Tuesday, October 26, 2010

Preparing for open season: making smarter health care decisions (with less stress!)

Each year, November is the month that I dread.  November is open season, where we must elect a health care plan that we will be stuck with for the whole next year.  Choosing a plan isn't as simple as just picking what we have this year for next.  Instead, a lot of thought goes into the decision making process.  With the health care changes, everything this year seems all the more confusing!  Fortunately, Aetna has launched a website explaining health care changes in normal words that people can understand called BeSmartAboutYourHealth.com.  There, you can find easy to understand explanations of health care changes and how to get your plan working for you.  See how much the Power of an Hour can aid you in making smart health care decisions for the coming year.

As a seasoned pro at open season, I offer you my five tips for making open season less stressful, while hopefully helping you to choose the best plan that gets your benefits working for you.  Some of these mirror those suggested on the Aetna site, actually!

1.  Take a look at maternity coverage if you are of child bearing age

If you are still of child bearing age, you should definitely be shopping for a plan that covers maternity care and, subsequently, offers great coverage for well child visits.  While you may not be planning on having another child -- we sure aren't right now -- things can happen.  Know that in the event that you are surprised with two lines on a stick that you won't have any gaps in coverage.

2.  Review your EOBs for the past year to find out who went to the doctor the most

In our household, this is easy as pie.  I know that I am the one who visits doctors the most.  For us, we need to ensure that any plan we elect during open season includes care for my health needs, which currently involve immunotherapy for allergies.  Having seen the EOBs for the cost of serum - several hundred dollars each time it is re-ordered - it is a necessity that any plan we select must cover allergy doctor visits and allergy shots to some extent.  Plan around your family's most pressing medical needs.

3.  Review prescriptions for the past year

Reviewing our prescriptions for the past year is actually very easy for us.  Our insurer, Aetna, provides online tools to make searching for this information very easy.  Since I take prescription allergy medicines, I verify that whatever plans we are looking at cover the cost of the medicine at at what tier.  I also look at how often I am filling it because that will factor into our decisions as well.

4.  Scheduling dental visits and other doctor visits at the right time

Another thing that we review is whether or not we are scheduling our provider visits at the most beneficial times.  If you are mid-root canal during open season, you know an expensive crown is coming down the pike.  Therefore, if you know you need expensive care, you can plan to start it now and ultimately be able to use both plan years if you time your visits just right.  For those with a FSA like us, we know that now is the time that we need to schedule appointments so that we are aware of any upcoming large expenses (like a root canal) now so that we have time to research our plans and ensure that the larger costing items are covered to the fullest extent to save us the most money.  In the past, this has included picking up a supplemental dental plan when our daughter needed orthodontic care.  Once her treatment was complete, we were able to drop it for the next calendar year.

5.  Think about what you could be doing to better your health

Our insurer sometimes emails us about special offers that are available to us as members of our plan.  This sometimes includes a discount on a deluxe, electric toothbrush or sometimes it might be a discounted or waived fee for gym membership.  These money saving opportunities, if taken advantage of, have the potential to lower our overall cost for our health care, not only reducing our bottom line when it comes to health care expenses (copays for care), but also because getting and staying healthy reduces the cost for everyone in the plan.

We pay attention when our insurance company mails us reminders to get our eyes checked or that it is time for that annual pap exam!  These preventative care reminders serve as a nudge to take care of our bodies the best that we can.

Using these five steps and Aetna's tool will help us to make the most beneficial health care decisions.  Our open season begins in just a few weeks and I know that I'll be able to get the most up-to-date information in layman's terms to help me and my spouse select the best plan for us for 2011.  Having the ability to easily identify the largest items that will factor into our health care decision is key to being smart about our health. 

Disclosure:  I wrote this blog post while participating in the TwitterMoms and Aetna blogging program, making me eligible to get a $30 Target gift card. For more information on how you can participate, click here.”
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