Five tips for navigating open enrollment

Posted at 10:20 AM, Oct 11, 2012
and last updated 2012-10-11 12:20:53-04

By Dr. Wendy Shanahan-Richards, Special to CNN

(CNN) — This fall, millions of Americans will be making an important decision that will affect their health care — and it has nothing to do with the presidential election.

Soon, many employers will ask people to select their 2013 health benefits — a challenging decision for even the most empowered patient.

In fact, Aetna’s Empowered Health Index Survey found that Americans rank choosing health benefits as the second most difficult major life decision behind saving for retirement.

Even though people found choosing health benefits to be more difficult than choosing a car or even parenting, there are some simple tips to follow that can help make the process easier.

Know the basics

You probably don’t have time to become an expert on every aspect of health insurance over the next few weeks.

However, if you can learn some of the basic terms about health insurance — such as “deductible,” “co-insurance,” “premium,” “in-network,” “flexible spending account” and “health savings account” — you will be in a position to make a more informed decision on your health benefits this year.

Take charge of your health and health care

It’s impossible to know what all your health care needs will be for the coming year. You can, however, be proactive and make a list of those health care products and services you use regularly.

The list can include prescription medications as well as planned surgeries or health care procedures.

Not only will tallying these costs help you pick the right benefits plan, it will also help you budget effectively for your health care in 2013.

Understand the costs of your benefit plan

Cost is likely one of the biggest factors that will affect your health benefits decision. It is important to understand all of the costs associated with your plan — not just the plan premium but also out-of-pocket costs such as deductibles and co-insurance.

Many consumers don’t monitor their own costs closely. Four in 10 consumers rarely or never track how much they spend on out-of-pocket health care costs, the Aetna survey found.

Many insurance companies offer their members tools that can help them better understand their health care costs and save money.

It’s also important for you to understand who is in your network. Visiting health care providers inside of your health plan’s network can result in lower out-of-pocket costs. Another good idea is to call your health care provider and ask for cost estimates ahead of a visit if your insurer does not provide a cost calculating tool.

If your life is changing, benefits may need to change, too

If you have had a major life change — marriage, a birth or retirement — you will need to adjust your health benefits plans accordingly. For example, after marriage or the birth of a child, you typically have 30 days to add your new family member to your plan.

Even if your life is pretty steady, you shouldn’t just stick with the same plan without doing some research. While your life may not have changed, there may be changes to your benefits plan, so it is important to evaluate your plan options carefully.

Start early

Just like any important assignment, you need to know the deadline for making your decision. Give yourself plenty of time to choose your benefits carefully before the deadline arrives, or you could be scrambling to make a rushed decision the night before.

Your employer should have details on your specific health benefits plans, and you should feel comfortable asking questions if you have them.

Editor’s note: Dr. Wendy Shanahan-Richards is a family physician, the co-author of “Navigating Your Health Benefits for Dummies” and national medical director for Aetna.

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