As we move into the New Year with new resolve to invest in our health and wellness, don’t forget one of the most basic tools: medical and dental insurance. While we often feel that our goals are something we strive for independently, the right health plan and care team can provide the resources needed to help you achieve your goals. The right coverage also means that you won’t be hit with unexpected costs for routine or emergency care throughout the year (which can help with any financial planning resolutions too!).
All Rhode Islanders who signed up for new health plans last year through HealthSourceRI or directly from an insurance provider will be automatically re-enrolled by December 23rd, though they may actively select coverage for 2016, by shopping around during open enrollment to ensure they’re enrolled in the plan that represents the best value for January 31, 2016. Each year there are new options available that may better address your healthcare needs and goals.
While individual needs vary, here are some tips to help you choose the plan that will not only give you the coverage you need, but help you to achieve your health goals.
Make lists: As you review your goals for 2016, take a minute to assess your healthcare needs, medications, and doctors, too.
When looking at different health plans, you’ll need to take into account the following basic information:
• Healthcare needs: What healthcare services do you use regularly? How often do you see your primary care physician and specialists? Do you anticipate any special needs next year, like an elective surgeries or pregnancy? Make sure these services are covered and compare out-of-pocket costs like copayments, coinsurance and deductibles.
• Medications: Check each health plan’s prescription drug list (also known as a formulary) to make sure your current prescriptions are covered, and compare out-of-pocket costs. This is a great time to ask to talk to your doctors about generic versions of drugs that may work equally well but cost less.
• Doctors: Make sure you check that your doctors participate in the networks of plans under consideration.
• Co-payments and deductible charges: With your anticipated medical expenses in mind, look carefully at the premiums, co-payments and deductible charges offered by each plan. Make sure you align the co-payments, premiums with your healthcare needs, medications and physicians.
Do your homework — at your convenience.
• You can purchase a health plan directly from an insurer, and many insurers allow you to not only call them or visit their websites for information. In addition to these options, Blue Cross & Blue Shield of Rhode Island has three convenient retail locations – Your Blue Store Lincoln, Bristol, and Warwick – with bilingual staff that can meet with you face-to-face to help you find the right plan. Take advantage of these flexible ways to learn about medical and dental plans—there are many options available.
• You may be eligible for a subsidy based on your income. If so, you can also purchase a plan through the state exchange online at HealthSourceRI.com
Other considerations as you weigh your options:
• Advanced primary care networks. Primary care practices known as patient-centered medical homes (PCMH) offer you coordinated care for all of your health needs, from specialist visits to lab tests to hospital services. Patients seen in advanced primary care practices are proven to have lower costs of care and better health outcomes compared to those in receiving their care by standard primary care providers.
• Other benefits. Some plans include dental, complimentary nurse visits for those living with chronic conditions like diabetes, and classes to better educate you about individual healthcare needs. Many health plans also offer 24 hour nurse care lines, access to telemedicine, and fitness discounts to name a few.
Above all else, take your time choosing a plan and make sure to weigh all of your options. With these tips in mind, you will be well on your way to choosing the health plan that will be the best fit for your and your family’s goals for 2016.
Corey McCarty has been with Blue Cross & Blue Shield of Rhode Island for over 15 years and currently serves as the Vice President of the Consumer Segment.