SALT LAKE CITY — Selecting a health insurance plan during open enrollment can feel overwhelming, but a few key steps can help you make the right choice for the year ahead.
If you've shopped for a health plan recently, you know how confusing it can get. Whether you're navigating open enrollment at work, comparing marketplace plans, or signing up for Medicare, the decisions can pile up fast.
So what should you be looking for? Dr. Mike Woodruff, executive medical director at Regence BlueCross BlueShield of Utah, shared tips to make the process easier.
What is open enrollment?
Open enrollment is a limited window — usually a few weeks each year, often in the fall — when you can change your benefits and elect new options in your health coverage. Outside of that window, you're generally locked in for the rest of the year, which is why it is important to know your deadlines.
Know the key terms
Woodruff said the best way to cut through the confusion is to ask for help.
Your employer, the individual exchange, and Medicare all have resources to help you understand what the terms mean.
Important terms to understand include your monthly premium, copay, coinsurance, deductible and out-of-pocket maximum.
Another key term is "network."
Networks are groups of physicians and health care systems where insurers have negotiated contracts, often meaning lower costs for you.
Knowing who is in and who is out of your network is important when choosing a plan.
Don't just pick the cheapest premium
The lowest premium isn't always the best plan.
A low premium usually means you'll pay more when you need care, while a higher premium can offer more predictable costs throughout the year.
"If you're paying a low premium, it probably means you're going to pay more when you need care," Woodruff said. "People sometimes like to have a higher premium because it makes a more predictable cost throughout the year and you're not stuck with a bigger bill one month when you need care."
Navigating Medicare
For seniors, Medicare can be especially confusing, with Part A, Part B, Part C, Part D and supplemental coverage.
Woodruff said no one should be expected to figure it all out on their own.
You can initially sign up when you turn 65 — three months before and three months after — but there's also an annual open enrollment period that typically begins in October and ends December 7.
Each state has a State Health Insurance Assistance Program, known as SHIP, which is available at no cost to you.
Medicare.gov also offers a wide array of online resources to help you understand your options.
Watch out for scams
Woodruff warned that scams often target seniors. If you get an unsolicited call, it's most likely a scam.
"Medicare almost never calls you," Woodruff said. "Note the call and then call the number you know is right for Medicare and say, 'Hey, were you trying to get in touch with me?' because the scams are really taking off and we want to avoid those as much as we possibly can."
His bottom line: Don't be afraid to ask questions if you have them.
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