Bella Terra Primary Care Blog

Open Enrollment: 3 Things You Should Consider

Written by BTPC | Oct 20, 2021 4:00:00 PM

Open enrollment is a great time to evaluate your anticipated health needs for the upcoming year. There are several reasons why you may be considering changing or modifying your health plan—including qualifying life events, changes implemented by your employer, or plan changes made by the insurance provider. Even if you’re already enrolled in a health plan and you’re happy with your coverage, you should take a few minutes to double check your benefits and available options before the enrollment period ends.

 

Selecting a health plan that’s right for you and your dependents will ensure that you get the coverage you need at a price that fits your budget. Unnecessary coverage may mean you could be overpaying, while insufficient coverage may end up costing you more if out-of-pocket expenses come up. The following are three questions you may want to consider during each open enrollment season.


1. Was I Happy with My Coverage Last Year?

Did your coverage meet your needs? Were you able to choose a doctor you like? Most people auto-renew their health plan and face the same frustrations they do every year as a result. If you experienced excessive out-of-pocket costs, limited provider options, or customer service hassles, now is the time to look into other options.

 

2. Do I Anticipate Any Major Changes or Events Next Year?

First, consider age-related changes. If you’re in your 20s, you may have been on your parents’ health insurance, but once you turn 26, you will age out and need to get your own health coverage. Similarly, if you’re turning 65, you will likely be eligible for Medicare.

It’s hard to anticipate health changes that will occur over the next year. If you are planning a pregnancy, changes to dependents, or any major surgeries next year, you can expect increased expenses as well. Factor this into changing your health plan if needed to accommodate the additional costs.


3. Changes in Plans/Providers

When it comes to health plans, there are individual plans and employer plans. Each option has their own benefits and drawbacks. When it comes to changes in the plans and providers offered, however, employer-paid group plans limit your options.

If you have purchased a personal health plan, changing your health plan or health provider is relatively easy. If you’d like, you can work with an insurance agent to help go over different plan options and costs to find the best fit for your needs.

An employer-sponsored health insurance policy presents you with a chosen provider and selected plan options. You may not be able to change providers, but you can still evaluate your plan options.

 

When evaluating health plans, you may see differences in more than just the premiums. Look into differences in deductibles, coinsurance, and copayment amounts. Consider your overall out-of-pocket costs for each plan and the likelihood that you will meet those maximums, especially as the amount you spend on health care may change from year to year. You can add up the costs of the different plans to find one that is better for your situation.

 

Your health needs will change every year. While you cannot anticipate the unexpected, you can evaluate your current health plan and make any necessary changes you need when open enrollment is available to you.  If you’re interested in receiving care at Bella Terra Primary Care under the service of Dr. Karki, we take the following health insurance options:

  • Optum (formerly Healthcare Partners)
  • Monarch
  • Medicare
  • Aetna PPO
  • Cigna PPO
  • Healthnet PPO
  • Anthem Blue Cross PPO
  • Blue Shield of CA PPO

 

For more information, please contact our offices at (714) 248-9068.