Use Open Enrollment to Choose a Plan That’s Right for You

There is a lot to consider when you’re choosing next year’s health plan during open enrollment. And as you get older, the factors influencing your decision will probably change. So, how can you make the best decision today? We’re here to help with a few tips based on where you are in your life.

If you are young or single:

If staying on your parent’s health plan is a possibility, it’s still a good idea to compare costs. It may be less expensive  to have your own insurance. To determine if the plan you’ve selected is the best value, it is recommended that you consider both the monthly premium and deductible. A high-deductible plan requires you to pay for most medical expenses until your spending reaches the plan’s deductible. For healthy, young adults, reaching your deductible amount can be tough to do. If you want to switch plans but want to continue seeing your current physician, ensure you choose a plan that lists your physician as in-network. 

If you are getting married: 

You and your spouse will have several options after you tie the knot. You could keep your individual health plans, one of you could join the other’s plan, or you could pick a new plan altogether. Start by comparing your health plans, including whether or not your doctors are in-network and what the premiums will be. If you’re in a high-deductible plan, adding a spouse probably means that you will jump from the “individual” deductible amount to the “family” deductible amount, which is often twice as high.

If you are pregnant or planning to become pregnant:

Take a look at your plan’s maternity benefits, including whether the providers and hospitals you’ve chosen for yourself and your baby are in-network. Once a child enters the picture, you’ll qualify for the “family” deductible, so check those costs for your plan. Your monthly premiums and co-pays may also increase after the baby is added to your health plan. If you can contribute to a Health Savings Account (HSA), now would be a great time to do that. You can save pre-tax income to use for future medical expenses. From prenatal care and childbirth to routine infant care, you can count on higher medical bills during this time in your life.

If you have children at home or in college:

Check to see whether your plan includes everyone’s doctors on their list of in-network providers. If you have a child who lives away from home, you’ll want to check the providers available in their area, too. While it’s not possible to be sure, predicting your likely healthcare expenses can help you estimate out-of-pocket costs, so that you can evaluate whether a lower-premium/high-deductible plan is really a better deal than a higher-premium/lower-deductible plan.

If you are an “empty nester”: 

If your child is younger than 26, you can choose to keep him or her on your health plan. If your child is covered by a health plan through their employer, it may make financial sense – for you and for your child – to drop him or her from your plan. Our best advice? Talk it over as a family. If you travel or live in a different place for part of the year, think through your care options in each location. For example, an open-access plan may cost more, but it comes with the benefit of being able to see any doctor you choose. 

Are you dealing with a chronic condition, like high blood pressure or diabetes? Figure in how much you expect your medical expenses to be using last year’s numbers as a baseline. Having a sense of your expenses helps you make an apples-to-apples comparison between plans with different premiums, co-pays, and deductibles.

You may have one or more prescriptions that you take regularly. Look at your health plan’s list of covered medications to see whether your medicines are covered.

If you are nearing retirement age:

In most situations, you don’t need to sign up for Medicare when you’re 65 if you’re still covered by an employer-provided insurance plan. On the flip side, you could go on Medicare at age 65 even if you’re still working and still eligible for an employer plan. Most doctors take Medicare, and the doctors on private health plans vary. Check to make sure that your doctors are in-network providers before switching health plans. You want great care, not just the cheapest possible plan, so make sure to compare all of your options. The highest-premium plan is not necessarily the best.

Also, consider what surgeries or procedures you might be planning in the next year. If you know that you’ll have surgery and will meet your deductible, it may make sense to choose a high-deductible plan with lower premiums. Finally, think about your comfort level. Although they can be a good way to save money, if managing an HSA or figuring out a new type of plan is not something you want to spend time doing, it’s okay to stick with what you know – as long as it is working well for you and meeting your needs.

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