By Gary Daniels
As millions evaluate their health plan options during this fall’s open enrollment season, a new survey finds that 3 in 5 Americans incorrectly defined key health care terms. This knowledge gap may result in less-than-ideal selections, which could cause them to miss out on plans that might better suit their needs and offer potential cost savings.
People with coverage from their employer, open enrollment typically happens during a two- or three-week period between September and December. For those eligible for Medicare, the Medicare Annual Enrollment Period runs from Oct. 15 to Dec. 7 each year. Coverage selections made during the fall will take effect on Jan. 1, 2025. For people shopping for individual plans on the Health Insurance Marketplace, enroll by Dec. 15 for active coverage on Jan. 1.
Here are a few tips to consider when choosing a plan that may help lead you to better health and cost savings:
- Plan ahead.
Take time to understand the benefits, services and costs of plans available – including what might have changed with your current coverage. Pay attention to more than just the monthly premium, also understanding what out-of-pocket costs like deductibles, co-pays, and co-insurance you may be responsible for.
Medicare members and caregivers: As you weigh your options, assess the differences between Original Medicare and Medicare Advantage.
- Help prevent unexpected costs.
Check if your doctor is in your plan’s provider network, since visiting in-network providers can help reduce out-of-pocket costs. Make sure your medications will be covered next year by the plan you choose. And consider filling your prescriptions at an in-network pharmacy or with home delivery – more cost-efficient options.
Original Medicare doesn’t generally cover prescription drugs. Consider enrolling in a Medicare Advantage plan with prescription drug coverage to help keep medication costs in check.
- Explore mental health coverage.
Beyond in-person mental health care, you may have access to a virtual network of therapists and psychiatrists, along with advocates to help find the right behavioral care or resources. Medicare members and caregivers: Look for plans that offer virtual mental health care with a zero co-pay.
- Look into specialty benefits.
Additional benefits, such as dental, vision, hearing, or critical illness insurance, are often available and may contribute to overall well-being. Original Medicare doesn’t cover most dental, vision and hearing services, but many Medicare Advantage plans do.
- Consider wellness programs.
Many health plans offer incentives for taking healthier actions, like completing a health survey or exercising. Others provide personalized support to those living with common chronic conditions like Type 2 diabetes. Medicare members and caregivers: Many Medicare Advantage plans offer gym memberships and wellness programs for members at no additional cost.
Gary Daniels is chief executive officer of United Healthcare of Washington.