5 ways to get more from open enrollment

Open enrollment is the period when you can select a new health insurance plan or make changes to an existing one. It offers a chance to review your coverage and make sure it still fits your needs and budget.

Whether your insurance comes through your job or you buy it on your own, knowing how the options work can simplify the process and help you make better use of your benefits.

Don Truong, chief sales officer at Sharp Health Plan, offers five suggestions for making the most of open enrollment:

1. Look beyond the monthly premium

Examine each plan’s premium, deductible, copays and out-of-pocket maximum. Be sure to also check which doctors, hospitals, medications and services are included.

If you expect to see specialists, take prescription drugs or need hospital treatment in the coming year, factor those needs into your comparison.

2. Learn the basic insurance terms

Understanding a few common terms can make plan comparisons much clearer.

• A premium is the amount you pay each month for coverage.

• A deductible is the amount you may have to pay for services before your plan starts paying.

• A copay is a set fee for certain services.

• The out-of-pocket maximum is the most you will pay for covered care in a year.

3. Pick a primary care doctor

Your primary care doctor is often your first stop for preventive care, health concerns and referrals to specialists. Consider the doctor’s location, languages spoken, accepted insurance and whether the medical group includes any specialists you may need.

If you prefer a certain hospital, look for a doctor who can treat you there or coordinate your care as needed.

4. Review more than medical coverage

If you get benefits through your employer, take a look at the full package. Your company may offer preventive care, telehealth, mental health support, wellness programs, fitness perks and health savings accounts or flexible spending accounts. These benefits can help support your health and manage expenses.

5. Ask questions before you enroll

If you are unsure which plan fits you best, Truong suggests reaching out to the health plan’s enrollment team. “The enrollment team can explain your options and answer questions about costs, coverage and provider networks to help you choose the right plan for your needs,” he says.

Sharp also provides an online open enrollment resource at sharp.com/choosesharp.

“Taking the time during open enrollment to compare plans and understand your benefits can help you move forward with the coverage and care you need,” Truong says.