesn’t mean they’re covered across the globe. Those who travel often, or even just once a year overseas, are going to want a policy that would cover medical expenses abroad. You never know when you’ll need medical attention, or what part of the world you’ll be in when you do.

In exploring various providers, the information can be overwhelming, and can cause information overload and anxiety. Health insurance is complex, so it’s important you ask a lot of questions, and make notes about each company you speak with, so that you can keep up with who offers what.

Questions you should ask each provider before you commit are:

  • What is the yearly deductible?
  • Is there a cap on out-of-pocket medical expenses, and if so what is the cap set to?
  • Will this plan cover my prescriptions?
  • Will this plan cover me for emergency treatment while overseas?
  • Is my current doctor covered by this policy?
  • Are there cover limits for specialists?
  • What benefits are included?
  • Are my routine exams covered?
  • Is my current medical supplier in-network with this policy?

Remember, before making changes to your health care, you will need to contact your medical supply company to ensure they accept the providers you’re considering. If they are in-network, you also should make sure you won’t be hit with additional out-of-pocket fees or deductible expenses from the provider under the new plan.

Just remember to do your research and ask lots of questions before making necessary changes to your health care plan. Your health is important and so is your budget. Take the time to explore a variety of options to ensure you put your health coverage in the hands of the right insurer for your individual needs.

Note: This article should be considered as informational only and not construed as medical or financial advice.

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