PORTLAND, Ore. — Signing up for health insurance can be overwhelming. It can be confusing picking the right plan; whether open enrollment is coming up at work or someone turns 26 and will soon be booted from their parent’s insurance.
Angela Dowling, president of Regence Blue Cross Blue Shield of Oregon, offered tips to help people navigate the process.
“If COVID has taught us anything: We’re not invincible,” Dowling said. “And so people need to plan for those occasions when maybe they need some additional assistance in the health care space.”
For many, health insurance comes through their employer during open enrollment. It’s a window that opens once a year, often in the fall, when people can sign up for health insurance, adjust their current plan, or cancel it.
“Open enrollment happens for every employer at different times of the year. However, about 70% of them do open enrollment in the fourth quarter. So, timing is good,” Dowling said. “It’s good to think about what your benefit needs are and what your healthcare needs are at this time.”
Open enrollment is a familiar place for many, but for young adults, it’s a whole new world and confronting health insurance decisions come quickly.
“They have to make a decision, likely for the first time in their lives, around insurance and it’s confusing,” Dowling said.
As students head off to college, most will be required to have health insurance at their school of choice. Many will offer their own health plan.
“When your student goes off to college, if you have health insurance for your dependents, including your student, you don’t need to enroll in the college plan. Keep that in mind. That could lower your expenses if your student is going off to college,” Dowling said.
Being a dependent on a parent’s insurance, however, only lasts so long. Young people have the option to stay on their parent’s plan, as a dependent, until the age of 26. Even with a full-time job, many people stay on their parent's plan. When the birthday month arrives, though, soon-to-be 26-year-olds need to opt out and get their own coverage.
“When that dependent rolls off into their own plan, they need to either go on to their current employers plan and/or get an individual plan that they can get in the marketplace,” Dowling said. “A producer or an agent can help them get that coverage or they can go to the exchange and secure that coverage themselves.”
When it comes time to pick a plan, Dowling suggests taking the time to weigh the options and think about how healthcare has been utilized in the past.
“If you’ve had a large number of claims because you have a condition where you see physicians frequently or medications, think about that in terms of how you want to continue your future health care expenditures. That helps you decide what kind of plan decide do you really need to accommodate for your health situation,” Dowling said.
Also, consider the provider and whether it's in the carrier network.
“There are no pre-existing conditions. So, if you want to change carriers, you absolutely can, but you should make sure that if you’re seeing a specialist or seeing a particular provider that you’re very interested in or have a relationship with – that [the] individual is in the network and is reimbursed at the level that you can afford,” Dowling said.
Another tip is to consider the plan type. There are several different types, each with pros and cons depending on a person's situation.
“Go back to your original situation. If you have a chronic condition, that might not be a great plan for you, but it really depends on the contributions that your employers make to the plan. So, maybe the cost of the monthly premium is offset by that cost of the deductible?” Dowling said.
Yes, picking a plan can be overwhelming, but there are resources in person and online to help people sift through the confusion.
Here are some online resources:
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