Factors to Consider When Purchasing a New Health Insurance Plan During Open Enrollment

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Price is just one factor to consider when deciding whether or not to opt for a new health plan. Here are some tips on what to look for when choosing a new plan.

Open enrollment, when people can buy health insurance or change their insurance plan, begins Nov. 1 and ends Dec. 15.

Price is just one factor to consider when deciding whether or not to opt for a new health plan. There is also: Co-pay, deductibles, network coverage and whether telehealth is included.

“The great thing about healthcare.gov and the plan selector is that it lets you really compare plans side-by-side,” said Jason Resendez, board member of Consumers for Quality Care. “It’s really about figuring out what’s important to you, and then seeing what plans align with those priorities for you and your family.”

Some new-this-year issues to consider — nearly three-quarters of the largest health plans across the country are no longer waiving cost-sharing for COVID-19 treatment.

Telehealth has become a lifeline for many Americans during the pandemic, according to Resendez, who said 70% of people who have used telehealth services say they are likely to continue using them after the pandemic ends.

But some insurers are canceling telehealth coverage.

A new law that will come into effect in 2022 will help protect people from “surprise billing”, when people are billed for out-of-network providers, such as anesthesiologists, at in-network facilities.

“In the meantime, it’s really important to be aware of potential surprise bills, know what’s in the network, and read that bill,” Resendez said.

Being charged twice or charging extortionate prices for items like wet wipes is something people should watch out for and talk about, Resendez said.

“It’s important to know that you have a voice and you have to use that voice, and sometimes that means pushing things back,” Resendez said. “We have seen many instances where these bills have been reduced or removed altogether.”

Resendez strongly encourages people to avoid short-term insurance plans. They go by many names such as short-term, time-limited, or short-term plan; there are different variations, but that “short-term” phrase is really the part to watch out for.

“These are really junk plans,” he said. “These are plans that look great on paper because they have low monthly premiums, but they often have dollar value limits on covered services or come with high deductibles and often exclude pre-existing conditions. So things like hypertension or even pregnancy can be excluded from these plans,” Resendez warned.

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