How to get the most out of health care open enrollment

Tips for choosing the best insurance coverage for you and your family

Open enrollment is an opportunity to weigh choices over your health care coverage, however, surveys have found that at least half of employees don’t understand their open enrollment options.

Sadly, researching open enrollment options is one of the last things people are interested in doing — so much so that 90% of people in one survey said they just re-up their benefits from the prior year.

Here’s a more methodical approach to open enrollment season:

1. Look at what you and your family actually spent on health care in the past year

Using this as a benchmark, ask yourself if you expect things to stay the same or do you anticipate it changing whether it be due to a recent diagnosis, upcoming surgery or possible pregnancy. If expensive medical care is in the near future for you, you might want to consider a lower deductible — the amount you have to pay out of pocket before your insurance begins to pay.

2. Calculate each plan option

Do the math when it comes to the annual amount you pay in premiums compared to the plan’s deductible, co-insurance, co-pays and out-of-pocket maximum. It may be worth paying more in premiums for different coverage depending on your situation.

3. Check if your doctors and preferred health-care facilities will be in your insurance network

This affects if they’re covered and how much. Also be sure to find out whether the medication you already take are covered, ideally on what is referred to as their preferred formulary. If they’re not, those prescriptions could cost significantly more.

4. Take advantage of any health saving or flexible-spending account

This especially applies if you have predictable expenses. You can do this to set pre-tax dollars aside to cover medical costs.

If your insurance choices are through your employer, don’t be afraid to talk with your human resources department to navigate your individual situation.

This process takes time, but it can save you money and stress in the new year.


About the Author:

Dr. McGeorge can be seen on Local 4 News helping Metro Detroiters with health concerns when he isn't helping save lives in the emergency room at Henry Ford Hospital.