Open Enrollment Health Insurance Mistakes to Avoid

The health insurance choices you make during Open Enrollment have a lasting impact. The decisions you make this year may take effect for the next 365 days. Unfortunately, many individuals make hasty choices or place too much focus on monthly premiums, and pay for it later. Learn about some common Open Enrollment mistakes to avoid so you can select the right coverage for your family.

Why Open Enrollment Matters 

The first step to enrolling the right health insurance plan during Open Enrollment is understanding why it matters. Health insurance is not a “set it and forget it” matter. Provider networks, prescription drug coverage, co-payments, and premiums can change every year. Last year’s plan may not be available, or may not be your best option.

Individuals who do not take the time to evaluate their health insurance each year end up with the same policy again by default, whether it is a good fit or not. The result of this mistake can be paying for a health insurance plan that is too expensive, or not using it enough to be worth the cost.

The good news is, that Open Enrollment provides one opportunity per year to make changes to your health insurance coverage without a qualifying event. Your family’s health care needs may have changed in the past year. A job or income change could have made a different plan more affordable. Evaluating your options during Open Enrollment is the best way to adjust your coverage when necessary.

Neglecting Health Care Needs 

It is human nature to focus on today instead of the distant future. The obvious mistake during Open Enrollment is to only consider your current health status when selecting a health plan. Coverage tiers are often tied to how much you anticipate using health care services.

A lot of people believe that if they are healthy now, nothing will happen to change that and their current plan will be sufficient. Unfortunately, many medical issues do not announce themselves and occur despite our best efforts. Choosing the cheapest plan only to find you need a service that it doesn’t cover can quickly become a bad decision.

A better approach to Open Enrollment is to evaluate your medical services realistically and not optimistically. Do you take prescription medications? Do you have a chronic condition that requires ongoing care? Ask your doctor for an honest appraisal of your health and use that to decide how much coverage you need.

Comparing Monthly Premiums Only 

Most people look at the monthly premium and determine their health insurance choice based on that. In some cases, this is not always the best strategy. In many cases, low premium health insurance plans cost more when you need health care services.

Compare the total cost of plans, including deductibles, coinsurance, and out-of-pocket maximums. Do the math on the potential costs in your budget. Paying less per month can sometimes mean paying more overall if you have ongoing medical needs.

While monthly premiums are important, they are not the only factor to consider. Balancing monthly costs with the expenses you face when you need care is a better strategy for most individuals and families.

Provider Networks and Prescription Drug Coverage 

It is also important to know the details of your health insurance plan and the health care services it covers. An all too common mistake is assuming your doctors and hospitals are covered without checking. Health insurance plans typically limit which providers will be covered. Visiting a doctor or hospital outside the network can be more expensive or not covered at all.

If you have preferred doctors or specialists, make sure they are in the network. Prescription drug coverage is another important detail that is often overlooked. Review the plan’s drug formulary to make sure your medications are covered and what tier they are in.

Invest a little time now to ensure you have access to the care you need later and that your medical costs are as expected.

Automatic Renewal 

Many people make the mistake of not shopping around for a new plan. They may automatically renew the plan they had the year before instead of making a decision during Open Enrollment.

This is a mistake because health insurance plans often change from year to year. Insurers sometimes make changes to benefits, premiums, or provider networks without telling policyholders until Open Enrollment arrives. It is up to individuals and families to make sure they are getting the coverage that is best for them every year, and review Open Enrollment notices carefully.

Seek Professional Help 

Navigating the health insurance system can be difficult. Terms like deductible, coinsurance, and out-of-pocket maximum are confusing. If you try to shop for health insurance on your own, it is easy to overlook details that end up costing you money or care.

Working with a licensed insurance agent or broker makes the process a lot easier. Bowthorpe & Associates Insurance Producer can work with you and your family to discuss your needs and coverages. We can explain complex details and help you compare plans side by side in an apples-to-apples way.

This guidance and assistance makes the Open Enrollment process much easier and help ensure your choices are the best for your family.

Special Enrollment Periods 

Most people who need to change their health insurance plans during the year have to wait until Open Enrollment to do so. There are certain life events that will qualify you for a special enrollment period. These life changes include marriage, the birth of a child, loss of other coverage, or a change in income.

It is important to know these options exist. However, it is a mistake to rely on them when making health insurance decisions. To qualify, you will need to prove the event happened with documentation. Deadlines are strict for these situations. Making changes during the annual Open Enrollment window is the safest and most predictable way to go.

FREQUENTLY ASKED QUESTIONS

What happens if I choose the wrong health insurance plan during Open Enrollment?

You will be stuck with that plan for the year, unless you qualify for a special enrollment period.

Should I change my plan every year? 

You don’t have to, but it’s a good idea to review your options to make sure your current plan is still the right choice.

Is the lowest premium plan always the best option?

Not necessarily. Lower premiums are usually offset by higher out-of-pocket costs when you get care.

Do health insurance plans change every year? 

Yes, they do. Premiums, benefits, provider networks, and drug coverage can all change every year.

Can I get help choosing a health insurance plan?

Yes, you can. A professional insurance agent or broker can help you compare plans and avoid common enrollment mistakes.