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Open enrollment season is approaching for the millions of Americans who get health insurance through an employer.
Obamacare has gotten a lot of attention this year, as Republicans repeatedly tried and failed to gut the federal law formally known as the Affordable Care Act. But it’s employers who sponsor health insurance for most Americans.
Employer-based insurance covered 55.7 percent of the population for some or all of 2016, making it the most common type of health insurance coverage, according to U.S. Census Bureau data.
Open enrollment is generally the one time of year you can change your health insurance plan or re-enroll. It can pass in a matter of weeks, so you should prepare for open enrollment before the period starts.
If you purchase coverage through the federal Health Insurance Marketplace or a state-run exchange, skip over to “2018 Obamacare Open Enrollment Period Cut Short” to learn more about preparing.
If you obtain insurance through an employer, consider the following steps to ensure you’re prepared to make the most medically and financially appropriate choice for yourself or loved ones when the time comes.
1. Get informed
If you have yet to hear when open enrollment starts, ask your employer’s human resources department for at least a general idea so you aren’t caught off-guard.
Then keep an eye out for information about your 2018 options, including what’s called a “summary of benefits and coverage,” or SBC. Federal law requires employer-sponsored plans to provide this document to you at certain times, including at the start of open enrollment.
The Society for Human Resource Management describes the SBC as “a document that will help consumers compare and select health insurance coverage that best meets their needs by providing easy-to-understand language of health plan benefits.”
2. Don’t renew without review
Even if you love your current coverage, you shouldn’t automatically choose the same coverage for 2018. Find out whether your plan is changing for the coming year, and, if it is, review all of your options. Also consider whether your health care needs or those of family members insured through an employer will change.
Questions to ask yourself while reviewing your options include:
- Does our family take specific prescription drugs? Are those covered by the plan, and what is the copayment?
- Is a baby potentially in our future? What is the plan’s maternity coverage like?
- Does the plan cover all of our favorite doctors and hospitals?
- If we go to a doctor outside the plan’s network, how much will we pay?
- How do we see a specialist? Do we need a referral, or can we see who we like?
- How much are copays for services we may need or want?
3. Consider an HSA
Your options may include a high-deductible plan. These plans can come with lower monthly premiums and are a good choice for some folks, although it’s important to understand how they impact out-of-pocket costs before choosing one.
If you do choose a high-deductible plan, also consider whether you would benefit from pairing it with a health savings account. An HSA is what the Internal Revenue Service describes as a “tax-favored” program, “designed to give individuals tax advantages to offset health care costs.”
As we explain in “10 Tips to Maximize Your High-Deductible Health Plan“:
“With qualifying high-deductible plans, the Internal Revenue Service allows you to create a health savings account — a savings or investment account where you can deposit pretax earnings to spend on health care. Any money and interest earned that you don’t spend remains in the account year after year. Many employers kick in some money too.”
Would you add any tips to this list based on your experiences with open enrollment for employer-sponsored health insurance? Let us know below or on Facebook.