As the COVID-19 pandemic continues to wreak havoc on the nation, many Americans feel the financial strain and are looking for ways to cut back on their expenses. Unfortunately, one area that is often a target for cost-cutting is health and wellness.
With so many people already stretched to their limits, it’s understandable that they would want to save wherever they can. However, with U.S. health officials predicting another pandemic wave this winter and new research emphasizing the importance of comprehensive medical benefits, it’s clear that this is not the time to skimp on healthcare coverage.
Open enrollment season is upon us, presenting a crucial opportunity for employees to reassess their insurance options and ensure they have the protection they need to weather any unexpected health challenges that may arise.
The pandemic has already caused many people to experience long COVID. And with rising inflation, it’s more important than ever to have insurance coverage that can help manage costs and provide financial stability in the face of unexpected medical expenses.
This article will delve into the key considerations to remember during open enrollment season, including costs and types of plans available, coverage for medical services and treatments, telemedicine options, prescription drug coverage, and more.
We will also discuss employer-offered resources such as wellness programs and health clinics, as well as the importance of understanding the terms and conditions of coverage and seeking advice from a financial advisor or insurance broker.
With the right coverage, you can protect yourself and your family against unexpected medical expenses and ensure you have the support you need to maintain your health and wellness during these challenging times.
Why Many Americans are Experiencing A Long COVID
As the COVID-19 pandemic continues to rage on, many Americans are experiencing what is known as “long COVID.” According to health experts, it may be the biggest public health disaster in waiting and one with significant repercussions estimated to cost upwards of $3.7 trillion.
The U.S. Department of Health and Human Services estimates that as many as 23 million Americans are currently suffering from the COVID virus.
These enduring health problems can range from mild to severe and last for weeks, months, or even longer.
The symptoms of long COVID can vary widely but may include fatigue, shortness of breath, chest pain, body aches, headache, and loss of taste or smell. Some people may also experience mental health issues such as anxiety or depression due to their experience with the virus. While some people may recover relatively quickly, others may struggle with ongoing health problems that can significantly impact their quality of life.
It’s not yet clear why some people experience long COVID, but it’s thought that a combination of factors may be at play. These may include the initial infection’s severity, underlying health conditions, and individual differences in immune system function. Researchers are still working to understand the long-term impacts of the virus and how to best support those experiencing long COVID.
While it’s impossible to predict who will experience long COVID, it’s clear that it can be a significant concern for many people. As such, it’s essential to have comprehensive medical benefits that can provide support and help manage the costs of ongoing medical care. By reassessing your insurance coverage during open enrollment season, you can ensure that you have the protection you need to address any potential health challenges that may arise.
Employees Considering Cost When Selecting Benefits
As the COVID-19 pandemic stretches household budgets near their limits, many employees consider costs when selecting their benefits during open enrollment season. According to the benefits platform Elevate, 28% of employees have postponed wellness visits and screenings, with cost being the most critical factor in determining their benefit choices for next year. This is understandable, given the financial strain many people face due to the pandemic.
Unfortunately, some employees may make trade-offs to save money, such as foregoing needed medical care. While this may seem like an excellent way to save in the short term, it can cause problems down the road. By neglecting necessary medical care, people may be putting themselves at risk for more severe health issues in the future. This can ultimately lead to higher costs and more significant financial challenges.
It’s essential to balance managing costs and ensuring you have the medical coverage to stay healthy. One way to do this is by reassessing your employer-sponsored health insurance during open enrollment. By reviewing your options and selecting the right coverage, you can protect yourself and your family against unexpected medical expenses and manage your overall health and wellness.
Key Considerations During Open Enrollment Season
Reassessing employer-sponsored health insurance during open enrollment season can help balance health and financial constraints. There are several factors to consider when selecting your benefits, including:
Costs and Types of Plans Available
When selecting your health insurance during open enrollment season, costs and the types of plans available are vital considerations. According to the Kaiser Family Foundation, annual family premiums for employer-sponsored health insurance average $22,463 this year, with workers contributing an average of $6,106. While these costs may seem high, it’s important to remember that health insurance can provide financial protection against unexpected medical expenses and help manage the costs of ongoing medical care.
In addition to premiums, many workers also have a deductible, the amount you pay before insurance kicks in. The average single deductible in 2022 is $1,763, more than double what it was a decade ago. This means that to access your insurance coverage, you may have to pay a significant amount out of pocket before your insurance kicks in. It’s essential to consider the monthly cost of your insurance and the potential out-of-pocket expenses you may incur in a medical emergency.
When selecting your health insurance, you will likely have a choice between different types of plans. Two standard options are high-deductible plans with health savings accounts (HSAs) and traditional preferred provider organizations (PPOs). High-deductible plans with HSAs may be a good option for those who expect low healthcare costs in the coming year. These plans typically have lower premiums but higher deductibles, so you may have to pay more out of pocket before your insurance kicks in. However, suppose you can contribute to an HSA. In that case, you can save money on medical expenses tax-free and use those savings to cover your deductible if you incur medical costs.
On the other hand, traditional PPOs may be a better choice for those with chronic health conditions or who typically hit their deductible. These plans usually have higher premiums but lower deductibles, which means you may pay more upfront but may have lower out-of-pocket costs if you need medical care.
It’s essential to consider the monthly cost of your insurance and the potential out-of-pocket expenses you may incur in a medical emergency. If you have chronic health conditions in your household and typically hit your deductible, a traditional plan paired with a flexible spending account (FSA) may save you more over a year, even if the plan’s monthly cost is higher.
Take the time to review all your options and seek the advice of a financial advisor or insurance broker if necessary. Only then can you ensure that you have the protection you need to manage any potential health challenges that may arise.
Coverage for Medical Services and Treatments
When selecting your health insurance, it’s essential to consider the medical services and treatments that are most important to you and your family. Make sure your policy covers these services and treatments, and be aware of any exclusions or limitations that may apply.
For example, if you have a chronic health condition such as diabetes or heart disease, ensure that your insurance covers the medical services and treatments you need to manage your condition. This may include regular doctor’s visits, medications, and specialized care. If you’re pregnant or planning to start a family, ensure that your health insurance covers maternity and newborn care. And if you have any disabilities or are at risk for specific medical conditions (like diabetes), be sure the policy will also cover treatments and services needed!
It’s also important to consider the cost of any drugs your insurance plan may not cover. If you take a prescription medication not covered by your insurance, you may have to pay out of pocket or seek an alternative treatment option. It’s good to check with your insurance provider and ask about generic alternatives or other cost-saving opportunities.
Telemedicine and Virtual Visit Options
Telemedicine and virtual visits can be convenient, and cost-effective alternatives to in-person visits, especially during the COVID-19 pandemic when accessing in-person care may be more difficult. When selecting your health insurance, it’s essential to check to see if your plan covers these types of visits and the limitations.
Telemedicine uses technology, such as video conferencing or phone calls, to connect with a healthcare provider remotely. Virtual visits allow you to access medical care from the comfort of your home and can be a convenient option for managing ongoing medical conditions, getting a second opinion, or receiving follow-up care.
Some insurance plans may cover telemedicine and virtual visits as part of their standard coverage. In contrast, others may require an additional fee or may have limitations on the types of services covered. It’s a good idea to check with your insurance provider to understand your options and potential limitations.
Prescription Drug Coverage
When selecting your health insurance, review your prescription drug coverage to ensure that it covers the medications you and your family take. If you take a prescription medicine not covered by your insurance, you may have to pay out of pocket or seek an alternative treatment option.
By reviewing your prescription drug coverage, you can ensure that you have the protection you need to manage any potential health challenges that may arise in the future. Whether you are managing a chronic health condition or need occasional medication, having the right coverage can make a big difference in your overall health and wellness.
Dental and Vision Coverage
Dental and vision coverage can also be essential for maintaining overall health and wellness. While many insurance plans offer basic coverage for these services, consider the type of coverage you need and what’s in the plan. For example, if you have a family, consider a plan that covers more than just essential services such as cleanings and exams.
Some plans may exclude specific treatments or procedures, while others restrict access frequency. By reviewing your coverage and understanding any exclusions or limitations that may apply, you can ensure that you have the protection you need to maintain your dental and vision health.
Life and Disability Insurance
Life and disability insurance can provide financial protection for you and your family in the event of an unexpected illness or injury. These types of insurance can help cover the costs of medical bills, lost income, and other expenses that may arise due to an unexpected health event.
When selecting your insurance, consider the type of coverage you need and what’s in the plan. For example, if you have a family, consider a life insurance policy that provides enough coverage to protect your loved ones in the event of your unexpected death.
Disability insurance can also be important, especially if you are the primary breadwinner in your household. This type of insurance can help cover your expenses if you cannot work due to an illness or injury.
Flexible Spending Accounts and Health Reimbursement Accounts
Flexible spending accounts (FSAs) and health reimbursement accounts (HRAs) can also be valuable tools for saving money on medical expenses. FSAs allow you to set aside a portion of your income to pay for certain medical costs, such as copays, deductibles, and prescriptions. The money you contribute to an FSA is taken out of your paycheck on a pre-tax basis, which can help reduce your overall tax burden and save you money.
HRAs are employer-funded accounts that you can use to pay for medical expenses. These accounts are often paired with high-deductible health insurance plans and can be used to pay for deductibles and copays.
Taking advantage of FSAs and HRAs can save money on medical expenses and help manage your healthcare costs more effectively. These accounts can be a valuable tool for helping you maintain your health and wellness during these challenging times.
Terms and Conditions of Coverage
It’s essential to thoroughly review the terms and conditions of your coverage to understand any exclusions or limitations that may apply. Make sure you know any deductibles, copays, or other out-of-pocket expenses you may incur.
It’s also a good idea to check for any waiting periods or pre-existing condition exclusions that may apply to your coverage. By reviewing the terms and conditions of your coverage, you can ensure that you have the protection you need to manage any potential health challenges that may arise in the future.
Seeking Advice
If you are still determining which insurance plan is right for you, consider seeking the advice of a financial advisor or insurance broker. These professionals can help you understand your options and make an informed decision.
They can help you assess your insurance needs based on your circumstances and help you choose a plan that meets your needs and budget.
Annual Review
It’s important to review your insurance needs annually during open enrollment season. This is when you can check your coverage and make changes if necessary. Consider any changes in your circumstances, like a new job, the birth of a child, or a chronic health condition.
Make sure you have the coverage to protect yourself and your family against unexpected medical expenses and manage your overall health and wellness.
Personal Circumstances
When reviewing your coverage, consider any changes in your circumstances. If you have a new job or have experienced a change in income, you may need to adjust your coverage accordingly. If you have a new family member, you may need to add them to your insurance plan.
And if you have developed a chronic health condition, you may need to review your coverage to ensure it meets your needs.
By reviewing your options thoroughly, you can balance your overall health and financial constraints and protect yourself and your family against unexpected medical expenses. Whether you are looking for a high-deductible plan with an HSA or a traditional PPO, it’s crucial to find a plan that meets your specific needs and provides the coverage you need to maintain your health and wellness during these challenging times.
Additionally, take advantage of employer-offered resources such as wellness programs or health clinics. These can help you manage your health and reduce costs and may be especially useful during the pandemic when in-person visits may be more challenging to access. Participating in these programs and taking advantage of available resources can help improve your overall health and well-being.
Conclusion
In these uncertain times, it is more important than ever to have adequate health insurance coverage to protect against unexpected medical expenses and illnesses. As the COVID-19 pandemic continues to pose risks to our health and well-being, it’s essential to take the time to review your insurance options during open enrollment season and choose a plan that meets your needs and budget.
By considering the costs and types of plans available, the coverage for medical services and treatments, and the options for telemedicine and virtual visits, you can ensure that you have the protection you need to manage any potential health challenges that may arise. And by seeking advice from a financial advisor or insurance broker and reviewing your coverage annually, you can stay up-to-date on your insurance needs and make the best choices for you and your family.
If you need help navigating the complex world of health insurance, contact the Healthcare Solutions Team to get a quote from the top agents offering customized healthcare solutions. They will help you find the right plan to meet your needs and budget.
So don’t delay – take the time to review your insurance options during open enrollment season and choose a plan that meets your needs and budget. Healthcare Solutions is a wholly-owned subsidiary of the National General Insurance Group, so rest assured you’re getting quality service. For more information, contact us today, and our teams will be more than willing to help.