We spring from one season to the next as we cycle through the year. Oftentimes, we celebrate different seasons whether they be meteorological seasons, ski or hunting season, or the season we’re entering now: the holiday season. In all the hustle and bustle, there’s one season that is frequently overlooked: open enrollment season!
What is open enrollment? It describes a specific window of time every year - typically in the fall – during which we are able to sign up for health insurance, as well as adjust or cancel our current plan.
You may not have realized but open enrollment season is happening now! Much like hunting season, insurance companies are hunting for people, who need to make an individual decision on healthcare coverage for the following calendar year. If you are one of those individuals, be cautious of the promises insurance companies offer during this time. Recently, you may have noticed that during every commercial break, there’s an insurance company advertisement competing for your attention and ultimately, your enrollment. Some insurance companies even go to the extreme of buying TV show time slots to get more than 60 seconds of your attention, to convince you their healthcare coverage is the best in the market. I encourage you to listen closely and question the promises made to entice your decision.
What promises might sound too good to be true? In a nutshell, any promise that makes you think you will have limited to no upfront out-of-pocket expenses such as no monthly premiums, no co-pays, no annual deductible, and expanded coverage of services, including free gym membership, dental and meal coverage. Healthcare services are not sustainable without a cost to the provider or the patient, so while you may not have to pay much upfront, you will likely bear a substantial burden of financial responsibility after receiving treatment for a service that’s either not covered at all, or not largely covered by the insurance company. Under such a plan, healthcare expenses could overtake a large portion of your living expenses in the following year when unexpected services such as outpatient therapies that require multiple visits are necessary.
Look beyond the bells and whistles and focus your attention on selecting a healthcare insurance plan that actually offers the healthcare coverage you need. A good place to start is to answer the following questions for each of the plans you are considering enrolling into.
- Does this plan require a co-pay for each service or only certain ones?
- How much will the insurance company cover on my behalf?
- What services will be covered in this plan?
- Is there an out-of-pocket maximum?
Once you determine which insurance company fits your healthcare needs and your financial capabilities, continue to be your own advocate as you enter the new calendar year. It is impossible to look into the future to determine what you will need; if you get denied insurance coverage, or you aren’t happy with your current plan, remember that open enrollment season will happen again next year.