Friday, November 3, 2017

Don't Do "eeny meeny"


Trees painting the outdoors with their leaves, chillier nights, shorter days—you know what that means.  It’s Medicare open enrollment season.

Okay, maybe that’s not what came to your mind first.  But working as I do (at least tangentially) with the Medicare program, I know October 15 to December 7 to be the annual opportunity for the Medicare-eligible population to choose their coverage for next calendar year.  But it’s also the time of year in which many employers have their own open enrollment for workers to select their health care plan or other benefits for the next twelve months.  And this week many Americans began shopping on the various insurance exchanges for their 2018 health insurance under the Affordable Care Act (ACA).

If you fit into any one of those categories, here are a few tips to making your selection.

Cost is about more than the monthly premium.  An insurance policy with lower premiums may not be a bargain. Your co-pay (the amount you have to pay at each health care encounter), your co-insurance (the percentage of the cost of a service that you are responsible for paying), and your deductible (the dollar amount of your expenses you are responsible for paying before your insurance even kicks in its first dollar of coverage) could all be much higher and more than erase whatever you save in monthly premiums. 

The deductible can be the real killer.  When I’ve called on doctors’ offices as part of my job, their main complaint about the ACA has been some of the plans’ high deductibles.  Patients come into their office, excited to finally have health insurance, only to learn it covers $0 of the first $5000, or even $10,000, of medical expenses.  Essentially, they just have catastrophic health insurance.  To avoid that trap, read the policy description thoroughly and try doing a little math based on the number and cost of your (and your family’s) doctor, urgent care, lab, radiology, and hospital encounters over the past year.  Will you likely meet the deductible early in the year?  Not at all?  If you or a member of your family suffer from a chronic condition or are otherwise a frequent user of physician or hospital services, then paying a higher premium to ensure the insurance company starts paying for services earlier might well be worth it.  Take note of the out-of-pocket limit, the maximum amount you would be responsible for paying before the insurance company begins paying at 100%.

Are your providers “in network” with the insurer?  Many health insurance plans have a limited universe of providers who are considered in their network.  It is important that you determine if your preferred doctors—both primary care and specialists—as well as the local hospital and pharmacy and the nearest full-service large medical center are considered “in network” with the plan you are contemplating buying.  Using in-network providers keeps your costs lower.

The insurer’s website is usually the best source for determining who is in their network. Be certain you select the correct plan on the website, because they are likely to have several plans, each with its own network of doctors.  

But I’ve found that those online listings can be out-of-date.  I recommend you also call your doctors’ offices and speak with either the insurance clerk or the office manager to double-check.  Let me stress that when you call that you do NOT say, “Do you accept XYZ Insurance?”  You SHOULD directly ask, “Are you in XYZ’s network of approved providers?”  The difference can be critical.  A provider may “accept” any insurance, in the sense that they will file a claim to any company.  But if they are not in-network then they will be paid less, and you will be responsible for more of the bill, if not all of it.

Investigate the reputation of the insurance company.  This can be easier than it sounds.  If you are shopping for a Medicare Advantage plan (also known as a Part C plan), the government rates them on a star system:  one star for poor customer service, up to five stars for superior service.  For other insurances, there is not an equivalent rating system; but friends or even co-workers can make recommendations based on their experiences.  And again, your physician’s office can be good source of intelligence.  I have found that the back-office staff freely discusses what insurance companies are better than others, which ones are reliable payers, and which they like more than others.  You might be surprised to learn that insurance companies that advertise the most and are best known by the public do not enjoy a good reputation among the providers I know. Just remember, a physician’s contracts with the insurance companies most likely restrict him and his staff from recommending one company over another, so don’t ask them to tell you which to choose. 

Happy Open Enrollment.  And until next time,

Roger

And perhaps the best way to save money on health care in 2018:

“Dear friend, I pray that you may enjoy good health and that all may go well with you, even as your soul is getting along well.” III John 2 NIV®*

 
*Scripture quotations taken from the Holy Bible, New International Version® NIV®
Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.™
Used by permission.  All rights reserved worldwide.

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