Angie's List: Choosing a Health Care Plan

Angie's List: Choosing a Health Care Plan

It's that time of the year again, open enrollment for health care options.

Open enrollment season is in full swing, the information overload can be overwhelming.

But it pays to be proactive.

Changes in health care have put us in the driver's seat.

Now is the time to do your research, weigh all options and pick a health plan that's right for you.

"Taking advantage of the open enrollment period is a time for you to evaluate what your insurance covers and make sure you assess needs you are going to have over the next year. If you have to make changes to your insurance you can do it now before it's too late," Founder Angie Hicks said.

When Charlie Klumpp turned 65, she learned her physician's practice didn't accept Medicare.

After paying for a couple of office visits out of pocket, Klumpp decided to switch doctors.

Now she always checks with doctors before scheduling an appointment.

"I called, talk to the business offices and said, "I am a Medicare patient. That's my primary. I have a secondary insurance. Will you file that for me? Do you have any concerns about taking on an additional Medicare patient," Klumpp said.

"One thing many people overlook is whether their doctor is going to continue to accept their insurance. While you are evaluating insurance, have a conversation with your doctor, especially if you're in the midst of a longer term treatment plan to be sure that you are still going to be covered. The last thing you want to have to do is change your doctor in the middle of treatment because of an insurance issue," Hicks said.

If you don't understand what your plan does and does not cover, you could end up spending more money.

Don't assume the plan and policy that you had this year will still cover your needs next year.

"The biggest mistake people generally make when they are buying insurance is not knowing what they are looking for. People know they need it and know they have to get it, per the new laws, but they don't have an idea of exactly what they are looking for and often when they purchase it they don't understand what they have," Insurance Broker Jacob Gorden said.

Take a look at what you spent last year in premiums and out of pocket expenses and compare that to what you expect to spend in 2014.

If you don't understand your health care options, don't be afraid to ask questions. Sit down with your benefits person at work or talk with a financial planner or insurance broker.

"We can shop every single insurance company licensed in your city and state. We can recommend plans and give you pros and cons of each. Brokers are compensated by the insurance company themselves so there is no fees or service charge to work with a broker. We can just make the whole process a lot smoother, more efficient, and make the whole process a lot easier on you," Gorden said.

Angie's List say if you decide to work with an insurance broker who's an independent agent, you'll want to make sure he or she has the necessary credentials and is appropriately licensed.

Angie’s List Tips: Evaluating your health insurance

·         Do your homework: Don’t assume your plan and policy that you had this year will be the best fit for next year. Take the time to evaluate your situation and research your options to find the best health care plan to fit your family’s needs.

·         Check with your providers: Preferred provider lists can change so before you enroll in a plan, check if your physician will be in your network. If you are on Medicare, contact your physician’s billing offices to see if they accept Medicare (and ask if they’re in-network if enrolling in Medicare Advantage.)

·         Look at costs: Take a look at what you spent last year in premiums and out of pocket and compare that to what you anticipate this year. For example, will you need long care treatment, specific prescriptions, or do you anticipate your child will need braces?  If you need help understanding the various health care plans, talk to your benefits person at work, a financial planner or insurance broker.

What is an insurance broker? Health insurance brokers set up various health care plans and other insurance products for people, their businesses and their families. They typically work for insurance brokerage firms or as independent agents.

·         The types of insurance offered may include not only health coverage but other types of policies, such as dental and vision insurance and short-term and long-term disability.

·         Working with brokers can prove beneficial because they have access to multiple health insurance coverage plans, so they can give you several options based on such factors as price, coverage, renewal options and limitations.

·         Brokers work as a type of intermediary agent between the health insurance companies and their customers. Their duties generally include both sales and administrative functions. They will not only set up and arrange a customer's coverage but they may also process claims and provide post-sales service and support, responding to questions or making changes and revisions to your policy.

Angie’s List Tips: Choosing a health insurance broker

·         If you decide to work with a broker who's an independent agent, you'll want to make sure that he or she has the necessary credentials and is appropriately licensed. Requirements may vary in each state, but generally insurance agents must pass an examination to become licensed and certified.

·         Preparation for entering the profession includes studying the laws, practices and policies associated with the field. Once an insurance broker becomes licensed, there's a general requirement for ongoing education so that agents can keep current with insurance guidelines and maintain a license to practice.

·         If you decide on an insurance agent that works for a brokerage firm, you will want to do a thorough background check before you do business and get coverage. Doing a little homework will help you make an informed decision when purchasing health insurance coverage.

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