Dr. Rhonda Randall is the chief medical officer for UnitedHealthcare Employer & Individual.
Millions of Americans review their health plan options during open enrollment each fall, often the only time they can choose or change coverage.
Choosing a health plan can feel overwhelming. With so much health information available, it can be difficult to know what’s relevant and credible. As healthcare costs remain top of mind, open enrollment is a chance to review your coverage and prepare for the year ahead.
Before enrolling, consider these five questions:
Do I understand what I’m comparing?
Health insurance terms can be confusing, but knowing the basics can help you make a more informed decision. Resources such as the Just Plain Clear Glossary (justplainclear.com) can explain health insurance terms — including deductibles, copays and out-of-pocket maximums — in plain language.
For Medicare information, Medicare Made Clear (medicaremadeclear.com) can explain options in easy-to-understand language.
Beyond my premium, what will I be responsible for paying?
The monthly premium is only part of the cost of a health plan. Also consider what you’ll pay when you use care, whether that’s a copay for a routine visit, coinsurance for a procedure, prescription costs or a deductible that must be met before certain services are covered.
Regarding Medicare, be sure you understand the differences between original Medicare and Medicare Advantage, including how costs and coverage may vary.
Will my doctor or prescriptions still be covered?
When reviewing plan options, check that the doctors and medications you rely on are covered. That may be a pediatrician who knows your child’s history, a specialist you’ve seen for years or a medication you take regularly.
Taking a few minutes to verify coverage can avoid disruptions in care and unexpected costs.
Medicare: Not all Medicare plans include prescription drug coverage, so be sure to compare costs, coverage and provider access when evaluating your options.
Will I know what care will cost before I receive it?
Most people wouldn’t book a flight or schedule a major home repair without understanding the price first.
As you review plans, look for tools and health plans that help you compare costs and understand treatment options before receiving care. Some plans provide upfront pricing information, allowing you to make more informed decisions before scheduling an appointment.
For Medicare patients: Before visiting a provider, confirm that they accept your plan and ask about any costs you may be responsible for.
Is mental health support included?
Whether you’re managing stress, anxiety or a major life change, mental health support can play an important role in your overall well-being.
As you compare plans, review what mental health services are covered, including in-person and virtual care, coaching, support lines and digital tools. Some insurers, like UnitedHealthcare, may provide a range of mental health offerings, like Calm Health.
Regarding Medicare, look for plans that include virtual mental healthcare with $0 copays.
Know your deadline
Coverage deadlines vary. Employer-sponsored plans typically have two- to three-week enrollment windows between September and December, Medicare’s annual enrollment period runs Oct. 15 to Dec. 7, and marketplace open enrollment runs Nov. 1 to Jan. 15 in most states.
To learn more about open enrollment, visit uhc.com/oe.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
