Open Enrollment: 10 Questions to Ask Yourself Before Choosing Health Insurance

Written By: Michael Dollar

Date: November 29, 2016

Open enrollment through the healthcare marketplace began November 1 and runs through January 31. For many companies, open enrollment is also taking place over the next few months. If your employer provides benefits, you’ll need to know if there are any new plans and whether or not you should make changes to your current plans. Smaller companies may opt to let employees choose individual plans.


For retirees, Medicare’s Annual Enrollment Period (AEP) began Oct. 15 and ends Dec. 7th. If you’re a Medicare beneficiary, this is the only time you can change your coverage (other than a few exceptions).


Whether you’re choosing an employer-sponsored plan, a Medicare plan, or a private plan (on or off the marketplace), it’s a good idea to first review your current plan, so you can make informed comparisons with new options. Paying attention to your benefits options can help you save money and get the coverage you need.


If you currently have coverage, consider: What did and didn’t work this year? What were your out-of-pocket costs this year, (including premiums, co-pays, deductibles and payments for non-covered expenses)?

To choose the benefits that best suit your needs, ask yourself these 10 questions:


What medical costs will I have to cover out of my own pocket?

Even with insurance, an expensive medical event such as an accident or serious illness can put a strain on your finances. And with deductibles, copays and coinsurance amounts rising, it’s more important than ever to make sure you know what costs you’ll be responsible for.


Does the plan cover any non-medical expenses?

Especially in the case of a major accident or illness, non-medical expenses like transportation, childcare and lodging can easily add up – as well as the amount of lost income from missing work. Make sure you know how much, if any, of these costs will be covered. You may want to consider supplemental insurance such as a critical illness policy, which would pay a lump sum cash benefit in case of a covered event.


What if I lost my income due to a disability?

If you become injured, would you be able to manage without your income? If so, for how long? Consider coverage for both long-term and short-term disability, which provides a percentage of your pay for a specific period of time.


What’s the medical history of myself and my family?

Do you or immediate family members have current or past health concerns that could present problems in the next year? If you expect you might have major medical needs, such as surgery, medical equipment, pregnancy, etc., review how those expenses would be covered by your plan, and decide if you should opt for additional coverage. For example, hospital indemnity insurance provides benefits in case of hospitalization.


What about your family medical history? If you have a family history of health issues like cancer, heart disease or high blood pressure, you may want to add cancer or critical insurance to make sure you’re covered.


What doctors can I see?

If you have specific physicians you see, check to see if they’re included in your plan’s coverage. Are they in-network or out-of-network?


What medication needs will I have?

Be sure to understand how a plan will cover any medication costs. Check out the plan formulary to see what cost tier any current or expected medications fall under.


Are you at risk for injury?

If you or a family member have an active or athletic lifestyle, you may be at a higher risk for injury. For example, if you have a son who plays football, how would any possible injuries be covered by your insurance? And would you need additional coverage like accident insurance to help pay for medical bills and out-of-pocket costs?


Do I need dental and vision insurance?

Consider your annual costs for dental and vision needs – from annual check-ups to any anticipated issues. Now compare those expenses to the cost of coverage for dental and/or vision coverage. And be sure to review what’s covered under these plans – especially if you know of specific treatments or care that will be needed such as orthodontics or lasik surgery.


How does age affect my insurance needs and rates?

Health risks are typically lower at younger ages, so certain types of insurance will be more affordable. If you’re getting older, both the need and the cost for coverage can increase. Be realistic about your aging health and make sure you’re covered – it may be more affordable than you think, especially at group rates.


Do I need life insurance?

If someone is counting on your income, life insurance can ease the financial burden in case of your death. If you already have life insurance, should you increase your level of coverage?


Asking these questions and selecting the right plans can help protect you and your family from potentially devastating financial issues. And if you’re an employer, helping your employees prepare for open enrollment and get the coverage they need can make a huge difference in their lives – both on and off the job.


We know that addressing these insurance needs – whether as an employee, individual or employer can be overwhelming. We’re always here to help with insights and affordable coverage options. Just give us a call: 800-432-2997.


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