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Ransom: Now is the time to think about your Health Insurance

November 5, 2019

This is the season for Health Insurance Open enrollment. Many employers are having employees make decisions and general open enrollment to buy, change, or renew a qualified health plan for 2020 began Friday, November 1 and runs to Sunday, December 15 for healthcare starting on January 1, 2020. MedChi, The Maryland State Medical Society, encourages all individuals to sign up for health insurance for themselves and their families.

Open enrollment is the only time of year you can enroll in a health plan, switch plans, or re-enroll in your current plan. If you miss open enrollment, options are limited to special enrollment, short term health insurance, employer-based coverage, Medicare, Medicaid, and CHIP.

To enroll in a Medicare plan or to change your Medicare coverage, Medicare Open Enrollment continues through December 15. For additional Medicare plan information, individuals may call 1-800-MEDICARE or visit Individuals do not need to renew their coverage if they are satisfied with their current plans, and those plans are still offered through Medicare.

It is of paramount importance to make sure you get the best health care plan for you and your family. When reviewing potential health plans it is important to do research on your health care plan options. MedChi recommends you ask the following five questions:

  1. Are your family’s physician’s in-network? Mistakenly seeing an out-of-network provider can leave you with unnecessarily expensive medical bills. Using in-network providers will save you from these additional costs.
  2. Does the plan cover your family’s medications? Check prescription medications against the list of plan-approved drugs. Choosing a plan that does not cover your most regular medications will severely increase your family’s health care costs.
  3. What are the plan’s prior authorization and step therapy policies? Prior authorization requires physicians to obtain the carrier’s approval before the carrier will pay for certain medications or treatment. Step therapy policies require physicians to prescribe cheaper alternatives before the insurer will cover the preferred treatment.
  4. What are the out-of-pocket costs and limits? In order to estimate the full cost of each plan, compare co-pays, deductibles, and other out-of-pocket expenses that you will be responsible for.
  5. What is hidden in the fine print? Reading the plan materials thoroughly will inform you of your rights and responsibilities under each plan and can prevent you from incurring unexpected costs.

If you have any questions about Open Enrollment, call MedChi 1-800-492-1056 x 3311 (toll-free). This is the time to make choices about your health insurance, if you know someone who doesn’t have insurance encourage them to look at the Maryland Exchange or Maryland Health Connection to see what is available. Access to insurance, doesn’t equal access to insurance, but having insurance helps take that step in the right direction.

Gene M. Ransom III

Gene Ransom is the CEO of MedChi the Maryland State Medical Society Twitter @GeneRansom

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