Open Enrollment - Page 4 - Health Insurance Anxiety? We've got you covered

Open Enrollment
- Page 4
Health Insurance Anxiety? We've got you covered
Overcoming the fear of open enrollment with education

By Lisa Baldino
Contributing Writer

If the thought of the upcoming “open enrollment period” for health care coverage has you running for cover, then you may want to build a fort out of blankets and get your flashlight ready to read in the dark for the next three months. While it may be confusing, health care coverage is a necessity, even though penalties for noncompliance will be lighter in 2019. According to the U.S. Census Bureau, the percentage of Marylanders without health insurance is 6.1 percent – a historic low, but it still leaves nearly 400,000 people without coverage. According to the Maryland Health Connection, the state’s official health insurance market, another 400,000 people enrolled in programs since the Affordable Care Act was passed.

You can make good choices for your health care coverage by educating yourself. That means determining what you’ll need in an insurance plan and learning about the options – both medical and financial.You can rest easy knowing there is no price negotiating involved. You’ll get the same plan for the same premium at every stop, no matter how many brokers you call or how many times you enter your personal information into the insurance websites. According to Ryan Stangle, president of Insurance Force in Annapolis, Md., “The carriers determine the pricing for each plan. You simply provide your personal information such as home zip code, gender and birth date. You will get the same pricing on an individual plan from any broker or if you go direct to the carrier.” Brokers are paid by the carriers, not the customer.

Before you begin reviewing plans, think about what your health needs will be for the coming year. Stangle says usually the top priorities are plan design (deductible amount, out-of-pocket maximums and co-pays), price and network of doctors (those who participate in that particular plan). “You should determine your threshold for the maximum amount you can spend if you have a catastrophic health event,” he says. “That will be your out-of-pocket maximum.” Some plans have higher deductibles and out-of-pocket maximums, but the premiums are lower, and other plans have higher premiums but the deductibles and co-pays are lower.

Determine the price you’re willing to pay per month for insurance. Review your network of doctors.Melissa Barnickel, principal at Baygroup Insurance LLC in Monkton, Md., says, “Check to make sure you’re comfortable with the doctors in the plan. There are two carriers available to individuals in Maryland and they each have different doctor networks.” The two are Kaiser Permanente and CareFirst.

Stangle advises looking at your family’s prior medical history to get an idea of where you spent your money in the past. “This will help you determine your needs moving forward. Every person who has medical insurance has online access to their prior claims data to verify what they spent on health care expenses. Some people would be surprised to see where their money was actually spent,” he says. Compare your options to how much you can afford for a 12-month plan.

Once you know your needs and your budget, insurance experts say the first place you should look for coverage is with your employer. Stangle notes that most employers often pay a portion of the premium so that costs are lower for participants. Although the Affordable Care Act mandates all businesses with 50 or more employees have health care coverage available to employees, that doesn’t mean they have the best plan for your family, he explains. “Some employers use health care coverage as part of the compensation package to attract workers in a competitive market, so the plan is very affordable and very good,” Stangle says. “Some are just making the plan available to be in compliance and there might be better options elsewhere.”

An employer’s plan may also provide more carrier options and plan designs than the two carriers available to the individual market in Maryland. Stangle, who specializes in employee benefits for businesses, says employers have access to more carriers and plan designs.“They can really customize the medical plans to meet the needs of their employees and their families. Most companies invest a lot of money into their benefits package, so they need to make sure these plans are well received by their employees,” he says.

Enrollment continued on page 15