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As millions of Americans now evaluate their health plan options during this fall’s open enrollment season, a new survey finds that three in five Americans incorrectly defined key healthcare terms. This knowledge gap may result in less-than-ideal selections, which could cause you to miss out on plans that might better suit your needs and offer potential cost savings.
For people with coverage from their employer, open enrollment typically happens during a two- or three-week period between September and December. For those eligible for Medicare, the Medicare Annual Enrollment Period runs from Oct. 15 to Dec. 7 each year.
Coverage selections made during the fall will take effect on Jan. 1, 2025. For people shopping for individual plans on the Health Insurance Marketplace, open enrollment begins Nov. 1 and ends Jan. 15, 2025, in most states. Enroll by Dec. 15, for active coverage on Jan. 1, 2025.
This is a crucial time to select optimal health coverage. Here are a few tips to consider when choosing a plan that may help lead you to better health and cost savings:
Plan ahead: Take time to understand and compare the benefits, services and costs of plans available to you – including anything that might have changed with your current coverage.
Pay attention to more than just the monthly premium, also understanding what out-of-pocket costs, including the deductible, copays and coinsurance, you may be responsible for.
Medicare members and caregivers: As you weigh your options, assess the differences between Original Medicare and Medicare Advantage. If you need a review, visit MedicareEducation.com — an online resource with answers to questions about eligibility, plan choices, prescription coverage and more.
Get to know the terms: If you’re overwhelmed by healthcare language, there are resources to help. As a start, check out the Just Plain Clear Glossary (in English, Spanish and Portuguese) at www.justplainclear.com/ to help you make informed decisions.
Medicare members and caregivers: There’s a lot to learn about Medicare and Medicare Made Clear (https://www.medicaremadeclear.com/) can help you understand the basics, the complexities and everything in between.
Help prevent unexpected costs: Before choosing a plan, check if your doctor is in your plan’s provider network, since visiting in-network providers can help reduce out-of-pocket costs. Make sure your medications will be covered next year by the plan you choose – even if you don’t expect to change plans. And consider filling your prescriptions at a participating network pharmacy or with home delivery – both of which are more cost-efficient options. You can also look for plans specifically designed to help you better manage health care costs.
Medicare members and caregivers: You may be surprised to learn Original Medicare doesn’t generally cover prescription drugs. Consider enrolling in a Medicare Advantage plan with prescription drug coverage to help keep your medication costs in check.
Explore mental health coverage: In addition to in-person mental healthcare, you may have access to a large virtual network of therapists and psychiatrists. Some health insurers also have specially trained advocates available to help members find the right type of behavioral health care or resources.
Medicare members and caregivers: Look for plans that offer virtual mental healthcare with a $0 copay.
Look into specialty benefits: Additional benefits, such as dental, vision, hearing, financial protection or critical illness insurance, are often available and may contribute to overall well-being.
Medicare members and caregivers: You may be surprised that Original Medicare doesn’t cover most dental, vision and hearing services, but many Medicare Advantage plans do.
Consider wellness programs: Many health plans offer incentives for taking healthier actions, such as completing a health survey, exercising or avoiding nicotine. Others provide real-time insights and personalized support to those living with common chronic conditions like Type 2 diabetes.
Medicare members and caregivers: Many Medicare Advantage plans also offer gym memberships and wellness programs for members at no additional cost.
Embrace digital capabilities: If you’re busy or prefer connecting with a doctor from the convenience of your home, consider a plan that includes 24/7 virtual care. Digital enhancements have also helped ease in-network provider search and cost comparison.
Digital health solutions for everything from wellness visits to weight loss and maternal healthcare are often available in one place – so be sure your plan offers these capabilities.
Medicare members and caregivers: Older adults are more digitally savvy than ever, and health plan apps can enable everything from reviewing claims to accessing rewards to refilling prescriptions.
Warren Murrell III is CEO, UnitedHealthcare Medicare & Retirement Plans of Florida.
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