Mistakes to avoid when you switch health insurance plans

Health insurance 101

Whether you’re starting a new job, switching to a different company health plan, or joining your partner’s employer-sponsored health insurance, there are some things you should think about before changing your health insurance. Avoiding these blunders may save you some serious money...and your sanity.

Not exploring all your options during open enrollment

When choosing a different plan, it can be tempting to find the first one that “works” and to go with it. While it may save you some time, it could cost you later. Unlike other types of services, outside of open enrollment, only persons with a qualifying life event (recent marriage, a new baby, starting a new job, etc.) are entitled to a Special Enrollment Period”. That means if you find out later that the allergist or another provider you‘ve been seeing for years isn’t on your plan, you’ll have to either pay out of pocket or fall in love with a new allergist.

It’s important to reassess your health needs each year to ensure that your current plan or a new plan will provide adequate health coverage (and features you want and will use) at a reasonable cost. So do your homework and make a decision before the end of the open enrollment period.

Not getting any coverage

Here’s one thing you don‘t want to risk, switching from a health plan to no plan. Without health insurance, one illness, accident, or injury could rack up thousands of dollars in medical bills that you would have to pay out of your own pocket.

If your employer doesn’t (or no longer) offer health insurance, consider checking out the health insurance marketplace (healthcare.gov). You might qualify for a subsidy that could lower your monthly premium significantly. There are often several high-deductible health plan (HDHP) options with lower monthly premiums allowing you to pay less while still proving safeguards risk for paying substantial medical bills if something does happen. What’s more, many HDHPs enable you to use a health savings account (HSA), which allows you to make pre-tax contributions to an account that can be used to pay for certain eligible health care expenses.

Not checking the health benefit details

All health insurance plans compliant with the affordable care act (or ACA) must cover certain  such as:

  • Screenings (like mammograms)
  • Annual physicals
  • Routine prenatal and well-child care
  • Immunizations

But, what about the other details. Does your plan have copays from the start (usually true for low or no medical deductible plans) or do you have to spend a certain amount before healthcare coverage kicks in? Are your doctors on the plan? How about your family members’ providers? What is the prescription drug benefit?

Is the new plan an HMO, PPO, or EPO? Do you even know what those terms mean? Some plan types  allow you to use almost any doctor or health care facility. Others limit your choices or charge you more if you use providers outside their network.  

It is important to factor all of this into your decision when choosing or switching a health plan as it could equate to lower medical expenses throughout the year. Not sure about a plan detail? Contact your benefits manager or the insurance company and learn more.

Only considering health plans with low premiums

While lower premium plans may appear to be more attractive for those on a tight budget, it’s important to consider all of the health plan costs to understand what your likely out-of-pocket costs will be. How do you do that? Predict your possible health care needs (number of primary and specialty care visits) and your prescription drug costs and you’ll get closer to your total healthcare coverage costs. An important step is to consider how much you can afford to pay, both upfront and over time. Remember all ACA-compliant plans have out-of-pocket limits, which is the maximum you will pay in one given plan year.

Missing out on Decent health plans

Decent is in the business of helping small businesses take care of their people. An essential part of that is offering affordable health benefits that employees like and will use. As the only PEO around that built its own health insurance plan, we’re helping small businesses do just that. Don’t take our word for it. Email us at hello@decent.com to find out more or check out how much you’ll save with our cool savings calculator.

Welcome to Decent: a new kind of health plan.

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