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Insurance > Dental Insurance
How do I pick the right health care plan for me?
AMY BALDWIN, AP Business Writer. Associated Press.
Copyright Associated Press
Q: It's open enrollment time at my company, when employees must choose health care plans for the coming year. How can I determine which coverage is right for me?
A: You're smart to be thinking about your health care coverage. Health care benefits consultants say there have been a lot of changes to employer-sponsored plans.
"With health care costs going up an average 15.4 percent (in 2003), employers are not going to be able to shoulder all of that and are going to pass it on to their employees," said Ken Sperling, of Hewitt Associates, a consulting firm.
"Now is not the time to spend 15 minutes on your enrollment materials," Sperling added. "For most employees, what they pay is going to go up, or their plan design is going to change, or the plan they are in now isn't going to be available next year."
In selecting your health insurance coverage, there are basically two factors to consider: access and cost.
Benefits consultants say to deal with access first.
"Make sure the network (of doctors) is an adequate match of your family's needs," said Leslie Miller of Marsh USA, a risk management and benefits consulting firm.
That means making sure that the doctors you and your family use now will continue to participate in your plan or that they take part in any new plan you are considering. Remember to take into account all your doctors _ pediatricians, gynecologists and other specialists _ not just your general practitioner.
The next step is to calculate and compare costs.
Figure out what you spent on health care this year by adding up your premiums, which are deducted from your paychecks, and your out- of-pocket expenses, such as doctor's office and prescription drug copayments and hospital or emergency room deductibles.
Then compare that cost with what your current plan _ if it is available _ will run you next year. Also run those numbers against other plans offered through your employer. If you are married, you'll want to weigh the cost of coverage through your employer against that of your spouse's.
Next, adjust those numbers to reflect other medical expenses that you anticipate next year, said Rich Niemeyer, a benefits consultant with Scheller Bradford Group.
That means, will your child need dental work? Have you been going to the doctor more often?
"For someone who isn't (often) sick, they might want a lower- cost premium where they would have higher out-of-pocket expenses, but they don't anticipate having those," Niemeyer said.
Also, check to see whether your company has a medical savings account program, which allows you to designate pre-tax dollars for certain medical expenses that might not be covered in your plan.
Lastly, take the enrollment period seriously. These are important decisions, and in most cases, an employee who misses a deadline can't request changes later.
"Things are changing," Sperling said. "Not paying attention will probably cost you money."
Reproduced with permission of the copyright owner. Further reproduction or distribution is prohibited without permission.
People: Sperling, Ken
Dateline: Undated
Text Word Count 487
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