Critical Questions to Ask About Benefit Enrollment

docIt’s that time of year again! If your employer distributed updates about your benefits plan for the upcoming calendar year, you’re not alone. And if you haven’t gotten anything yet, chances are you will.

Although it may not necessarily be the most exciting topic to talk about, it’s definitely an important one. NPR outlined several questions to explore while determining whether or not to stay on your current plan.

1. Is your doctor still in your network? Yes, plans change and as employers shift to plans that may resemble HMOs, there may be limited networks of doctors. Plus, affiliations may simply change. Your best bet? Call your physicians as well as hospitals to see if they take your plan.

2. Is your employer going to change vendors? If you’re currently being treated for a condition that requires lab visits, do your due diligence. The piece points out, “Getting infusions or prescriptions outside this network could cost thousands extra, just as with doctors and hospitals.”

3. How will your out-of-pocket costs increase? This is critical. As employers shift plans and absorb less of the overall cost, of course your out-of-pocket cost will increase as a result.

Find out what the new deductibles will cost. That is, the amount you’re paying for care before the actual insurance starts covering visits and procedures. According to the Kaiser Family Foundation, the average deductible for a single employee increased to $1,217 this past year.

In addition, employers are ditching co-payments in many cases. If you previously paid $20 to fill a prescription that normally costs $100, you might start to pay the full $100.

4. How do the prices compare to the quality of services? If your packet is unclear, make phone calls to your employer’s benefits department. Many of them will actually have a hotline in place to field such inquiries. Take advantage of it and do your homework now.

5. How does your prescription plan work? Bills from doctor’s offices, labs and hospitals are one thing; prescription costs are quite another. Per the piece, employers are “splitting pharma benefits into more layers than ever before.”

Cost-sharing is lowest for cheap generic drugs and highest for specialty drugs. So, if you’re currently on a long-term prescription, find out how it’s covered and explore investing in a health savings account with pre-tax dollars. Plus you can always find out if a less expensive, more generic drug will offer the same benefit.