Thursday, December 5, 2013
By Marcia Heroux Pounds, McClatchy Newspapers
In choosing health insurance, Cariann Moore used an online spreadsheet tool provided by her employer to compare insurance plans. She found that a high-deductible plan with a lower price tag would save her money.
"For me, it makes it so much easier and demystifies what can be a little overwhelming when you have all these options," said Moore, who works for the C3 customer-service firm in Plantation, Fla.
With health insurance premiums up an average of 7 percent for 2013, employees are finding they need to be savvier consumers. To deal with rising costs, employers are putting the onus on workers "to take control over what their health expenses are," said Terri Byers, national benefits enrollment manager for Oasis Outsourcing, a West Palm Beach, Fla., business that handles payroll and benefits for companies.
Here are seven tips on choosing health insurance and reducing costs:
• Make sure you enroll. If you don't re-enroll in your benefits or are given new plan options, you could end up without coverage for 2013. Check your enrollment dates, often in early November or in the spring, and make sure you sign up.
Most people who are offered employer-sponsored health insurance should take it, said Keith Mendonsa, consumer insurance specialist for eHealthInsurance.com, which provides insurance quotes online. And people with pre-existing conditions should definitely take it, since they could be declined on their own, he said.
• Pay attention to your insurance costs. Look at three things: your premium cost contributions this year compared to last; your maximum "out-of-pocket," which is your financial obligation for a catastrophic health issue; and your deductible.
Byers offered an example: "If my deductible is $2,500 and my out-of-pocket max is $5,000, I know I'm going to have to pay $2,500 if I go into the hospital. Can I afford that?" But if the deductible and out of pocket are both $2,500, then all your health care expenses will be covered by your insurance after the deductible is met.
Consumers make the mistake of picking what they think is the "richer" plan, Byers said. But check whether your doctors are on the less-expensive HMO plan, as well as the pricier PPO insurance.
"It's really understanding your plan," she said.
• Compare traditional with high-deductible plan options. More employers are offering a high-deductible plan, which generally offers a lower premium.
But be prepared to pay the amount of the deductible in the coming year if you have serious health care issues, said Mendonsa.
Moore, 34, chose a high-deductible plan because she's relatively healthy and doesn't have to buy many prescription drugs. "It made more sense for me," she said. "Knock on wood; I haven't been in an emergency room for a very long time."
But a family that has frequent visits for the children to the pediatrician or even an emergency room may prefer the co-payments and lower deductible of an HMO, Byers said.
Ask your employer if there's a "gap" plan available, which is combined with high-deductible insurance to offset the cost if an employee lands in the hospital. Under a high-deductible plan, the employee has to pay the deductible, which can be $5,000 or more, before surgery or other major health care expenses are covered.
• Use incentives to reduce costs. "Employees should think about how they can be better consumers with the services a carrier offers," said Heather Leck, president of Corporate Benefit Advisors in Delray Beach, Fla. Some plans offer a hotline to a nurse or doctor, price checks on tests ordered by a doctor, or where to find the best deal on a prescription.
• Set pre-tax dollars aside. Use a flexible spending account either from your employer or a third party, such as a bank, to deposit money to cover health costs not covered by insurance. Find the list of IRS-approved expenses on your health insurer's website.
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