November 25, 2004 06:03 AM

Use Open Enrollment To Review Health-Insurance Plan


Excerpt: It's important to examine your health-insurance options every year during open enrollment whether you plan to change your health plan or not, says Linda Schofield, an independent health consultant and president of Schofield Consulting.    News Source


In the midst of holiday shopping, end-of-year tax saving steps and other seasonal activities, don't forget to review your health-insurance plan during your company's open enrollment period.

It's important to examine your health-insurance options every year during open enrollment whether you plan to change your health plan or not, says Linda Schofield, an independent health consultant and president of Schofield Consulting.

Open enrollment, which usually occurs during November and December, is when many companies allow their employees to sign up for health benefits or reselect their health care plan.

"People need to recognize that they have a choice of plans, and not all plans are alike," Schofield says. She recommends that you ask yourself three things during open enrollment:

1. Are the services, providers and medications that I use covered? Schofield says most people check services and providers, but forget to check medications. Make sure the prescription medications you use are covered, especially if you have a chronic illness or other condition that requires constant medication.
2. How much will my services and medications cost? Depending on the plan, you'll have different co-payments -- money you pay out of pocket for medical expenses, including doctor's visits and prescriptions. "Co-pays are getting higher and higher," Schofield notes. Some plans have tiered co-pay, which means prices will vary for services and medications. Note where yours fall.
3. Are there restrictions on access? Your plan may require your doctor to call your insurance company for permission before prescribing certain drugs or recommending treatment. You should also check for limitations on type or dosage of medication, Schofield says. So-called step therapy restrictions require doctors to prescribe the less-expensive version of a medication first.



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