If there’s one thing we can all agree on when it comes to healthcare, it’s that we’re spending much more of our hard-earned cash to get it. Unfortunately, rising healthcare costs are a reality. Although there are limits to what we can control, making informed choices is a critical part of managing medical costs.
In the final few days of open enrollment for people who buy insurance through the Marketplaces set up under the Affordable Care Act, here are a few items to consider:
1. Go shopping: If you don’t get insurance at work, you have until this Sunday, February 15th to select a health plan for this year. Even if you’re happy with the plan you had last year, there’s a good chance you can find a better deal. The Department of Health and Human Services recently reported that 70% of people re-enrolling in a plan this year can find one with a lower premium by shopping new options.
2. Choose and use your plan wisely: Whether you’re in the market for a new plan or keeping the one you have, be sure to confirm that your doctors, clinics and hospitals of choice participate. Frustrating as it may be, this has to be an annual exercise because the details of these plans and what they cover change all the time. Also check that your medications are covered and how much of the cost will be paid for.
Staying within your health plan’s provider network and taking drugs included on the formulary can have an enormous impact on your costs. In today’s world, it’s a good idea to check with your plan and your doctor to confirm participation and avoid surprise bills.
3. Confirm your income: Go back into the Marketplace to make sure your information is current. This is a good idea for everyone, but especially if your income or family size has changed because those factors impact your eligibility for tax credits, and/or help covering your out-of-pocket costs when you go for care.
Continue to keep this information updated throughout the year. A good rule of thumb is that if your earnings increase or drop by about 10%, report that right away to the Marketplace.
4. Follow the rules: Each health plan has a set of guidelines you must follow in order for your care to be covered. Many procedures and services, for example, require you to first obtain prior authorization from your insurance company. Without it, your claim can legitimately be denied, even if your care is technically covered by your plan. Always check with your plan before you schedule any medical procedure.
