Fall is the time of year when many people are in the midst of an open enrollment period for health insurance. During open enrollment, employers who offer more than one health insurance plan give their employees a chance to choose a new insurer.
Open enrollment is a time for employees to think carefully about health insurance options they may have available to them, according to Wisconsin Commissioner of Insurance Sean Dilweg.
“This is an opportunity for consumers to switch insurers if they are unsatisfied,” Dilweg said. “At the very least, people should be checking their current policy to see if it is still meeting their health and financial needs, and reviewing any new materials provided by their employer.”
The Office of the Commissioner of Insurance (OCI) offers the following tips for those who have an open enrollment option:
• Take time to evaluate the health care coverage you and your family are likely to need for the next year. Providers associated with health plans can change at any time, so make sure providers you want to see will continue to be available in your health plan.
• Make sure you understand any requirements your health plan has for referrals or prior authorization for services – they can vary among different plans.
• Consider your total cost for health care during the year. Higher deductibles can mean a lower cost for monthly premiums, but you will likely have higher out-of-pocket expenses at the time health care is provided.
• Compare benefits that may be available under the different options. There may be differences in benefits such as pharmacy, physical and occupational therapy or preventive care.
• Pay close attention to any dates for change documents to be filed with your employer.
• Do not be afraid to request information in writing from either the insurer or your employer.
Information is publicly available on quality for select health plans that consumers may want to consider. Many HMOs participate in national quality studies and these scores are available to the public. The OCI also publishes selected information in its brochure, Consumers Guide to Managed Care Plans in Wisconsin. This publication and more information is available on the OCI Web site at www.oci.wi.gov or by calling 1-800-236-8517.
