Health insurance open-enrollment season tips - East Valley Tribune: Nation / World

Health insurance open-enrollment season tips

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Posted: Monday, October 24, 2011 9:15 am

It's that time of year again. Nope, not holidays, hunting or Halloween. We're talking open-enrollment season for health care coverage.

For those still fortunate enough to have health insurance through work, now until early November is typically when you have to choose your coverage options for 2012.

Poring over the paperwork can be a pain, but with employees shouldering an ever-bigger chunk of their health care costs, it could be financially worth your time to look at your choices. "People hate to do this. It's like having a root canal or writing a will: They don't want to think about it," said Nancy Metcalf, a senior program editor at Consumer Reports magazine. "But if you get sick and have the wrong insurance plan, it's too late." According to a nationwide survey in August by Aflac insurance company, 76 percent of U.S. workers admit to making mistakes with their health benefit decisions in the past. And 42 percent of workers say they've wasted money because of those mistakes.

The most common errors: Not electing available benefits such as vision or dental; choosing the wrong level of coverage (too much or too little); or not putting enough in a flexible-spending account.

To ensure you don't get shorted by your health care coverage, here are some open enrollment tips from experts:

-- Don't go on autopilot.

That's the advice of eHealthInsurance.com expert Carrie McLean, who said too many people just plug in the same choices year after year, without looking at the details.

"You need to do your homework. Pay attention to what your employer is changing, so it's not a surprise next year," said McLean.

Since surveys show a majority of employers are raising premiums or changing coverage for 2012, this is not the time to skip over the details.

-- Get past the premium.

If it's cheap, there's likely a reason. Either the benefits are very limited or you'll pick up a bigger share of the cost.

-- Consider high deductible.

They're becoming more prevalent, says Consumer Reports, which last week released its rankings of 830 health plans nationwide.

A high-deductible plan can yield a significantly lower premium, but be sure you have enough set aside to cover your out-of-pocket expenses before you've met your deductible.

-- HSA or FSA?

They're both ways to set aside dollars to pay for out-of-pocket medical costs.

A flexible spending account, or FSA, lets you set aside a certain amount of pre-tax income for items not covered by insurance, everything from Lasik eye surgery to prescriptions. But be careful: Any unspent FSA money reverts back to the employer on a "use-it-or-lose-it" basis. Currently, the annual amount you can set aside is set by your employer; starting in 2013, it will be capped at $2,500.

A health savings account, or HSA, is paired with a high- deductible plan and typically lets you carry over the balance year to year, or take it with you when changing jobs.

-- Consider going solo.

Last year, the average family paid about $15,100 in premiums for employer-provided health insurance, according to a recent Kaiser Family Foundation study.

In some cases, it might cost less to move a spouse -- or a son or daughter -- to a separate plan. If you and your spouse are both working, compare your employers' plans to see which is most cost- effective to cover your family.

An adult child, who can now stay on a parent's health plan to age 26, may pay a hefty premium for that privilege. A separate plan might cost less.

-- Is a layoff likely?

If you think company layoffs might hit your workplace next year, consider getting a lower-priced policy, in case you have to pick up the premium costs through COBRA.

And for some additional year-round ways to cut health care costs:

-- Look for Rx savings: When it comes to prescription drugs, use generics. Take advantage of cheaper order-by-mail programs, if available. Look for pharmacy discounts offered by chains.

-- Get healthier: More employers, McLean said, are considering new incentives -- either rewards or penalties -- to encourage healthy behaviors such as losing weight or quitting smoking.

-- Don't stray: If you are in an HMO, don't stray from doctors who are covered by your plan, so-called "in-network" physicians. Always check that any doctor you're seeing is covered by your health plan, even those recommended by your personal physician.

-- What's in/out: Under the new health care reform act, many types of preventive care -- well-baby visits, annual physicals, certain immunizations, colonoscopies, etc. -- are free and not subject to co-pays or deductibles. But if a problem shows up and more diagnostic work is needed, it likely won't be covered. Be aware of what's free and what you'll have to pay for yourself.

-- Avoid the ER: Even if you're covered by insurance, avoid the emergency room unless it's truly critical. Instead, check if your health plan offers after-hours office visits or urgent-care clinics.

-- Offer to pay cash: Some doctors and dentists will give you a discount for paying directly by cash or check.

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