Open-Enrollment 101: Here is What you Need to Know
It’s open insurance enrollment time and choosing a health plan can be stressful, especially if you’re dealing with chronic pain or are expecting to have surgery in the New Year.
With new provisions to health care laws, new lingo, endless forms and a confusing system, a few tips from health experts can make navigating health insurance and completing your insurance enrollment forms easier and with less hassle. Living with chronic pain is tough enough, so you don’t need the added headaches of insurance enrollment.
So, what should people know before making a decision?
Many insurance plans require you to use specific doctors, hospitals, and pharmacies. And of those, they may or may not cover specific costs associated with prescriptions, doctor visits, etc. Before making a decision, do your research and make sure your preferred doctor is in your health plan‘s network.
Next, while you don’t have a crystal ball, it’s smart to be proactive about what your health care needs are likely to be for the coming year. Are you having surgery or needing physical and occupational therapy to treat chronic pain? Consider a plan that offers flexibility and doesn’t restrict the number of treatments, or event alternative types of medicine, etc.
Finally, let’s consider costs. It can be easy just to focus on monthly insurance premiums, but it’s important not to let this impact receiving the coverage you need to help you deal with chronic pain, treatments, and prescriptions.
Here are some factors to consider:
Deductibles and Co-Payments
Until your deductible is met, remember you’re required to pay for any services other than preventative care. If you’re seeking treatments for chronic pain, expect to pay out-of-pocket. Once your deductible is met, you will often have the option to pay a higher monthly premium in exchange for a lower deductible. Keep in mind; you may still need to provide a copayment at each doctor visit. The co-payments may not seem like a lot if you rarely see the doctor, but they can add up if you have a chronic pain condition or are having regular post-surgery visits.
Out-of-Pocket Maximums
Do you or a family member suffer from a chronic condition? Will you need special therapy or surgery in 2017? Some health insurance plans offer special programs for people with chronic conditions such as osteoarthritis, rheumatoid arthritis, diabetes, or chronic pain. Services may include a 24-hour nurse line, multidisciplinary pain rehabilitation, and wellness programs. If you need special service, experts recommend looking closely at this figure since your health plan will pay the full cost of all the services it covers once you meet this level.
Do you still have questions? With open-enrollment deadlines quickly approaching, don’t be afraid to reach out to your healthcare provider and/or pain specialist with specific questions related to what they cover and treat based on your current plan and how new options might impact coverage. Also, visit your preferred healthcare website. Many of the sites have online tools that help answer questions and compare costs.
For more information, or to speak with a pain specialist visit Summa Pain Care or call your Arizona pain specialists at (623) 776-8686 today.
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