Tips for Navigating Open Enrollment

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Friday, December 4, 2015

When open enrollment season starts, you'll be making important decisions about your and your family's health care coverage for 2016. Navigating the details can be tricky. Here are some factors to consider and questions to ask during the open enrollment process.

  • Know your needs. Do you have a chronic condition, or is your family relatively healthy? Where will you go for care in an emergency and will you be able to cover the expenses? Choosing a plan that covers your known and unexpected needs requires careful consideration of costs and benefits.
  • Consider family changes. Do you have a child going to college out of state or studying abroad next year? Is there a new job on the horizon for a spouse or a new child entering the family? These factors can influence the type of coverage you choose.Know what's covered. What services are important to you and your family? Do you have any procedures planned for the coming year? Review the services available through each plan, and determine the coverage that's available.
  • Identify your provider network. Different plans include different doctors. If you like a particular provider or hospital, you'll want to ensure they are in your network. Many insurance carriers now offer different tiers of coverage at different costs, so the same insurance may not cover the same network of doctors and hospitals.
  • Calculate your costs. In addition to your monthly premium, and annual deductible, you'll want to factor in out-of-pocket expenses such as copays for doctor visits and medications. Add up what you spent this past year so you can determine which plan works best for you and your financial situation moving forward.
  • Evaluate your health savings (HSA) and flexible savings account (FSA). Did you spend the money you put aside, or are there funds left over? HSAs and FSAs allow you to lower your taxable income by saving money for health care expenses before it is taxed. If you haven't contributed before, start with a conservative monthly allocation. If you have, consider whether your monthly savings met your needs or needs to be revised.
  • What other insurance do you need? In addition to health care coverage, you may be making decisions about dental care, vision care, disability insurance, and other types. Choose the insurance that meets your and your family's needs.Don't ignore open enrollment. Even if you are happy with your insurance, you'll want to review the details to determine what, if any changes have been made. Some companies may roll over your current plan into your next year, but others may not and you'll be left with no coverage.

Click here to see a list of insurance plans accepted at Duke