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By Harvard Pilgrim Health Care
Open enrollment season is here—and this year is unlike any other. Every year when selecting your health plan, you should consider upcoming major life events that could impact your coverage needs, like family planning or a procedure requiring more serious medical attention.
But with the current pandemic, “health” is at the forefront of our lives and has taken on a new meaning. Caring for the health of ourselves and our loved ones is top of mind—and more complicated than ever before.
During this year’s open enrollment, it’s critical to re-examine plan decisions and adjust what’s right for your family so you’re prepared in the coming year.
Here are three key considerations as you compare and select your benefits:
1. Know what you’re paying for—and only pay for what you need
The cost of health care has long been the top ranked consumer concern, with nearly three-quarters of Americans worried about their ability to pay for medical treatment if a serious condition arises.
Now, in the face of a pandemic, economic challenges, and employment uncertainty for many, it’s critical to make coverage decisions that protect both your health and your finances. As you calculate the cost of care for the year, consider these options:
• Choose the right plan for your unique needs: Though nine in 10 people choose the same health plan every year without re-examining their needs, about one-third of Americans actually understand the basics of their benefits. Less knowledge can lead to more money wasted or spent inefficiently.
Selecting the right plan can put you on the right path for the year and can help you save on your medical costs. Portland, Maine based MyHealthMath, is an insurtech startup that is on a mission to radically change the way people, and corporations, make health insurance plan decisions. By looking at your expected medical usage, and integrating it with co-pays, coinsurance, deductibles, and out-of-pocket limits, MyHealthMath helps identify the total expected cost of your health care, not just your premiums. The tool can even help you optimize your plan selection based on what your employer offers. Harvard Pilgrim Health Care currently offers access to MyHealthMath’s decision support to some of their member population.
• Consider a health savings account: A health savings account (HSA) is an account you, and potentially your employer, contribute to each month to help pay for qualified medical expenses. HSAs are typically offered alongside high-deductible plans, which can be associated with higher health care expenses. However, informed management of an HSA alongside legislative changes during COVID-19 that enable consumers to be more flexible with their account can help reduce the overall cost of health care.
• Examine the costs of medication: Many Americans are spending more on health products than previous years, in addition to the hundreds most spend on over-the-counter (OTC) medications each year. However, where your medication is categorized in the “tiering” system of a drug formulary may vary from plan to plan. The ACA regulated the coverage of many preventive services (and preventive medications) to make sure they are available under benefit plans—including health insurance. Some insurance providers also offer preventive drug riders on HSA plans that could carry lower or no cost on medications for common chronic conditions (and the costs won’t be applied to a deductible). Also, insurers such as Harvard Pilgrim are trying to help alleviate costs for members on common OTC medications like allergy medicine, cough medicine, and anti-inflammatory medications by including these are part of the plan’s formulary. Check your benefits to learn more.
• Understand what you’ll pay for care: If you or your family member encounters a medical need, you likely already know the cost of providers can vary. But cost is not necessarily reflective of the quality of care you’ll receive. Your health insurer could help you estimate the cost of a service or procedure, and in some instances, help you to compare costs among providers for common health services and procedures through a cost estimating tool. Harvard Pilgrim takes it one step further for many members through their Reduce My Costs program, which offers additional incentives for making an informed decision regarding where to receive care.
When it comes to your health care costs, small decisions can have a big payoff. Think of it like this: Even $83 per month can total to $1,000 in a year—a stimulus check back in your pocket.
2. Consider telehealth benefits beyond the short term
The pandemic has accelerated many virtual ways of life, with most health insurance companies offering virtual and remote care offerings for the duration of the health emergency. However, telehealth isn’t just a solution for COVID-19 care. Telemedicine is a smart solution that can help you access the medical guidance that you need without the wait—from any location. Telehealth can also help manage chronic conditions like asthma, diabetes, and high blood pressure and in some plans and situations, provide a platform to connect with your PCP. Check to see how your plan options cover the costs associated with telehealth services beyond support during the pandemic.
3. Whole self care for a “new normal”
As “health” has taken on a new meaning this year, so has needs for care. As you examine your plan options, look beyond the benefits to the plan’s well-being offerings and additional services to help support the physical and emotional health of your household.
• Mental health: Pre-COVID, one in five Americans experience a mental health condition at any given time. During the pandemic, mental health challenges impact the majority of Americans, with an anticipated increase in stress and anxiety throughout the winter months. Mental and emotional health can be just as important as physical health. As you select your plan, ensure you understand the mental health benefits, treatment options, and coverage, as well as the different ways you can access this support.
• Factor in holistic and well-being support and incentives: Now more than ever it’s critical to care for your whole self—mind, body, and overall well-being—to make it through a challenging time. As you select your plan, learn about the offerings available to you outside of your plan’s benefits. You could even find savings on ways you’re already caring for yourself.
Your health plan may offer discounts and savings on popular wellness programs, virtual fitness, wearables, and more. And, some insurers, such as Harvard Pilgrim Health Care, will include unlimited acupuncture and chiropractic visits as part of the benefits for some of their plans as well.
Many health insurers will also include access to premium versions of popular health and well-being apps or could even offer discounts at local merchants for items such as running sneakers!
Choosing the right plan starts with being informed
Take control of your health plan in 2021 so you and your family can stay safe, healthy, and save. For more information on selecting your plan, talk to your HR Benefits manager, explore MyHealthMath if it’s available to you and log-in to your Harvard Pilgrim account to learn more about your coverage options.
Sponsored by Harvard Pilgrim Health Care
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