Even outside of open enrollment, countless numbers of us make the decision: Do I enroll in my company’s benefits plan or do I enroll in my partner/spouse’s plan? When it comes to deciding which one is better, there’s a lot at stake.
You want to make sure that you’ve got all the important bases covered and that you’ll be satisfied for the upcoming year.
Think about what’s important to you for your coverage. When trying to decide which plan makes the most sense for you, consider making a list to compare key elements. You may want to consider some of the following items:
Compare how much you have to pay upfront before the plan begins covering your medical expenses. A high deductible doesn’t necessarily mean that the plan is more expensive. Some plans have high deductibles and then cover a greater percent of your medical expenses.
Copays Or Coinsurance.
Will the plan make you share in the costs of your medical care (coinsurance)? Or will you have a flat dollar amount for each of your expenses? Most plans now require participants to contribute a certain percent to the costs of expenses.
Out Of Pocket Maximums.
What’s the most a plan will make you pay out of your pocket in one year?
Compare how much you’ll pay each month for your coverage.
Access To Physicians Or Specialists.
Take into account whether you’ll be able to see your physician and/or specialists, or will need to start new relationships. If you have a long-standing relationship with your physician, that may trump all other things to consider.
If you’re on any maintenance drugs (think allergy meds, birth control, etc.) you’ll want to find out what kind of coverage each plan has. What does the formulary list look like? How much are you expected to cover? Is there a mail order option?
Whether it’s saving costs or access to care, you’ll want to make sure you’re clear on what each plan offers so that you can make an informed decision. But, most importantly, get to know your plan and ask your partner about his or her plan—right now! The more you know about how the plans work today, the easier the decision-making process will be when enrollment time comes around. Plus, the more you know about your plan’s benefits, the better you’ll use them.