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Consumer
Read fine print during open enrollment period
NEW YORK (10/22/08)—Instead of raising 2009 premium prices significantly for workplace health benefits, some firms will be charging more for out-of-pocket items such as deductibles, co-payments, and other fees, catching many workers off guard during the open enrollment period (The Wall Street Journal Oct. 9). Read the fine print before you enroll. Benefits consulting firm Hewitt Associates, Lincolnshire, Ill., estimates that nearly two-thirds of workers select the same option they picked the previous year, which could result in sticker shock when the bills come in. Look for these and other changes that could have a significant impact on your budget:
* Higher out-of-pocket maximums * Higher deductibles * Higher co-payments * Co-payments for outpatient procedures * Shifts from flat co-pays to co-insurance charges that require you to pay a percentage of the total cost of a service * Confusing fee structures (for instance, a hospital admission may require a co-payment, as well as separate co-insurance charges for services during the hospital stay) * Elimination of certain drugs from the approved list * Reduced physical and/or speech therapy benefits
Before you enroll, check for coverage of any care you know you’ll need and see if it’s included in next year’s plan—don’t assume it’s included. Then decide on the plan that’s best for you. You may opt for a plan with higher out-of-pocket charges and a lower premium, or a high-deductible plan paired with a health-savings account, or some other plan solely based on your situation. Understand the real costs and coverage you get with each of the plan options. For more information, read, “Does Your Generic Drug Make the Grade?” in Home & Family Finance Resource Center.
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