One of fall’s annual events that has yet to be taken over by the greeting card industry is the time between Halloween and Thanksgiving. “What happens during that time?” you might ask. Why, it’s open enrollment period for health plans!
If that last sentence made you groan, you’re not alone.
Picking a health plan is one of the most important decisions we make each year, but most of us spend more time researching appliances, automobiles and even our phones than we do health insurance.
The exact dates of your open enrollment period – the time when you can select and make changes to your health insurance plan – vary depending on where and how you get your insurance. That said, open enrollment periods commonly occur toward the end of the year. A good rule of thumb to follow is that if the leaves are falling, it my be time to think about health insurance.
Open enrollment for individuals and families purchasing insurance on HealthCare.gov began Nov. 1, 2016 and continues until Jan. 31, 2017.
Similarly, those receiving insurance through Medicare have from Oct. 15, 2016 to Dec. 7, 2016 to make selections for 2017.
Finally, if you get health insurance through your job, be sure to check with the human resources department to find out the key dates and deadlines for your company’s open enrollment. Some businesses don’t follow a calendar year for their health plan, meaning you may be asked to pick an insurance plan at a time other than the end of the year.
No matter when your open enrollment period occurs, confusing insurance terms and jargon can make it difficult. At Anthem Blue Cross and Blue Shield we’re working hard to make our materials easier to read so you can make better, more informed decisions. Still, it’s a good idea to know a few commonly used insurance terms:
- PREMIUM: This is the amount you pay the health insurance company each month. If you get your health insurance through your job, this is likely automatically deducted from your paycheck.
- DEDUCTIBLE: This is the amount you have to pay before your insurance starts paying for portions of your medical care. For example, if you have a health insurance plan with a $1,500 deductible, you’ll be responsible for paying the first $1,500 of your health care expenses before insurance starts to help pay the bills.
- COINSURANCE: This is the percentage of the costs you are responsible for paying after your deductible is met. Example: You’ve already paid your deductible for the year, but your health insurance plan requires you to pay 20 percent coinsurance. This means that if you have a $10,000 surgery, you’ll be responsible for 20 percent of the bill ($2,000) and your insurance would cover the remaining 80 percent ($8,000).
- PROVIDER: Generally speaking, this term always refers to the person, facility or health system providing a medical service or care to you. Your primary care doctor is a provider, as is the urgent care facility you visited, and the hospital where you had your tonsils removed. If you get confused by the term “provider,” try replacing it with “doctor” and that will often help make things easier to understand.
- NETWORK: Your “provider network” is the doctors, hospitals and facilities you can visit and get the full benefits of your health insurance. Visiting an “out-of-network” doctor or facility may not be covered by insurance, meaning you could be personally responsible for the whole bill. Check your health insurance plan’s website for details or call the toll-free number on your insurance card if you have any questions about your network before seeking non-emergency services.
We hope this short list of terms clarifies some common jargon and gets you off to a solid start this open enrollment season: as a consumer-focused company, Anthem Blue Cross Blue Shield understands that health insurance is an investment, and you deserve the tools to make the most of it. Above all, never be shy about asking questions. If you’re confused about health insurance terms or a given plan’s provisions, consult your HR department, insurance broker or trusted adviser before making a selection. Picking a health insurance plan should be an educated choice, not a game of chance.
Additional resources to prepare for 2017 Open Enrollment:
- Healthcare.gov – This website provided by the federal government includes a glossary of insurance terms, as well as instructions on how to pick a health plan and buy health insurance using the Health Insurance Marketplace.
- Medicare.gov – The official site of the Medicare program, this is a one-stop shop covering all things Medicare, as well as how to sign up or change your Medicare plan.
- MyHealthPlan.guide – A joint effort between America’s Health Insurance Plans and the National Consumers League, this website allows you to select a topic from pull-down menus to quickly find easy-to-understand information. The site also features a “Resources” tab with handy tools and tips, such as a printable list of questions to ask your doctor if you are prescribed a new medication.
- The Benefits Guide – Created by Anthem Blue Cross and Blue Shield, The Benefits Guide provides information on workplace wellness strategies as well as tips for selecting insurance benefits that meet you and your company’s unique needs.