Millions of Americans evaluate health plans during the open enrollment period each fall, usually the only time of year when people can choose or change their health benefits.
Choosing health coverage can be overwhelming. And with health advice available everywhere, it can be difficult to know which sources of information are reliable and relevant.
As medical costs remain a priority, open enrollment is the perfect opportunity to review your coverage and prepare for the new year.
Know the registration deadlines
Open enrollment dates are not the same for everyone and depend on your type of health coverage.
– If you get your insurance through your employer, open enrollment typically occurs during a two- to three-week period between September and December.
– If you are eligible for Medicare, the Medicare annual enrollment period occurs from October 15 to December 7.
– If you get coverage through the ACA health marketplace, open enrollment begins November 1 and ends January 15 in most states.
The coverage you choose during open enrollment will generally begin on January 1. Even if you prefer to keep your current plan, costs, coverage and benefits may change from year to year.
When comparing plans, consider the following questions:
1. Do I understand what I am comparing?
Health insurance terms can be confusing, but there are resources like Just Plain Clear (https://www.justplainclear.com/es) who are available to help you make decisions with confidence.
– Medicare: Medicare Made Clear (https://www.uhc.com/medicare/medicare-education.html) breaks down the fundamentals and complexities of Medicare in an easy-to-understand way.
2. Beyond my premium, what will I have to pay?
It’s common to just look at your monthly premium, but that’s only part of the total cost of health coverage. Also consider the costs you may have to pay when you actually use the service, whether it’s a copay for a routine visit or a prescription, the cost you have to pay for a hospital stay or procedure, or the amount you’ll have to pay before certain services are covered. Understanding these costs ahead of time can help you prevent surprise expenses later.
– Medicare: Make sure you understand the difference between original Medicare and Medicare Advantage. Find trusted Medicare educational resources that explain options, costs and coverage. More information at https://es.uhc.com/news-articles/medicare-articles .
3. Will my doctor or medications still be covered?
When comparing coverage options for next year, look for the people and services you trust and already use. It could be a pediatrician who knows your child’s history, a therapist you’ve developed a relationship with, or a medication you take every month. Make sure these doctors, services, and prescriptions continue to be covered.
– Medicare: Not all Medicare plans include prescription drug coverage, so be sure to compare costs, coverage, and provider access when evaluating your options.
4. Will I know what the cost of care will be before making an appointment?
It has been difficult for many to understand what they can pay for care before receiving it. Most people wouldn’t book a flight or schedule a major repair without first understanding the costs.
However, too often people undergo back surgery, MRI, or physical therapy without knowing how much they will pay, although costs can vary significantly depending on where you receive care. More information at https://es.uhc.com/news-articles/benefits-and-coverage/surest-price-transparency .
When comparing options, consider what resources are available to help you understand costs and treatment options before receiving medical care.
Some health plans like Surest (https://www.surest.com/) offer price transparency, helping you understand exactly what you’ll pay, compare care options, and make more informed decisions before making an appointment.
– Medicare: A quick call before an appointment can be very helpful. Ask if the provider accepts your plan and what costs you can cover before you receive care.
5. Is mental health support included?
Mental health needs can be different for each person. Whether you are dealing with stress or anxiety, helping your teen deal with social pressures, or going through a major life change, having access to the right support can be important to your overall health and quality of life.
When comparing plans, review which mental health services are covered, such as in-person and virtual visits, coaching, 24/7 support lines, and digital self-care tools. Some insurers like UnitedHealthcare can offer a wide range of mental health offerings, including tools for in-the-moment support like Calm Health (https://es.uhc.com/news-articles/healthy-living/behavioral-coaching).
– Medicare: Look for plans that include virtual mental health care with a $0 copay.
6. What other benefits should I consider?
As you review your options, look beyond medical coverage. Benefits such as dental coverage, vision coverage, and financial protection may be available even for critical illnesses. Understanding what’s included can help you avoid leaving valuable benefits unused.
Some plans help identify if you are eligible for benefits you may not be aware of. For example, if you are hospitalized or experience an unexpected health event, you may be eligible for a cash payment, and in some cases, the process to identify your eligibility may begin before you know the benefit is available. More information at https://es.uhc.com/news-articles/benefits-and-coverage/benefit-assist .
– Medicare: Don’t forget that dental, vision, and hearing coverage may vary depending on Medicare coverage options, so it’s important to compare benefits when choosing a plan.
7. Will this plan be easy to use in real life?
Questions about health insurance can arise at any time. Whether you’re managing conditions like diabetes, choosing a new doctor, or trying to understand a bill, having the right support can make your experience less overwhelming.
When comparing plans, think about the resources available to help you use your plan year-round. Some plans offer personalized recommendations through easy-to-use mobile apps to help you compare options in advance based on cost, quality or convenience. Others can connect you with support tailored to your needs, whether it’s nutritional counseling, care resources, or women’s health programs.
– Medicare: Older people are adopting digital tools. Health plan apps can help with claims, rewards, and prescription refills.
For more articles and videos on open enrollment, visit es.UHC.com/oe.
