It’s that time of year again! Open Enrollment – or simply put, the time of year when you can enroll and change your health plan – may feel intimidating with the health plan options available. Overwhelmed? You aren’t alone. In fact, 96% of Americans overestimate their understanding of health insurance, potentially leaving them with analysis paralysis regarding their choices for coverage. 

Inundated with industry jargon, Open Enrollment can feel daunting—but Centivo is here to make it easy because we believe that healthcare shouldn’t be complicated. 

So, what is open enrollment?

Open Enrollment (sometimes referred to as Annual Enrollment or Benefits Enrollment) is the time of year when employees can enroll, change or cancel their health plan for the following year.

When is open enrollment?

For most employers, Open Enrollment typically occurs during the fall months (between October and early December), but exact dates will vary depending on your employer.

What should I know before I select my plan?

Health plans vary in whether they offer in-network only coverage or flexibility to go to out-of-network doctors, whether your costs are set up front or you pay a percentage of the cost of the visit (known as coinsurance), and more.

To explain this further: 

  • Plans that offer “in-network only” coverage mean that insurance will not pay for a doctor visit outside of its already established network of physicians, and you would have to pay out-of-pocket for that visit. 
  • For plans with a deductible, this means you would have to pay a certain amount of money before the health plan would begin covering your healthcare expenses. For example, if you had surgery for $3,000 but your health plan requires a deductible of $1,000, you would have to pay the $1,000 out-of-pocket before your insurance would cover any of the remaining $2,000. 
  • A copay or coinsurance usually kicks in after the deductible is met. A copay is a fixed amount of money previously agreed upon in the plan that you will be responsible for paying out-of-pocket, i.e. $20, versus coinsurance, which is a fixed percentage of remaining cost post-deductible that you would be responsible for, i.e. 20%.  

Breaking it down

How do I choose the best plan for me?

You may be under the impression that the best plan option is the one that has the lowest cost out of your paycheck. Or, some may prefer a plan that has the lowest cost when you get care. But, the key is to consider your overall costs.

When looking at a health plan, it’s most important to identify which types of care you expect to need and compare what that care will cost you under each option. For instance, does Plan A have a desired mental health provider? And if so, can you afford those visits? It’ll also be important to look at the providers in the network to see if your current go-to’s are included, or if you’ll need to switch to an in-network provider. 

Once you’ve analyzed and identified which preferred treatment areas are most important to you for your health plan, you can also evaluate the deductibles that are required for each option. Some plans, like Centivo, typically don’t require a deductible at all.

How do I know which plan is right for me?

The first step in determining which plan is right for you in the upcoming Open Enrollment season is evaluating your current health plan. Have you utilized all of its benefits that make the deductibles worth paying? Are there areas that you didn’t have coverage in that you paid out-of-pocket for last year? Were there any types of coverage you didn’t use at all? Based on this analysis, you can then look to assess your current healthcare needs and anything you anticipate in the coming year. 

You can also compare the options of health plans offered based on monthly costs. For those working with a tighter budget, you can evaluate the cost of each plan, its coverage and its deductibles, to determine which plan might make the most financial sense for you in the coming year.

What makes Centivo’s plans a great option?

We at Centivo understand the struggle of choosing between care and cost – and we want to ensure that our members get the care they deserve at a price they can afford. With Centivo, there are typically no deductibles, low, predictable copays and an extensive network of primary care physicians, which are available at no out-of-pocket costs. Our members pay less than 25% of the industry average when it comes to out-of-pocket costs, averaging around $409 per year, if we exclude other plans with a high deductible. We offer care when you need it and where you want it with our in-person and virtual primary care options, making it extremely easy to find and schedule an appointment with your doctor.

For more information on Centivo’s offerings this Open Enrollment season and how to enroll, we encourage you to reach out to your Human Resources department.