Fall is the time that most employers, Medicare, and the HealthCare Marketplace hold their benefit open enrollment period, during which employees/individuals decide on their benefits for the next 12 months. Open enrollment can often be complicated and overwhelming; here are some tips to help you navigate a successful open enrollment period.
Review Your Current Coverage & Understand Your Upcoming Needs: Review your current benefits and how well they met your needs this past year. Consider things like coverage levels, out-of-pocket costs, and any gaps or issues you’ve experienced in the past year. Identify any changes in your life that might affect your benefits in the upcoming year, such as a new health condition, changes in family status, or changes in your financial situation. This can help you prioritize what’s most important for you.
Compare Plans & Calculate Your Out-of-Pocket Costs: Carefully compare the different plans available to you. Look at premiums, deductibles, out-of-pocket maximums, and coverage specifics. Don’t forget to check the network of providers and whether your current doctors are included. In addition, determine if your plan offers any saving and spending accounts that can reduce your tax liability and help you set aside funds that can be used to cover out-of-pocket healthcare expenses. Consider both the monthly premium and the potential out-of-pocket costs like deductibles, copayments, and coinsurance.
Coordinate Deadlines & Enroll on Time: Households with two working adults may have more than one open enrollment period to navigate. Make sure you check open enrollment deadlines for both employers and coordinate. If one open enrollment period is early on, and the other isn’t until later in the season, contact human resources to request open enrollment information early to help you compare options. Pay attention to your deadlines to ensure you don’t miss out on enrolling in or changing your benefits. Changes to insurance during the plan year can only be made with a qualifying life event, so it is important that you complete your enrollment on time.
Review and Update Beneficiary Information: Now is a good time to review your beneficiary elections for any 401(k), retirement, and/or life insurance/disability insurance plans that you are enrolled in. Update any changes that may have occurred over the past year.
Check your Resources: If you are enrolled in an employer-sponsored health plan, your employer should have tools and resources to help you compare plans. If you are enrolled in Medicare, you can visit medicare.gov to comparison shop to find a plan that works for your needs. At healthcare.gov, you’ll be able to preview 2025 Marketplace health plans and get pricing estimates prior to the start of the open enrollment period, which starts November 1st.
Ask Questions, Seek Professional Advice: If you’re unsure about your benefit options, don’t hesitate to ask your Human Resources department or benefits broker for clarification. They can help explain the differences between plans and answer specific questions. If you are enrolled in Medicare or the Marketplace and you’re overwhelmed, consider consulting a benefits advisor or financial planner. They can provide personalized advice based on your specific situation.
Taking the time to carefully review your options and consider your needs can help you make the most informed choices during Open Enrollment.