2020 has been A YEAR, to say the least. Between Covid-19, it being an election year, and the economy…it’s not far fetched to say, even open enrollment is going to look a little differently this year.  According to an article on CBSNEWS.COM, “70% of employees say they will take more time to review benefits as a result of the pandemic than they did during the last enrollment period”.

The question is what should the focus be? The pandemic should have been an eye opener to us all that we can no longer sit idly by, relying on the cookie cutter policies provided by employers.  Boilerplate isn’t enough anymore.  The time has come to pay closer attention to the policies being presented and when possible, solicit the help of professionals who care more about making sure the client is covered according to their needs and not just making sure a sale is made.

During this month of open enrollment, I’m going to be sharing a few areas you should pay close attention to when you’re making your individual health insurance selections.  This week, I’m shining the light on drug prescriptions and “In Network” providers.  Both have been frustrating areas for a lot of people (post health insurance selection) but as THE INSURANCE EDUCATOR I’ve been called, I want to help you feel good about your policy selections this year.

Prescription Drug Policies

When it comes to prescriptions, the best rule of thumb is to have a list of the specific drugs you use handy when you’re picking your plan.  Not every plan covers EVERY drug. Additionally, you want to understand the attitudes and distinctions between brand name drugs and generic ones.

Generic drugs have the same chemical composition, dosage, strength, risks, safety and intended use as brand name drugs. In this article by WISERXCARD.COM, approx. 8 in 10 people in the US prefer generic drugs because, like most generic things…they cost less.

I’ve been an insurance agent for over seven years and I write policies in over a total of eighteen states and I am repeatedly asked “how much a medication will cost”. Unfortunately, this is one of the few questions I don’t have an answer to.  Different drugs, made by different manufacturers, sold at different retailers makes this an impossible question to answer with any certainty.  What I can say is this… regardless of the cost, there are a variety of websites and apps you can use to compare pricing.  Start there and make the best decision for your budget.

“In Network”

A provider network is a list of health-care providers who are contracted by an insurance company, and provide medical care to those enrolled in plans offered by that insurance company.  These “In Network” plans cut costs for enrollees by being full of in-network providers, according to America’s Health Insurance Plans (AHIP).  If you’re familiar with Sam’s or Costco, you already have a good understanding of the relationship between providers, insurance companies and enrollees.  Providers charge less in exchange for the ability to serve the large number of enrollees insurance companies cover through their health insurance plans.

During this open enrollment period, consider your current health, what you were told at your last check up (about your health trajectory), and what you look for in a doctor.  These factors are important when it comes to identifying your next plan.  If you’ve been told you are “Pre” anything, look for the doctors who would be handling those issues.  If distance from care is an issue for you, you’ll want to know who’s in your area AND “in network”.  See how it works?

With Coronavirus still an issue in our country, your health insurance coverage is not something to play around with.  As the insurance educator, I am committed to empowering my clients with as much information as they need to make the right healthcare decisions for themselves and their families.

If you’re unsure about the direction you should be taking with your insurance OR you have questions about your current policy, Let’s have a conversation. I’ll get you on the right path with no pressure to make a purchase.