These strategies could make your open enrollment a breeze

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Open enrollment: how to choose the best insurance coverage for your family

Open enrollment can feel intimidating — especially if your family’s needs for healthcare are changing.

Here are a few strategies that can make choosing health insurance for the next year a little easier.

1. Start planning early. Will you take part in your employer’s open enrollment period? Are you signing up for Medicare? Do you want to find coverage in the individual marketplace? Give yourself time to get clear about what’s important for your coverage choices. 

2. Understand your deadline. Many people, including those on Medicare, need to a make decision about insurance in the fall for coverage that’s effective for the next calendar year. 

3. Review past claims. Look at the types of claims paid last year. Past claims often give you an idea about what future claims you might have. Categories might include things like: 

  • Office visits
  • Medications
  • Surgery or procedures
  • Eyeglasses, hearing aids or other devices
  • Therapy visits

4. Think about next year’s needs. Do any of the following apply?

  • Is someone in your household planning to have a baby?
  • Is elective surgery on the horizon? 
  • Did you get a new diagnosis that needs specialized care? 
  • Do you have any existing chronic conditions that will require continual care?
  • What medications are you needing?
  • Are you due for any routine procedures, like a screening colonoscopy for colon cancer? 
  • Do you need new glasses or hearing aids? These can make a difference in how you look at what insurance will best meet your upcoming needs.

5. Use available tools. Many insurance or open enrollment websites offer tools to help you get a clear picture of your total costs. That way you know what you’ll pay in premiums (the price you pay for your insurance) every month plus deductibles and copays (the costs you pay when you use healthcare services). For example, PeaceHealth’s MedicareOnDemand page includes resources to help you compare Medicare plan options.

6. Get familiar with terms. Insurance can be confusing. Get acquainted with common words you’ll encounter. And review the difference between things that sound alike but work different such as:

7. Talk with others. You can learn from friends and family members who have experience with different types of plans or carriers. Insurance agents, health plan staff or your benefits team at work can also help guide you through the process.

If you’re interested in a Medicare plan, you can connect with highly trained licensed insurance agents that represent PeaceHealth’s accepted Medicare plans. Call our Medicare Insurance Helpline toll-free at 866-391-7750, TTY 711 or visit our MedicareOnDemand resources.

8. Identify your priorities. It would be great to get everything you want in a plan — high benefits, low premiums, low cost-sharing and the ability to see your existing provider. Sometimes you have to make trade-offs. Your ultimate choice might come down to what’s most important to you. These questions can help you narrow that down: 

  • Do you want to stay with a specific provider? This often means making sure your provider accepts your insurance and that your plan covers their specialty.
  • Do you want to be sure a hospital or other local facility is part of your network? This will be an important consideration if you expect to have any procedures next year.
  • Do you want to keep premiums low? If you don’t need much care and don’t have a preferred provider, this can save you money. Just know that it may come with more cost-sharing such as a higher deductible when you use services.
  • Do you want low cost-sharing when you get care? If you’re on regular medications or see a provider frequently, this option can help you know how much you’ll pay each time you use a service. However, this feature could mean you’d have higher premiums.
  • Do you want certain types of benefits?  Plans typically cover standard types of care, but there might be different levels of service. For example, you might get more visits under one plan than with another.
  • Does your plan’s drug formulary (list of covered medications) include the medications you need? If you’re on a pricey medication, see how much you can expect to pay for it. Sometimes formularies require you to use a generic version to have it paid for.

You can check the list of insurance plans that cover services at PeaceHealth hospitals and clinics here:

At PeaceHealth, we care for everyone, regardless of their ability to pay. If you need help, please let us know. We offer financial assistance (sliding fees) based on family size and income. 

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