What factors affect your health-plan choices at open enrollment time?
Posted at 5:00 AM on November 14, 2011
by Eric Ringham
(15 Comments)
Filed under: Health
This is the time of year when employers typically hold open enrollment periods for employees to change their medical plans and other benefits. It is also open enrollment time for people covered by Medicare. Today's Question: What factors affect your health-plan choices at open enrollment time?
Comments (15)
Grade A stuff. I'm unqusetoinably in your debt.
I can lose my family's doctors or pay about $2000 more next year.
I've been disabled and on Medicare for 6 years, so this time of the year is always difficult for me. I must change providers each year and have come to rely on the Medicare site to help me chose who will provide the best care for my particular disease. My health needs steadily increase as providers steadily offer less service at increasing prices. Six years ago I could cover my health costs with about 25% of my disability income, but this past year, with the worst care to date (Humana), my costs have eaten over 50% of my monthly check. Clearly it will be only 3-4 years till my whole check will go to health costs.
I have found the Medicare tool that finds the best cost-effective provider to be very helpful. It has allowed me to keep my drug costs under control, but this past year it truly failed me. I do not know how it happened but I paid about 75% of my drug costs (with Humana contributing only 20-25%). I was forced to give up my most costly perscription which would have cost me $75 per month.( The prior year I paid $28.) Two of my meds cost less paying actual cost than if I'd used my insurance.
I've not begun the decision process yet, but I've asked a friend to doublecheck my work this year. Hopefully I'll be able to find an affordable plan that allows me to afford all of my perscriptions and offers lower co-pays.
Insurance? What insurance?
We have a choice between Blue Cross Blue Shield of MN and Health Partners. For the coming year Blue Cross decided to change their internal policies to allow an employer to cover the full range transition related treatments for transgender patients deemed medically necessary by the World Professional Association of Transgender Health (WPATH). While Health Partners does cover some transition related treatments, they chose to continue excluding some specific treatments deemed medically necessary by WPATH. I'm not sure if I'll need to take advantage of the newly covered treatments in 2012, but I have certainly chosen the Blue Cross plan. Their efforts toward solving this unmet need are greatly appreciated!
We spend some time weighing cost/benefit/convenience with the primary emphasis on overall cost after our assumed personal usage of the covered benefits.
The only choice we have is coverage or no coverage.
Before I retired and qualified for Medicare, I had at most two choices. Now that I am on Medicare I have a number of choices for my Supplemental and Plan D Prescription plan. The open enrollment period is commonly that November and December period when a Medicare recipient can chose to change either his Supplemental and/or Plan D. I did not have that option when I was covered by a company provided plan. As a medicare recipient, I can change provider without having to prove insurability. I choose to go with a PPO plan by a well known company that my agent offered and that he had placed his parent on . I am well pleased.
I don't have a choice. If I did, it would be a choice of which way to help overpaid health care executives profiteer from people's sickness or fear of sickness. I long for the day when Americans wise up and learn from Canada's experience.
Factors regarding "Clearing the Smoke" about Cannabis. Medical Marijuana is everyone's right. The world's most useful and versatile plant, Hemp, has been hidden like the elephant in the living room.
This is a big issue to me. Employers should not be involved in the health care system, because they exercise influence over how we spend our health care dollars to benefit the employer, not the employee.
For example, the company I work for provides both a PPO and a High Deductible plan with Health Savings Account. They promote the HD plan because it costs them nothing to administer, unless an employee has costs above the maximum out of pocket amount. They influence our decisions about which plan to take, by making the maximum and minimum costs for the HD plan significantly lower than the PPO plan. However, those who take the HD plan are exposed to the possibility of having to pay thousands of dollars in health care costs if an injury or sudden illness occurs.
The PPO plan is complex, with co pays that do not apply to the maximum out of pocket, deductibles, and high out of network costs, but the costs are spread over time and, if we don’t use the services, others who do are helped.
I always choose the PPO plan because it’s the closest I can get to my principal of pooling the money of many people for many people. But, I’m lucky. I can afford to make that decision. Most employees can’t and must guess at the best plan to take.
We, as a nation, could provide good health care to everyone if everyone would pay into a single payer pool of money that would cover the cost of anyone’s health care. It would be simpler and less expensive to operate because the costs would be spread over time and many people, and insurance companies would not be taking their profit. Everyone would be covered.
For me, every year I get hopeful if I hear my employer has chosen a new health care option- I'm always hoping that they can offer me something I'd actually want to pay for. So far that hasn't happened. I have my own plan through Health Partners that is an individual plan and not through my employer. A lot of people ask me why- it's one more bill to worry about (since it doesn't come out of my paycheck), isn't it more complicated, does it cover anything, etc etc. Why do I keep it? Because it's better than anything an employer health plan can. I get my preventative covered along with 3 doctor visits (for sickness or emergency)- and the big bonus as a young woman- Health Partners covers birth control under their prescription drug plan. Until other health care companies wake up and realize that birth control needs to be covered under prescription drug plans (otherwise it's usually upwards of $40+ per month) I'm not switching. I appreciate a company that understands that I don't just take birth control to have tons of sex with multiple partners- I take it so I don't get pregnant, so my periods are regular and I suffer less symptoms of pms because it keeps my hormones more in balance.
Two - Either my heath plan at where I work or my wifes heath plan at her place of work. What one has the best heath coverage is the one we choose.
The number of options to choose from. We only have one now, due to cost.
Value is the factor affecting my decision. I'm dropping dental, keeping vision and will continue contributing to my FSA . Dental is not getting used enough to warrant the premiums. Vision is getting used and I see value in the plan/premiums.The FSA is my best value. By using pre-tax dollars, my FSA covers most of my out of pocket expenses as well as covering any deductibles from my insurance programs.
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