Open enrollment is a window of time when you choose or change your health insurance plan. It’s an opportunity to take a fresh look at your health coverage and ensure it meets your needs and budget.
Whether you get insurance through an employer or are shopping for coverage on your own, understanding your options can make the process easier and help you get the most from your benefits.
Don Truong, chief sales officer at Sharp Health Plan, shares his top five tips for getting the most out of open enrollment:
1. Compare more than the monthly cost
Review each plan’s premium, deductible, copays and out-of-pocket maximum. Also check which doctors, hospitals, medications and services are covered.
If you expect to see specialists, take prescription medications or need hospital care in the coming year, consider those needs when comparing plans.
2. Understand common insurance terms
Knowing the basics can make comparing plans less confusing.
• A premium is what you pay for insurance each month.
• Your deductible is what you may need to pay for services before your plan begins paying.
• A copay is a fixed amount you pay for certain services.
• The out-of-pocket maximum is the most you’ll pay for covered care during the year.
3. Choose a primary care doctor
Your primary care doctor is your point of contact for preventive care, health concerns and coordination with specialists. Consider their location, languages spoken, insurance accepted and whether their medical group includes any needed specialists.
Additionally, if you have a preferred hospital, choose a doctor who can provide or coordinate your care there when needed.
4. Look beyond medical coverage
If you receive benefits through work, review your entire package. Your employer may offer preventive care, telehealth visits, mental health services, wellness programs, fitness incentives, and health savings accounts or flexible spending accounts. These benefits can support your health while helping you manage costs.
5. Ask questions before enrolling
If you’re unsure which plan is right for you, Truong recommends contacting the health plan’s enrollment team. “The enrollment team can explain your options and answer questions about costs, coverage and provider networks to help you choose the right plan for your needs,” he says.
Sharp also offers an online open enrollment resource at sharp.com/choosesharp.
“Taking the time during open enrollment to compare plans and understand your benefits can help you move forward with the coverage and care you need,” Truong says.
