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The third annual open enrollment period opened on November 1 and we are all digging in to find the differences from last year’s plans to this year’s benefits. The devil is in the details, so here are the major considerations for choosing a plan this year:

  1. What does the plan deductible apply to? We can all see the various deductible levels, but does it only apply to the traditional expenses of hospital stays, surgeries, lab work and x-rays? Beware, some plans have deductibles that apply to emergency room services, office visits and prescriptions. Be sure that you are clear what services are covered first dollar and which are not to avoid unpleasant surprises.
  2. Are the providers you use participants in the network you are selecting? All networks are not the same and some plans have VERY restricted provider lists. Be sure to check with your providers’ offices with specific network names to save balance billing after claims have been incurred.
  3. Check the prescription lists to be sure your drugs are covered. If you need to switch to alternate medications or generics you will want to speak with your providers sooner rather than later. It can take a little while to see if different medications are as effective as the ones you are currently on.
  4. Are you one of the lucky individuals who can simply renew what you currently have? Be careful to read the details of plan updates so that you know what may have changed in your plan.
  5. If your plan is being discontinued start researching your options today. Time flies at this time of year.

We have until December 15 to get enrolled for January 1 effective dates so let’s start doing our homework now. Let’s not find ourselves making quick decisions at the deadline because we did not manage our time wisely.