Open enrollment season is upon us! I don't know about you, but in our home this time period always involves an intensive sit-down with a big stack of paperwork and coffee. Lots of coffee. Health care choices can sometimes feel like a meandering path. After a few health scares and four back-to-back pregnancies, though, our family has learned that taking time to do a little research up-front can pay off BIG in the end. Here are the steps we've taken to select the right health plan for us and become experts on our care options.
Navigating Health Plans
Get the facts.
When initially looking at health care plans, the biggest thing to consider is your individual needs. The most expensive option isn't always the best. In fact, that price hike may be mostly for things that you don't require. Start by assessing what services you think you'll need most over the upcoming year, and investigate each plan's coverage of those key factors. For example, my provider is excellent at offering postpartum support with tons of free breastfeeding classes and meet-ups. A senior citizen may be more concerned about the company's reputation with bone or heart care. Someone else may be looking for chiropractic service or a coverage for a specific brand-name medication. If you're already loyal to a specific health care provider, check with them to make sure your chosen plan will include them in the new year. Premiums and deductibles are a factor, of course, taking into consideration the frequency with which you typically seek care and whether or not you have major upcoming needs.
Ask for advice.
I have a very supportive group of knowledgeable friends and family around me (local parenting Facebook groups can also be a good resource if you're new to an area). I've learned that I can save a ton of aggravation by simply asking people who have been in my situation for input. Ask specific, detailed questions like, “Does anyone have a good care provider near this part of town who is supportive of an alternative vaccination schedule?” We live relatively far from medical facilities so a big part of our plan decision was choosing between limited care providers closest to us.
Explore your plan's referral process and available resources.
Every healthcare plan has a different path to specialized services such as dermatology or physical therapy. Our family has encountered more specific health care issues recently, so over half of our visits have been to see specialists as opposed to primary care doctors (above, I'm doing some alignment exercises that a physical therapist taught me after delivery of my second kid caused long-term back problems for me). The specialists will be the people you see when things go really wrong, so you should feel completely confident seeking their assistance and even asking to see another primary care provider if your needs aren't being met.
Get the right tool for the job.
Finally, consider ease-of-use features such as mobile apps, online scheduling, remote visits and auto-pay. Options like this can help save a ton of time!
How do you navigate your health plan?