Evaluating Your Health Care Choices and Options – Open Enrollment and Supplemental Insurance #AFLAC #MC #Spon

Changes.  Almost everyone in the country is facing changes in their health care options.  We are all struggling to evaluate our choices and identify the best plans.  As you look at coverage details there are a number of terms that you need to understand to get a grasp on what your health insurance is, or isn’t.  All of us have the same goal- to ensure our family has the necessary coverage in case of a medical emergency and to do it and the most reasonable cost.  Aflac’s 2013 Open Enrollment Survey found we’re not alone, as 74 percent of workers sometimes, rarely or never understand everything covered by their current health care policy.

Please note:  I am not a health care professional and everything depends on your particulars.  These are just general guidelines and information – consult with your Human Resources or other insurance professional to verify details of your plan or coverage.

The first term you will most likely encounter is Open Enrollment Period.  That is the time period when you can make changes to your coverage without an event of some kind.  For example, if you have a child that is currently not covered and want to add them to your policy, you can do it during the open enrollment period, just because you want to.  During another time, outside the open enrollment period, you might possibly need a change of custody or some other event that justifies a change.

Premium is the periodic payment you make for your insurance.  It is most commonly a monthly charge.  The amount of the premium depends on many things, including the options you choose.  Out of Pocket is the amount you pay each time you receive a health care service.  If you have a high premium, then you most likely have a low out-of-pocket.  If you have a low monthly premium, then you most likely have a high out-of-pocket.  So if you are healthy and seldom incur health care costs, you are most likely to have lower overall costs by choosing a low premium, high out-of-pocket plan.  On the other hand, if you need frequent or costly health care services, you would be better served by a plan with a high premium but doesn’t require you to pay a large portion of each time you use it.

When you are looking at cost, Deductible is an important factor to consider.  The deductible level determines how much of your health care costs you will pay before insurance will kick in.  The time period for a deductible is usually a year.  If your company starts the plan year on January 1st, for example, and your deductible is $100, – beginning each Jan. 1st, you will have to pay $100 before insurance will start paying.   Generally, the lower the deductible, the higher the monthly premium.  If you prefer to have a fixed, known amount each month versus unexpected bills’; if you have very little cash or savings on hand; or if you have high health care needs, then you would be better with a low deductible, high premium.  But if you do have available savings, if you are very healthy and seldom incur health care costs, you may be better off with a high deductible and a low monthly premium.

Co-Pay is another important characteristic.  The co-pay is what you pay out-of-your-pocket every time you have a health care visit or need.  For example, if you go to the doctor’s office, you may have to pay a co-pay.  If you have a high co-pay, your premium costs are most likely lower than if you have a low co-pay.  If you only go to the doctor once or twice a year, you may be better off with a high co-pay and lower monthly premium.  If you go to the doctor frequently, you might have a lower overall cost if you choose the lower co-pay/higher monthly premium option.

I hope this makes sense.  For me, quite a bit of the choice depends on a person’s risk tolerance.  If you are the kind of person that purchases extended warranties, doesn’t have reserves of savings, doesn’t like surprise bills, you would be more comfortable paying more for insurance and less for services.  If you are the kind of person that would prefer to take the chance that you are not going to need health care and to pay-as-you-go, then you will most likely be more comfortable with a low premium, high out-of-pocket plan.

An important option to consider is supplemental insurance.  Especially if you don’t have a reserve of savings and don’t want to risk the chance that you might have large health care needs.  Supplemental insurance, as the name implies, supplements or adds to your standard insurance.  It covers things that traditional insurance does not.  For example, if you become ill and can’t take care of your children, most traditional insurance will not help with child care costs.  Supplemental insurance might give you that assistance.  There are many costs of illness beyond doctors visits and medication.  For example, where you go for cancer treatment may be far from your home.  Traditional insurance will help pay for the treatment, but not the gas for someone to drive you there.  That’s where supplemental insurance comes in.  It might pay for lodging and travel expenses when treatment is far from home.

For more information go to:  Aflac’s Open Enrollment Resources http://bit.ly/1bePWaa

Disclosure of Material Connection:  I participated in a campaign on behalf of Mom Central Consulting (#MC) for Aflac. I received a promotional item as a thank you for participating.