Choosing a health care plan

Things to consider during open enrollment, end of the year


JACKSONVILLE, Fla. – Changes in health care have put us in the driver's seat. This is the time of year to make the changes you want.  Health insurance policies can be complicated and too few of us take the time to read through them and understand how the coverage works. But if you don't understand what your plan does and does not cover, you could end up spending more money than is necessary.

A nationwide Angie's List poll found: Of those who are on Medicare, one-third responded that they've contacted a doctor who doesn't accept Medicare or new Medicare patients.

  • As more seniors age into Medicare and doctors face uncertainty with the future of the program, some patients fear more doctors will opt out.
  • Before you enroll in a plan, contact your physician's billing offices to see if they accept Medicare.

Angie's List Tips: Evaluating your health insurance

  • Do your homework: Don't assume your plan and policy that you had this year will be the best fit for next year. Take the time to evaluate your situation and research your options to find the best health care plan to fit your family's needs.
  • Check with your providers: Preferred provider lists can change so before you enroll in a plan, check if your physician will be in your network. If you are on Medicare, contact your physician's billing offices to see if they accept Medicare (and ask if they're in-network if enrolling in Medicare Advantage.)
  • Look at costs: Take a look at what you spent last year in premiums and out of pocket and compare that to what you anticipate this year. For example, will you need long care treatment, specific prescriptions, or do you anticipate your child will need braces?

If you need help understanding the various health care plans, talk to your benefits person at work, a financial planner or insurance broker.

What is an insurance broker? Health insurance brokers set up various health care plans and other insurance products for people, their businesses and their families. They typically work for insurance brokerage firms or as independent agents.

  • The types of insurance offered may include not only health coverage but other types of policies, such as dental and vision insurance and short-term and long-term disability.
  • Working with brokers can prove beneficial because they have access to multiple health insurance coverage plans, so they can give you several options based on such factors as price, coverage, renewal options and limitations.
  • Brokers work as a type of intermediary agent between the health insurance companies and their customers. Their duties generally include both sales and administrative functions. They will not only set up and arrange a customer's coverage but they may also process claims and provide post-sales service and support, responding to questions or making changes and revisions to your policy.

Angie's List Tips: Choosing a health insurance broker

  • If you decide to work with a broker who's an independent agent, you'll want to make sure that he or she has the necessary credentials and is appropriately licensed. Requirements may vary in each state, but generally insurance agents must pass an examination to become licensed and certified.
  • Preparation for entering the profession includes studying the laws, practices and policies associated with the field. Once an insurance broker becomes licensed, there's a general requirement for ongoing education so that agents can keep current with insurance guidelines and maintain a license to practice.
  • If you decide on an insurance agent that works for a brokerage firm, you will want to do a thorough background check before you do business and get coverage. Doing a little homework will help you make an informed decision when purchasing health insurance coverage.