Open enrollment: Five mistakes to avoid

If your company offers health benefits to its employees, that means two things.

a. Your annual open enrollment period is probably coming up soon.
b. Count your blessings. The proportion of Americans under 65 who have coverage through an employer—theirs or a family member's—has declined steadily since 2000 and now rests at just 63 percent, according to the latest Census Bureau figures.

With the economy struggling and health-plan costs steadily increasing, it's an even worse idea than usual simply to default to your existing plan. Yet that’s exactly what three-quarters of insured adults say they expect to do for this coming year, according to a just-released national poll co-sponsored by the health insurer Aetna and the Financial Planning Association.

Even if you don't end up making changes, you owe it to yourself to review your coverage to make sure it’s still right for you and to take full advantage of your company's options. Here are five mistakes to avoid:

1. Declining coverage. With the employee share of premiums, deductibles and copays steadily rising, "there’s a growing trend, especially among young people, to opt out of their group coverage," says Tracey Baker, a financial planner from Fairfax, Va., speaking for the Financial Planning Association. That is a bad, bad idea. The cost of even a single serious health condition—an injury, an accident, a bout of depression, an unexpected illness or surgery—can hit five figures before you know it and lead rapidly to financial ruin. The purpose of health insurance is to protect against such catastrophes.
2. Failing to compare. Premium contributions, cost-sharing and deductibles can change from year to year—and recent history shows, not usually for the better. The plan that has worked fine for you for the past few years might  be more expensive next year than an alternative. If your spouse has a plan through his or her job, it might now be a better deal than your own plan, even though it wasn’t last year or the year before. At a minimum, get information on all plans available to you and compare them side by side. Here’s a worksheet to make that job easier. And to get a sense of how good a plan would be if you really, really needed it, use this interactive calculator to estimate your out-of-pocket costs under five common health scenarios.
3. Not planning ahead. Do you expect to get married or have a baby next year? If so, review the costs and benefits of "employee plus one" or family plans. Make sure the plan you pick covers things like routine baby checkups and immunizations, fertility treatments, and—it should go without saying—all costs associated with pregnancy and delivery. Is there a possibility you'll retire early or get laid off, and thus need to turn to COBRA to continue your health coverage? In that case, you'll be paying the entire premium, including the share your employer pays now. Once you go on COBRA, you can't switch plans until your former employer's next open enrollment period. So ask your employee benefits department what your COBRA premiums would be for all the plans your company offers. You might want to consider a precautionary switch to a cheaper plan.
4. Snubbing HMOs. Only one-fifth of people with job-based health coverage belong to HMOs, which have steadily lost popularity over the past decade to Preferred Provider Organizations, which offer a broader choice of physicians. But, as our own surveys and those of others have repeatedly shown, HMOs are the most economical type of health plan. If you haven’t looked at your company’s HMO options recently, do so this time around. It may be worth your while to trade a wider choice of doctors for lower out-of-pocket costs. And, suggests Baker, if your doctor isn't on the provider list at the HMO you’re considering, ask if he or she might consider joining on your behalf.
5. Not signing up for a Flexible Spending Account. These accounts enable you to pay out-of-pocket health costs with before-tax dollars. If you're in the 25 percent tax bracket, for instance, it’s like getting $250 back for every $1,000 you spend. Click here and here for details on how to make FSAs work for you.

—Nancy Metcalf, senior program editor

Comments

[Jane]

I believe if you have a chronic condition that requires monitoring, a HMO is the best way to go. I have been fortunate that the HMO physicians I have encountered were professional and took the time to discuss any of my concerns. By the same token, it is important to realize that Dr. Welby no longer exists, physicians have time constraints, so go prepared, perhaps writing a short list of questions, so your time is spent constructively.

[Marnie]

I'm sure that everyone's experience differs but my experiences with HMOs has been abysmal. I recall feeling like I had been placed on a conveyor belt and anything I couldn't fit into a conversation before I fell off the end, was not of interest to the doctor. Often, I'd be asking the doctor questions as she walked out the room because I had reach the prescribed time for that visit. This was different doctors and different plans but consistently, I felt rushed through my appointments with the HMOs I tried. Worse, I often felt like the doctors I had available to me were not particularly interested in treating me. They seemed terse and inconvenienced. I don't know much about how HMOs are designed, but they don't appear to be a great value for the doctor or the patient.

Now that I only use PPOs, I still occasionally end up with a doctor I'm not thrilled by, but I never feel rushed. Going to the doctor is stressful enough without having to feel like a burden and when both you and the doctor feel that time is well spent, it's worth the additional fee out of each pay check.

[lenore rutkowski]

i am 65 i am looking to join medicare supplement i did get a quote from bankers insurance co. and also from united world insurance company. can you give me an imputon these companies