Open enrollment season has officially started and I am officially stressed about it.
Like many employed Americans, I have health insurance through my workplace plan. My yearly opportunity to choose my benefits for 2021 kicked off on October 15th and I have until the 29th to make my elections.
What, exactly, makes me so anxious about open enrollment? Well, for starters, I’m never certain that I’m choosing the best plan for me. I know that I’m extremely lucky to be able to choose between three different options – many others aren’t so fortunate – and truly, my company offers tools to make the process as smooth and understandable as possible.
But…health insurance matters are confusing!
There’s too much math involved for me, a person who considers herself allergic to basic arithmetic!
There’s too much unpredictability in it all – how am I supposed to know how many times I may need to meet with specialists next year? How am I supposed to forecast any possible health issues besides my diabetes? How do I go about guessing things that are impossible to guess?
Do I stick with the plan that I’ve been on for the last year and a half or so, that has high co-payments for my doctor appointments but the lowest deductible? Or do I change it up and go on a high deductible plan with a lower premium?
Please reassure me that I’m not the only person with diabetes who absolutely loathes this entire process and overthinks it every step of the way…
Just over 365 days ago, I made the switch from my parents’ health insurance plan to my own plan, provided by my employer.
In the last year, I’ve learned some important lessons about being responsible for my own healthcare coverage. Some lessons were easier to learn than others. I figured it might be helpful to others who just made the switch themselves (or who will be doing so in the near future) for me to sum up three big takeaways I’ve discovered along the way in the hopes that it makes the transition a little easier for those individuals, or at least saves them some time down the road.
Take advantage of a flexible spending account (FSA), if the option is available. I grew up knowing that FSAs exist – my parents would always bring their FSA account cards to all my doctor’s appointments and pay for all of my supplies using those cards – but I had no idea what the big deal was about them until I switched to my own health insurance plan. Basically, FSAs are a great employer-sponsored benefit because they allow account holders to pay for eligible medical expenses on a pre-tax basis. So those who have an FSA are able to pay for things they need tax-free, and the money is typically available to account holders on the first day of the health insurance plan year. My current health insurance plan allows a maximum contribution of $2,300, so I was able to put up to that amount on my account for 2020. It really comes in handy because my wallet doesn’t take as much of a beating from all of my necessary (and very expensive) diabetes supplies, and unlike the last half of 2019, I’m not paying as much out of pocket after my deductible is met.
Keep records of everything. It might seem fussy to hold onto any and all receipts or transaction records, but there might come a day when one is needed. Case in point? At the end of 2019, my company announced during open enrollment that our FSA administrator was changing…which, at the time, I didn’t think was a big deal. I knew what the maximum contribution was, and I figured I’d only need to log into my FSA account sporadically to see how much money I had left for the year. Well…I was wrong about that. Back in February, I got a notification that I needed to submit verification of purchases of my regular OmniPod shipment, Dexcom sensors and transmitters, and my Humalog prescription. And you can bet your bottom dollar I didn’t have receipts for all three of those transactions because, well, my old FSA provider never once asked for receipts. As silly as it sounds now, I guess the thought never crossed my mind that my new FSA administrator would need purchase records. Long story short, I was able to submit an explanation of benefits in lieu of the receipts, but it would’ve been easier just to hold onto the original records (and I can assure you I’ve done that since this whole incident).
Don’t be afraid to ask questions when things don’t add up. I had my annual physical in January and I had quite the shock when I was billed over $300 for all of the lab work that my primary care physician had me do. The moment I got that charge, I knew something wasn’t right – never before in my life have I been charged that much for a standard battery of tests that I take for my physical. So I wrote in to my PCP’s billing department and asked about the charges. That’s when I learned that I was mistakenly charged this amount and that I needed to reach out to my health insurance provider to re-run the charges. Although it was a little annoying to have to go back and forth between my health insurance provider and my PCP’s office, it was worth it because I saved myself $300 that I never actually owed in the first place. This taught me the importance of asking questions and following up with people until I understand, well, anything that’s confusing to me when it comes to my health insurance.