Struggling to complete open enrollment? Here are three simple steps to help you finish it today.
It's understandable if you haven't made a decision on your coverage during this open enrollment season, given the delay.
Many workers struggle to choose an affordable and understandable health insurance plan from a range of expensive options. According to a survey by Willis Towers Watson, U.S. employers anticipate a 7.7% increase in healthcare costs in 2025. As a result, approximately one-third of companies plan to increase employee premiums to help cover these expenses.
To ensure you're getting the most cost-effective plan that meets your health-care needs, you can take a few simple steps and fully utilize your benefits.
GoodRx's certified public accountant and personal finance editor, Charlene Rhinehart, compares shopping for shoes to personal finance.
"The type of shoes you purchase depends on your needs and how you'll wear them, and health insurance functions similarly by requiring you to consider all your requirements and choose the best plan."
To make the most of open enrollment, follow these three easy steps to complete it promptly.
1. Do a health audit
Before selecting the best insurance policy, it is essential to assess your healthcare requirements, advises Rhinehart.
She suggests taking a step back and doing a personal health audit before starting the process.
In the past year, how frequently did you visit the doctor? Did you see your primary physician or did you require the services of specialists? Which medications are you currently taking and what were the costs associated with them? Do you have any ongoing medical expenses or were they one-time occurrences?
Could you list the providers you frequently use? Do any of them stand out as indispensable? Or do you consider all dermatologists to be equally effective?
What are some questions that can help you determine your desired health care for the upcoming year and the most suitable payment method?
2. Know your acronyms
You will likely be given a list of insurance options, which are typically divided into two categories: high-deductible health plans and co-pay plans.
Here's a quick breakdown.
High-deductible plans
These plans require you to pay for most medical expenses up to a certain amount before your coverage begins. For 2025, the minimum deductible for individuals is $1,650 and $3,300 for family coverage, though some plans may have higher figures.
Health savings accounts (HSAs) are commonly associated with certain plans and provide a distinctive "triple" tax advantage. Contributions to these accounts can be deducted from taxable income, and any growth in investments is tax-free. Additionally, as long as HSA funds are used for qualified medical expenses, withdrawals are tax-free.
You can take your HSA with you when you switch jobs and there's no requirement to spend the money within a specific timeframe.
If you frequently have high medical expenses or expensive prescriptions, these plans may not be suitable for you, as you will have to pay out-of-pocket costs.
"According to Carolyn McClanahan, a physician, certified financial planner, and founder of Life Planning Partners, if you are healthy and rarely visit the doctor, an HSA plan is usually the best option. However, if you are not as healthy and require frequent visits to the doctor, a co-pay plan may be more suitable."
Co-pay plans
Unlike high-deductible plans, co-pay plans have fixed costs for services such as office visits, prescription drugs, and medical procedures. You pay a small amount out-of-pocket, and your insurance company covers the remaining cost.
If you pay high premiums for health insurance, you may be able to save money on medical procedures in the long run.
Flexible spending accounts are often included in co-pay plans, allowing for tax deductions on contributions. Unlike HSAs, however, the money must be spent within the year or it is lost.
These plans come with two common coverage options:
- To manage your care, HMOs require you to consult with a primary physician. To see a specialist, you'll typically need a referral, and you'll only be covered if you use a doctor within your plan's network.
- A PPO allows you to visit doctors both within and outside of your network without a referral, but you may need to meet a separate deductible for out-of-network care before coverage begins.
HMOs are typically cheaper than PPOs, but it's important to ensure that your preferred doctors are within the plan network before selecting an HMO.
Before making a decision on your prospective plans, calculate the total cost of your doctors visits and prescription drugs from the previous year to determine which plan would be more beneficial.
Before switching plans, review the new plan's benefits and coverage summary to determine the cost of specific procedures or treatments. If you take prescription medication, contact potential insurers to inquire about the cost of refills at the pharmacy.
"The simplest solution is to call your doctor's office to determine if your preferred provider is in your new network," advises McClanahan.
3. Don't forget the perks
Before making a decision, consider any additional advantages your company may offer.
You may be concerned about the affordability of care under a high-deductible plan. However, 62% of companies that offer an HSA provide some form of contribution to employee accounts, which can help offset the costs, according to the Society for Human Resource Management.
Your firm may provide telehealth services at no cost, which can significantly reduce out-of-pocket expenses if you rarely visit a doctor.
""Our virtual care is free under high-deductible plans, and there are many ways to take advantage of virtual services, including having a primary care physician relationship virtually," says Matt Phillips, assistant vice president of benefits at AT&T."
Reviewing the benefits offered to employees at your firm during open enrollment season is a great opportunity to take advantage of them in the upcoming year.
In exchange for completing annual preventative health screenings, your company could deposit funds into a tax-advantaged account.
You can purchase supplemental insurance policies through your employer, such as pet, life, accident, disability, and ID theft coverage. However, it's important to review the premiums and coverage details to determine if these policies are suitable for your needs. In most cases, you can expect to pay less than if you bought the same insurance independently.
Employers, especially large ones like AT&T, have utilized their bargaining power to secure excellent deals for their employees, according to him.
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