Reviewing your health plan may not be high on your to-do list but open enrollment is around the corner, starting October 15 and there is more than one good reason why you should want to have an Annual Health Plan Review with your insurance agent.
Before we jump into those reasons let’s be sure we are on the same page and understand what an annual health plan review is.
What is an annual health plan review?
When it comes to health insurance, the National Center for Health Research writes, “Each year, health insurance companies make changes to their benefits, premiums, deductibles, and copayments. During open enrollment, you can enroll in a health insurance plan that fits your needs.”
During an annual health plan review, you will meet with your insurance agent and have a chat about your current life situations and she will make sure your health plan accommodates for any changes you have had since your last review. This allows you to have a policy that is just right for you and your unique needs.
We are going to touch bases on a few things you will want to consider during the review and why these things are important to find out before renewing your existing policy.
Keep in mind that meeting with your insurance agent for your review will include more in-depth thoughts and questions to help create the health plan that’s perfect for you!
Find out if your premium has changed.
Your insurance company will send you a letter via snail mail that goes over any changes to your health plan, premium, co-pays or deductibles. Review the changes and see if your premium has increased or decreased.
During an annual review of your health insurance policy, your insurance agent can chat with you to be sure you understand the changes and what they mean for you.
Understand what your health plan really will cost you.
While you’re confirming what your month to month premium bill will cost, you should also review the total cost of your health plan. That means learning the cost of these three things outlined at HealthCare.gov:
- Deductible: How much you have to spend for covered health services before your insurance company pays anything (except free preventive services)
- Copayments and coinsurance: Payments you make each time you get a medical service after reaching your deductible
- Out-of-pocket maximum: The most you have to spend for covered services in a year. After you reach this amount, the insurance company pays 100% for covered services.
Make sure your preferred healthcare providers are ‘in network.’
Most insurance plans require you to use specific doctors, hospitals, and pharmacies. They would be considered ‘in-network.’ If you use a healthcare provider outside your approved network—what the insurance company likes to call out-of-network—your insurance may pay for only a portion of the cost.
Do not assume any of your healthcare providers will be in your network next year. Be sure the doctors, hospitals, and pharmacies you prefer will continue to be in your health plan’s network. You can do that by calling your providers or insurance company. Most insurance companies have an online tool you can use to check, too.
Plan accordingly for upcoming medical expenses.
If you think that the amount of income you made and health will be about the same next year, you can just look at last year’s spending to judge your expenses for the new year.
However, if you are planning on a huge change, like have a baby, you can plan on increased expenses and can think about changing your health plan if needed to accommodate the additional costs you believe you’ll have
Perhaps your doctor has been recommending that you receive a surgical procedure such as joint replacement surgery. If you are planning on having any surgical procedures and have a surgeon in mind, now is the time to make sure that your preferred surgeon is in your health plan’s network of healthcare providers.
Keep in mind that after certain surgical procedures, physical or occupational therapy is often recommended. This is something to consider as you will want to make sure your health plan offers the type of therapy you need and doesn’t have a session cap that’s too low.
Now is the time to ask if any current treatments you receive will continue to be covered at the same price, too. Your insurance company will send information via snail mail informing you of any changes to your premiums, copays, deductibles, etc…Be sure to compare that to your existing coverage and make decisions accordingly.
Double check that your prescriptions are covered.
Assuming that prescription medications covered this year will be covered next year can be a costly mistake.
Conducting an annual health plan review gives you the opportunity to take stock of your current prescription medication and be sure they will continue to be covered.
You can give your insurance company a call and ask. Nowadays, most insurance companies have an online web tool you can use to find out what medications are covered.
Trust Us – You Need An Annual Health Plan Review
As everyone’s needs are different, there’s not a right or wrong choice when it comes to your health plan. Taking advantage of an annual review of your health plan – now THAT is always a right decision.
Enrollment is open for a limited time so don’t procrastinate on scheduling your review. If you decide to skip open enrollment, you are usually stuck with that choice until the next open enrollment which is usually a year later.
As a full-service, independent insurance agency, the insurance agents of Linc Financial Group take pride in our careful evaluations of your unique needs in order to find the most suitable health plan.
Allowing us to assist you with reviewing your health plan during open enrollment will help save some money in your pocket while getting the health coverage that you need.
After your review, you will leave with a sense of understanding and be armed with a knowledge of your health plan to help you make the best decisions for your healthcare next year.
Sources
Health Insurance: It’s Open Enrollment Season – Now What?. Retrieved from http://www.center4research.org/health-insurance-open-enrollment-season/
5 Questions to Ask Yourself During Open Enrollment. Retrieved from https://www.hccmis.com/blog/insurance/5-questions-to-ask-during-open-enrollment/
