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3 mistakes to avoid during Open Enrollment

Don't Make These Common Mistakes During Open Enrollment

Open enrollment is in full swing, with millions of Americans making decisions about their health care for the upcoming year. Given all of the options people have these days, it can be an overwhelming time. Should I stay on my group plan or get an individual policy? If I get an individual plan for myself or for a family member, which insurer should I choose? What is the difference from one network to another with the same insurer?

The following are three mistakes to avoid when making your decisions.

1. Thinking that “out-of-network” means you can’t see your doctor. 

Ideally, the plan with the least expensive premium would also have all of your doctors in its network. Often, however, this is not the case. Instead, the plan may treat some of your doctors as “out-of-network.”

It is a mistake to interpret that as meaning that you cannot see your doctor anymore with that plan. You generally can still see your doctor — it is just that the costs associated with doing so will not accumulate toward your in-network deductible or out-of-pocket maximum. Let’s use an example to illustrate how keeping this in mind can save you a lot of money.

John is pretty healthy and trying to pick which health plan is best for him. He sees that the least expensive plan for him is a plan with CIGNA. He lives near TriStar Summit Medical Center, and so it is important to him for that hospital to be in-network. He also sees a dermatologist once a year who has her own practice. CIGNA has TriStar Summit Medical Center in-network, but does not have the dermatologist in its network. Blue Cross has the dermatologist in-network, but only with its P Network (which is its most expensive network).

The P network plan from Blue Cross would cost John $420 per month. The CIGNA plan would cost John $320 per month. The difference in premiums of $100 per month equates to $1,200 over the course of the year.

If he chooses the CIGNA plan, John can still see his dermatologist — it is just that he will have to pay the full price of the office visit (which might be around $100) and that cost will not count toward his in-network deductible. John does not expect to hit his deductible, so this is unlikely to matter anyway.

In this example, CIGNA would be the best choice for him. He may have missed this if he had automatically thrown CIGNA out of the analysis just because his dermatologist is not in-network with CIGNA.

2. Not going all the way to the confirmation screen. 

It has happened to all of us. We thought we completed an action online, only to learn later that there were some more buttons we had to click.

It happens on and insurance company websites as well. Make extra sure when you’re signing up that you go all of the way through the process. If you’re not sure whether you really got enrolled, call the insurance company to confirm they’ve received your application and first month’s premium.

3. Only looking at options on only has plans that can be partially paid for with a subsidy. If you don’t qualify for a subsidy, then there are other plans that you might want to consider for yourself and your family. You can find the most complete list of available plans for a given insurance company on its own website. Don’t miss considering these other options if you’re not getting a subsidy anyway.

Shopping for health insurance is a new experience for many. Avoiding some of these common mistakes can help improve the likelihood that it is a positive one.

This column originally appeared in the October 6th edition of The Tennessean

If you enjoyed this post, you may like 4 steps to picking the right plan during Open Enrollment.

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