Choosing A Health Insurance Plan During Open Enrollment? Some Tips For Picking The Right One For You

posted by AHIP

on October 19, 2017

No matter what your age, shopping for health insurance can be a tricky task. Between deductibles, premiums, co-pays—understanding what those benefits are and how they factor into your coverage can make a difference when it comes to choosing a plan. With Open Enrollment just a few weeks away, consumers are already starting to think about insurance choices for next year.

That’s why AHIP and the National Consumers League (NCL) are working together to make choosing and using health insurance easier. This starts by providing clear, straightforward information about insurance benefits, including provider networks, deductibles, and cost sharing, so that consumers can select the plan that works best for them and their needs.

Here are a few tips to help consumers get started –

  • Make a list of monthly health expenses: Knowing how much you pay for health care on a monthly basis will make it easier to compare different insurance options based on your own experience and needs. Make sure to account for any routine doctors’ visits, prescriptions, and the cost of your current insurance coverage. Make a note of what you may pay out-of-pocket for those services now. And importantly, what the list price of these would be without insurance.
  • Look beyond the Monthly Premium: Health plans design a range of coverage options, so it’s important to consider more than just the monthly premium cost when selecting a plan. Consumers that prioritize paying a lower monthly premium will likely select a coverage option that has a smaller network of providers and hospitals. They also may be willing to pay more out-of-pocket for medical services upfront.
    Some consumers would rather pay less out-of-pocket for their medical care, so they will choose a higher monthly premium to cover more services and benefits. More comprehensive coverage will likely include a broader network of providers and hospitals and also lower cost-sharing for medical services. Understanding your individual health and financial needs will make it easier to prioritize the benefits that are most important to you.
  • Know the preventive services and benefit mandates included with your plan: All health plans cover a range of preventive services, including recommended vaccines and annual physical exams, without any additional out-of-pocket costs. Individual states may require additional benefits to be included as part of coverage. Check out your health plan’s summary of benefits and coverage options for the list of services covered under each plan.
  • Check that your providers and prescription drugs are covered: Before selecting a health insurance plan, make sure your health care providers and prescription drugs are covered. Health plan provider directories are available online and customer service representatives can also provide information about in-network providers. Same for prescription medications. But it’s important to know that providers and pharmaceutical companies may change the prices they charge over the course of the year. That can impact how much you pay for your doctor’s visit or a particular medication. If your provider leaves a plan network or coverage of a prescription drug changes, contact your health plan to hear more about transition plans to help make sure your care is not disrupted.

Visit and learn more about AHIP’s and NCL’s efforts to inform, educate, and engage consumers.

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