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What Does Open Enrollment for Healthcare Mean?

The open enrollment period is from November 1, 2020, through December 15, 2020 for 2021 plans.

Open enrollment happens every year, but do you know how to select the right health insurance plan? There is no “best” plan. Depending on your health needs, life circumstances, and budget, there is a plan that is the best fit for you.

There are many things to consider and questions to ask when picking or changing health coverage.

Let us start with the basics- what is open enrollment? Open enrollment is a period of time each year when eligible people can sign up for health insurance. For 2021 health insurance plans, the open enrollment period is from November 1, 2020, through December 15, 2020.

During this period, you should consider how well your current plan fits your requirements. Does it cover the services you want? Does it cover your prescription drugs? Work with Medicare? Have there been life changes to consider as a marriage, birth of a child, or a death in the family? After current coverage has been considered, it is time to review the different choices a new plan will offer.

Choosing the Best Health Insurance Plan

There are generally three kinds of health insurance plans to pick from- health maintenance organizations (HMO), preferred provider organizations (PPO), and point-of-service plans (POS). Selecting one of these types of plans is different for everyone.

• An HMO requires consumers to use physicians within a specific network, which is less flexible but typically at a more affordable cost.
• A PPO allows customers to stay in-network or go out of network. This means higher fees and out-of-pocket costs, but more flexibility.
• POS plans combine components of HMOs and PPOs. Customers have the option to go out of network, but a primary care physician will need to be chosen in-network. A primary care doctor will make referrals to specialists.

Depending on your needs, the kind of plan that fits best will vary. If you have an established relationship with a physician and where the doctor’s office is situated could impact your decision.

Do the Math

You should calculate costs of various health coverage plans since they differ.

Costs for various health coverage plans can vary. Attempt to create a sample situation and run through how much it would cost in monthly premiums, deductibles, co-pays, and coinsurance for every plan. Employ your medical history from this year to help choose the right plan for next year.

Remember that preventive services are 100 percent covered by your health provider, so your physical does not count! Be sure to understand what is covered and what is expected out-of-pocket.

Plan Ahead

Have an upcoming vacation? Some plans provide coverage even if consumers are traveling. It is best to find this out in advance before going on vacation and falling ill.

Expecting to have surgery the next year? Select a plan that will help cover more of those expenses during this open enrollment period.

Ask a Professional

Still unsure which health insurance plan is best? Seek out a professional. This could be as simple as finding a friend or neighbor with certain policies and asking them how they like their coverage. Or divulging in a trusted advisor who can walk you through the details. Most health insurance companies can connect employees with an advisor, and many insurance companies also have welcome centers for customers to walk in and ask questions.

Open enrollment can sound scary but does not need to be. Just remember, there is no “right” answer and no “best” plan. There is a health insurance plan out there that will be the best fit for you, depending on your health needs, life situations, and budget.

Resources and References:

• Preferred Provider Organizations
• Out-of-Pocket Costs