Thursday, October 24, 2013

Are You Ready for Open Enrollment? Will You Make the Right Coverage Choices for Your Family? #Aflac #MC #Sponsored

Disclosure:  I participated in a campaign on behalf of Mom Central Consulting (#MC) for Aflac. I received a promotional item as a thank you for participating.

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"As October 1 Nears, 7 out of 10 Employers Have Yet to Communicate Employee Benefits Changes.
Yet Most Employers Expect More Gaps in Insurance Coverage, More Costs to Employees due to Health Care Reform"

It is that time again...Open Enrollment.  Next to tax season, many people dread open enrollment, when it comes to selecting the proper health care benefits and other coverage for their families through their employers.  One reason for this stress is that many consumers don't really understand the benefits and what is covered and what isn't.  I learned the hard way back in 2008 when I was diagnosed with cancer and needed to get multiple scans before starting 6 months of treatment.  Prior to my cancer diagnosis,  I was a relatively healthy person.  I dealt with sinus infections, allergies and the occasional cold, but never anything that suggested to my husband and I that we needed to switch from the HMO plan to the PPO.  I would go to the doctor every 6-7 months for my annual appointments, and then maybe 1-2 times a year see the doctor for a sinus infection or cold.  And, my husband, like many men, didn't like going to the doctors.  I would have to drag him tooth and nail when he gets really sick and sit there with him -- just to know he went.  So, based upon our health needs, we chose the cheapest plan, which had the highest deductible.  And, come open enrollment, year after year, we would simply renew our current health plan options, as things hadn't changed.

Because you can only elect your benefits during open enrollment in the Fall, we weren't planning on my diagnosis and all that went along with it -- tests, treatments, medicines, follow up care, etc.  Hopefully you will never be diagnosed with a life threatening disease like cancer, but if you have or know someone who has, then you probably know how expensive the treatment and care is, and more times than not is not covered by health plans.  It wasn't until my diagnosis, that I saw the benefit of having a PPO, for our needs.  I don't know about you, but it can be very frustrating trying to get your doctor's office or even your health insurance company on the phone.  One time during my cancer treatment, I found myself on hold for over an hour, just waiting for the health insurance company to take my call, and get a bill straightened out.

Because of my frequent trips over the years to different health care specialists, a PPO has saved me on the hassles of seeking out my primary care doctor to ask for a referral.  In the past, either I couldn't reach my doctor, he would forget to put the referral in, or my ability to book an appointment would be stalled due to the the specialist's office waiting for the referral and running my insurance coverage.  Ugg!  Now, with a PPO plan, I can see any doctor I want within our coverage area, without a referral.  But, this doesn't come without a price - and a hefty one at that.  If we were to stay on the HMO plan at my husband's work, it would only be $375 taken out each month.  But, with the PPO plan, we pay $698 per month.  While the benefits of not needing a referral are great, I have found that even with the most expensive health insurance plan, that many of the tests and medicine I need for post cancer care are not covered, which means more unexpected out-of-pockets costs for us.  A few months ago, I was hit with a $500 bill from the hospital for a routine cat scan I needed to make sure I was still cancer free.  I had no idea that my husband's health insurance had made changes to their benefits plan, until I called them to ask about this bill.  Usually, I am on top of things when it comes to open enrollment each November.  But, last November was a crazy time with the girls and other life events that I quickly asked my husband if their were changes to the coverage.  Leave it to a guy to not look into things, he came back and said 'No.'  I know I should have looked myself, but pressed for time, I had him re-enroll us in the same coverage and plans that we had elected the year before.  And, as a result, I was now being charged for scans not covered and non-generic medicine at the pharmacy.  

So many other consumers find themselves hit with unexpected bills or bumps in the road when it comes to seeking medical care, mainly because they didn't do their homework when it came time for open enrollment and electing the right plan/coverage for your family, and looking into a flexible spending account.  It wasn't until we welcomed the girls that we started using a Flexible Spending Account to put money in and have available for non-covered expenses.  Do you have a flexible spending account set up for your family?  Do you know how it works?  During the open enrollment period at yours or your spouse's workplace, there are representatives from the HR dept., health insurance organizations, to answer your benefit questions.  In addition to these representatives, you may also find an Aflac representative there talking and answering questions about their supplemental health insurance coverage?  Did you know that you could buy additional health insurance coverage?  I didn't until we went through my cancer journey in 2008.  If it wasn't for the additional supplemental health insurance coverage, we would have gone broke trying to pay for all my treatments and post-care.

Aflac recently released their 2013 Open Enrollment Survey, and I was surprised at some of the statistics.  First and foremost, this was most startling to read: 

"The Aflac survey found that 69 percent of workers say their employer hasn’t communicated changes coming to their benefits package due to health care reform despite the October 1 deadline for employers to notify their employees of their coverage options.  Employers’ delay in communication thus far regarding potential employee benefits changes may be in part due to their own lack of preparation for health care reform. In fact, only 9 percent of companies indicate they are very prepared to implement required changes to their business based on the health care reform law at this time.2 Although the implications of health care reform are yet to be seen, some employers (41 percent) believe more gaps in coverage will be created and 69 percent believe costs to employees will increase as a result of health care reform.2"

Other survey results about consumers not being prepared for open enrollment included:

• 74 percent of workers sometimes or never understand everything that is covered by their insurance policy today.
• Now, nearly 4-in-10 (37 percent) workers think it will be more difficult to understand everything in their health care policy with the changes dictated by health care reform.
• Nearly a third (28 percent) of employees is confused, worried or simply unsure about the change their employer is making to their health care coverage or benefits options due to health care reform.
• 60 percent of workers have not begun to educate themselves about coming changes to their benefits package due to health care reform.
What Mistakes Can Employees Avoid?

"The fact is many workers simply don’t understand their employer’s benefits offerings and the majority (68 percent) admit to making mistakes or having regrets during the open enrollment process. As a result, the Aflac survey found that more than half (54 percent) of workers waste up to $750 because of benefits mistakes made during open enrollment. Additionally, 74 percent of workers admit they only sometimes, rarely or never understand everything covered by their current health care policy.

In order to avoid mistakes, employees need to educate themselves about what their insurance plans actually cover and carefully review policy changes each year. Here are some changes to look for:
Top Tips

• Prepare ahead of time: Be aware of annual insurance policy changes and compare your new benefits package to your policy from the year before. Do your homework to ensure you choose the right policy that fits your needs and make sure that all of the health insurance costs you’re responsible for are within your budget. Also, review the deductibles and other out-of-pocket costs for health care services and pharmacy purchases you’ll be responsible for paying to ensure your plan offers the coverage you need.
• Don’t make assumptions: Keep in mind that if your company hasn’t made any material changes to its health insurance plan since health care reform legislation was passed in 2010, it may be exempt for now from offering widely discussed essential health benefits, including free preventive services. Ask your HR manager if your policy options changed to include new benefits made available by health care reform.
• Check your spouse’s benefits package: Your employer doesn’t have to offer insurance to your spouse and as costs increase, more companies are cutting this option. Even if your employer does offer your spouse insurance, the company is not obligated to pay anything toward the premium. If your spouse has access to employer-sponsored health insurance through his or her job, it may make the most financial sense to purchase two individual policies as opposed to one family policy.
• Don’t double up: Health care reform legislation requires plans in the individual and small group markets to offer essential health benefits like pediatric vision and dental and, chronic disease management services. Check all aspects of your major medical plan so you know what is covered and what isn’t.
• Examine premium costs carefully: Cheaper isn’t always better, since plans with the lowest monthly premiums likely mean you’ll pay more in co-insurance and receive less coverage.
• Consider supplemental insurance such as accident, hospital or critical illness plans to help reduce rising health care expenses. "

More information is needed to make better decisions when it comes to choosing the best benefits and health care needs come open enrollment.  If you don't research and plan accordingly, this can cause you to choose a plan that may not cover health issues, leaving you with out of pocket costs.  So, do your homework, look at your family at a whole and make your decisions based on these factors. Don't go into open enrollment unprepared. If you are unsure of the plans and options available through your employer, make a visit to the HR dept.  They will be able to provide more information, handouts, and even answer some of your specific questions, so come open enrollment, you will be prepared to make the best choices for your family's needs.  And, if they can't answer your questions, they will direct you to a person who can.  The last thing you want to have to worry about in this trying economy is how to pay for necessary medical expenses when they unexpected hit.  We weren't ready back in 2008, but we are today.  And, with the addition of our two daughters, we have added a flexible spending account and supplemental coverage to our family's benefit plan.  We will be sleeping a little easier and stressing out a lot less, now that we do our homework and make conscious decisions based upon our families needs.  You should do the same!

To learn more about Aflac, the No. 1 provider of supplemental and guaranteed-renewable
insurance in the United States, please check out their online
Aflac’s Open Enrollment Resources here --

Disclosure:  I participated in a campaign on behalf of Mom Central Consulting (#MC) for Aflac. I received a promotional item as a thank you for participating.

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