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The ACA’s of Open Enrollment: Always Confirm & Ask!

Open Enrollment

Ahh, November, that magical time of year when comfort food, crisp days (crisper nights) and family time for the holidays abound. It is also when millions of Americans make their ACA and Medicare elections for next year during Open Enrollment. Knowing the language of healthcare benefits can be intimidating, we at Robertson Ryan Insurance spoke to our in-house Benefits specialist, Robert Baranski, about common misunderstandings people have during policy selections and advice he offers his clients as they navigate their choices.

Preferred Network policies change, year-to-year: Make sure you look up your preferred hospital and Physician Network to confirm they are still available to you with the new plan.  This includes your doctors who practice at multiple locations – always confirm the location you frequent is still available to you and your family. When/if you have an upcoming procedure, always call the carrier number on the back of your insurance card and verify the specifics of your upcoming medical needs are covered, this is especially true with end of year healthcare planning and new year procedures.

Prescription cards and the list of covered drugs change, year-to-year: This is a big one, especially for Medicare Part D card holders. Insurance carriers negotiate annually with drug companies to get the best rates on medication. Your prescription might not make the cut with your plan every year or the newer rates could exceed your means. Always ask if there are any changes in price or availability to the meds you regularly take.

Your doctor doesn’t know the intricacies of your network: Never assume when your physician recommends labs, screening or prescribes a new medication, that they know what your healthcare plan entails. Your agent and carrier do. Contact an agent, in lieu of the carrier if you have one, and disclose what was discussed with your treatment team. This ensures you stay within your coverage allowances to avoid any unexpected surprises after the fact.

If these common conditions (or others) affect you when making decisions about your benefits plans, then having someone who can assess your needs and suggest alternatives that align with you and your family’s particulars is highly recommended. A trusted agent can walk you through whatever new and continuing benefits you require. All of our Benefits Specialists at Robertson Ryan Insurance, will encourage you to Always Confirm and Ask questions when it comes to securing your best possible plan.

If you are looking for an agent to broaden your coverage options or help with your Open Enrollment questions, please reach out, we are here to help with all of your insurance needs.  Echoing Mr. Baranski’s parting words, “Don’t be afraid to ask”, ever…

Helpful links and dates to remember for 2024 Open Enrollment Coverage:

Medicare Annual Open Enrollment: October 15th – December 7th

ACA Annual Open Enrollment: November 1st – December 15th for coverage beginning January 1st, and December 16th – January 15th for a February 1st effective date