You are here

What Should I Consider During My Open Enrollment Period When My Employer is Offering New Plans?

And Is There Anything Else I Should Be Thinking About Before the End of the Year?

As the end of 2017 approaches, there are certain questions you need to ask yourself about your health insurance. Regardless of how you and your family obtain your health insurance, it is ultimately your responsibility to understand your plan. It is up to you to choose the plan that is right for you and your family’s healthcare needs. Understanding your plan can have a huge impact on both your health and your finances.

Individuals affected by primary immunodeficiency diseases (PI) need to make educated decisions about their coverage options. Do a thorough plan comparison to determine what plan best fits your needs. Things to look at include:

  • What is my premium?
  • What is my out-of-pocket maximum?
  • What are my deductibles?
  • Is deductible included in the out-of-pocket maximum or is it in addition to the maximum?
  • How is immunoglobulin (Ig) covered?
  • Do I have a coinsurance or a flat co-pay?
  • Do I have options for site of care?
  • Are my doctors in the plan’s network?
  • Are there out-of-network benefits?

You may need to contact the insurance carrier or get assistance from your benefits or human resources department in obtaining the answers to these questions. Once you have these questions answered, you can make an informed choice.

If you’ve been utilizing a Flexible Spending Account (FSA) or Health Savings Account (HSA), you will want to check on your FSA. An FSA is an account offered and administered by employers that allow employees to set aside pre-tax dollars out of their paycheck to pay for the employee’s share of insurance premiums or medical expenses not covered by the employer’s health plan. Typically, benefits or cash must be used within the given benefit year or the employee loses the money. Now employers may offer you the options of rolling over $500 of your balance to the next plan year, or they may provide a grace period of up to 2 ½ months after the end of the plan year. If you are offered a grace period any qualifying medical expenses during this period can be paid from the balance in your account. Please note that the employer can offer one of these options but not both. Also, the employer is not required to offer either option so make sure to inquire about your employer’s FSA rules during open enrollment.

An HSA is a medical savings account available to individuals enrolled in a high-deductible health plan that meets certain federal rules for out-of-pocket costs. The funds contributed to an account are not subject to federal income tax at the time of deposit. HSAs are employer established benefit plans that reimburse employees for specified medical expenses as they are incurred, and the employee contributes funds to the account through a salary reduction agreement and is able to withdraw the funds set aside to pay for medical bills. Funds roll over year to year if you don’t spend them.

IDF is here for you! The IDF Health Insurance Toolkit can provide you with information and resources, including comparison worksheets, to help you understand health insurance plans and make the best possible choice in your selection. Download your toolkit at the IDF Patient Insurance Center today: www.primaryimmune.org/patient-insurance-center.

If you have further questions, contact IDF.

This post originally appeared in the IDF monthly e-newsletter, Primary Immune Tribune. Click here to subscribe.

News Category:

Patient Lifestage:

Audience:

Resource Category: