Open Enrollment for Healthcare Plans

It is open enrollment time for Marketplace health insurance. This is a four-month period of time starting November 15th and if you fail to enroll via healthcare.gov during this window of time, you won’t be able to buy Marketplace coverage. Yes you can purchase healthcare outside the Marketplace, but why would you? It is therefore important that consumers completely understand their options through the Marketplace.

With the Affordable Care Act, all US citizens are entitled to health insurance coverage via government exchanges, although the majority of Americans still get health benefits through their employer. Most companies that offer healthcare as a benefit give their employees two months to choose from a couple options. All plans in 2015 must include at least the same set of 10 essential health benefits. Below are three important tips to ensure a successful open enrollment season.

Open Enrollment Tip #1: Review Your Options

Invest the time to look over your options with a keen eye for detail. Ask as many questions as you can. Go beyond just comparing deductibles and monthly investments required per household. Consider your monthly costs on prescription drugs or if there are any big events that you can plan for such as having a baby, scheduling the hip replacement you have been putting off or consider the level of care required to treat a chronic pre-existing conditions.

There are some insurers that offer incentive programs or wellness programs that can help you quit smoking, lose weight or lower cholesterol levels. These incentives can include lower premium costs, merchant gift cards or membership discounts.

Open Enrollment Tip #2: Ensure Your Doctor is In-Network

Always double check with your primary care doctors and the specialists you see. Sometime doctors move in and out of networks based upon reimbursement agreements and the hospital networks they are connected with. In an effort to control costs, many insurers renegotiate terms with network providers. These new agreements often take place at the beginning of their fiscal year. Those decisions can and will impact a doctor’s practice and they may choose to participate in this new plan or stop accepting that insurer’s terms abruptly.

Open Enrollment Tip #3: Don’t Forget Specialty Benefits

Specialty benefits like vision and dental plans are usually available at a minimum cost, and cover eye exams and teeth cleanings. There are also vision plans that offer reduced pricing on lenses and frames. Research suggests that there is a connection between oral health and overall health, so having the right dental plan can help you prevent more serious medical problems and control those out of pocket costs.

For some people, open enrollment can be very confusing, given the numerous choices of individual health insurance plans that are available through both the individual Marketplace and through health benefits for employees and employers. If you want more guidance on low cost health insurance in Bucks County, contact a reputable health insurance agent to help you choose the most desirable and cheapest health insurance in Philly that fit your specific needs.

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