How should I choose a health plan during open enrollment?

Every year, the open enrollment period for your health insurance plan comes along, usually during fall. Make sure that before you immediately put a check mark next to your health plan, you know if you need to make any changes.

If you aren’t enrolled in a health plan during the open enrollment period, you may do so at this time. If you are already enrolled, you may switch options, add eligible dependents and correct inaccurate information.

You may also switch plans without undergoing medical screening or pre-existing conditions. There is one time a year during which you have the opportunity to make changes to your plan without having to sit out any pre-existing condition exclusion period. Otherwise, put to 18 months of waiting for coverage of pre-existing conditions will face late enrollees in group health plans. 

You can make changes to your health insurance plan using the several health plan varieties including traditional indemnity fee-for-service plans (FFS), point of service plans (POS), preferred provider organizations (PPO) and health maintenance organizations (HMOs). Each plan has its own features. Depending on your circumstances, your needs may vary.

You might also consider a drug formulary. A drug formulary is basically a list of medications which a health plan pays for. Talk to your health insure and ask if you will be eligible for a drug formulary during your open enrollment.

You can also choose a flexible spending account, also known as FSA, which is a benefit plan that allows companies to give workers the opportunity to pay for their out-of-pocket department and health care costs on a pre-tax basis.

You should also take a look at a medical savings account, also known as MSA, which is a tax-deferred trust or custodial account in which you set aside money to pay for your routine. A major medical plan with a high deductible should be paired with a medical savings account.

If you have any questions, ask your current health insurer. If you don’t have a health insurer or don’t have a health insurance policy, you should contact your state’s insurance department. Your state department also has special insurance analysts who will be able to assist you further.

If you have any questions about a self-insured health plan (a plan where your employer pays all your health insurance claims), contact your regional office of the United States Department of Labor (DOL). The Employee Retirement Income Security Act (ERISA) governs self-insured plans.