Insurance plan

Choosing a good health insurance plan can be confusing. Here’s what to keep in mind

HMO, PPO, FSA – OMG!

Open enrollment season is upon us and it’s time to sign up for a health insurance plan for the next calendar year. But between the alphabet soup of acronyms and all those daunting data tables, it can be hard to know which plan to choose.

While we know this task isn’t as exciting as spooky szn or anything pumpkin spiced, it’s important to your health (and will serve you much longer than that polyester Halloween costume).

The good news: Life Kit has expert advice to help you take the dread out of this process. Here’s a cheat sheet of what to keep in mind when making a decision.

Read your plan’s summary of benefits

The first step is to know what’s in your health insurance plan, says Tasha Carter, the state of Florida’s insurance consumer advocate. “Many consumers miss out on the benefits of their health insurance policy simply because they don’t know they exist — or worse, they end up paying out of pocket for expenses that could have been covered.”

So even if you’ve had the same plan for years, take a moment to review the latest summary of your plan’s benefits. Health insurance companies are required to provide a summary of benefits and coverage written in plain language. If you do not receive it by post at the start of the year, log on to your health insurance website or call the number on the back of your insurance card and ask for it.

“Often insurance companies change benefits, so you want to make sure you understand what those changes are and how they may affect you” and your health, Carter says. Listen to our episode on how to maximize your health insurance coverage here.

Get an idea of ​​your medical needs from a doctor you trust

It may dictate what kind of health insurance you might need in the coming year. “Having someone who has been following you, ideally for years, is extremely valuable in helping you make decisions” about your health care — and therefore your coverage plan, says pediatrician Dr. Nicole Rochester.

And make sure your preferred primary care doctor and prescription medications are always covered by your insurancesays Aaron DeLaO, former director of health initiatives at nonprofit group Foundation Communities. If not, he says, you should “eliminate it” and “find a plan that will cover those.”

Demystifying health insurance jargon

Find out what common health insurance terms such as “CHIP”, “cost sharing”, and “deductible” mean. It can give you a better understanding of what signing a plan could mean for your budget and your health. Read our handy glossary of terms here.

Take advantage of the gifts…

Even if you have a simple plan with high deductibles, screenings and other preventative care should be included in your coveragesays Carter, the insurance consumer advocate. This includes screenings for diabetes, cholesterol and blood pressure. To get an idea of ​​what you might need in the coming months, check out this list of recommended screenings by age compiled by the American Academy of Family Physicians.

… and benefits

Another benefit of reading your insurance coverage plan very carefully? You could discover useful benefits. Your insurer, for example, may offer discounts on your local gym membership or on services that improve your quality of life, such as LASIK surgery or massage.

The digital story was edited by Malaka Gharib. We would love to hear from you. Leave us a voice message at 202-216-9823or email us at LifeKit@npr.org.

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