Health plans can bring stress
Making picks is daunting task
The time has come to whip out the crystal ball and ask: What are the chances I’ll break an arm this year?
Health care consumers are getting ready to choose their plans for the upcoming year, but they’re faced with the uncertainty of making a choice that will come back to bite them in the future.
Employers provide a window of time, usually having a Dec. 15 deadline, when employees can select their options regarding health, dental and life insurance for the calendar year. The one caveat that seems to burden many: There’s no going back. You’re locked in for a year.
For the most part, employees must carefully pick which benefits align with their family’s health and living status at the end of the year and stick
with them even if they experienced a freak accident later in the year. The only exceptions are specific circumstances in which you lose access to your existing health insurance plan or add – or lose – covered family members, situations such as having a baby, getting married or divorced, permanently relocating or death of someone on your plan.
The reason? Adverse selection. Health insurance companies survive by having more healthy members than sick members. The money it pays in its claims comes from its members’ premiums. In any case that one member needs urgent medical care, their bill was paid with the help of the premiums of other members who didn’t experience any health problems.
“The whole system is set up to disincentivize people to wait until something happens before they get health insurance,” says Eliot Fishman, senior director for health policy for Families USA.
One of the biggest errors you can make when it comes to choosing your plan can be making coverage choices on autopilot, says Suzanne Goulden, director of Total Reward at Society for Human Resource Management. She says to consider that the insurance your employer provides might have changed, or maybe your life readjusted, making your usual health care plan less effective.
“People don’t take the time to look at their options and stay in whatever plan they selected in the past,” says Goulden.
Younger employees could feel the burden harder. With Generation Z joining the workforce, a broader cross section of people don’t feel confident about their benefit decisions. A recent study found that only 44% of Gen Zers feel prepared for the open enrollment period, while 78% of baby boomers feel ready to make their choices.
Millennials are getting a steady grasp, with more than 69% feeling prepared, but some of them find the process frustrating for other reasons.
“It’s frustrating to see how expensive it would be to pay monthly premiums and the deductibles would end up being,” says Angelina Alcabano, 33. “I can see the mind-set of thinking it would be cheaper, in the long run, to pay out of pocket.”
This period can also be overwhelming for people with a lack of health care literacy. The same study indicates that 67% of adults don’t know what “out-ofpocket maximum” means, for example.
“I think people don’t have insurance because it’s hard to understand,” says Becca Beberaggi, who’s been trying to sign up for health insurance through open enrollment for six years. Because Beberaggi suffers from a disability, she has had trouble integrating into a nongovernmental health care system.
“I don’t think insurance companies make it very easy for the common person to read their documents, to know what they’re getting and to know what their lengths are,” she says.