Photo courtesy of Healthcare.gov

Open enrollment for 2016 health coverage begins Nov. 1 for workplace benefits, Affordable Care Act plans and Medicaid. That means it’s time to choose a health insurance plan for you and your family. There are a lot of options. If you don’t know where to start, here are four tips for choosing a health insurance plan that’s right for you.

Be aware that there are three distinct open enrollment periods. If you are choosing a plan for yourself and helping family members with their health insurance decisions, the timing could vary.

• Employer-Sponsored Coverage. Most large employers schedule a two- to three-week period when their employees can select health benefits for the following year. This period is often in the fall, but the exact dates depend on the employer.
• Medicare Open Enrollment Period. For most Medicare beneficiaries, the open enrollment period, from Oct. 15 to Dec. 7, is the only opportunity to make changes to Medicare coverage for next year.
• Health Insurance Marketplace. The federal insurance exchange may be a good option for people under 65 who don’t have health insurance.  Open enrollment starts Nov. 1,and ends Jan. 31. To learn more, visit gov.

1. Set aside enough time to review your options, and attend information sessions at work or in your community. You may find ways to save money on your health care costs – whether it’s by selecting a plan with a lower monthly cost and/or deductible level, or a plan that will cover more of the expected costs for a major health event you anticipate, such as having a baby or surgery, or evaluating prescription drug coverage.

2. Select care providers who participate in the insurer’s network. Even if you don’t plan to make any changes to your health insurance, it’s still a good idea to ensure any doctor you plan to visit during the coming year participates in your plan’s care provider network. Many health plans offer a broad choice of local in-network health care professionals, from primary care physicians and pediatricians to specialists, and these in-network care providers agree in advance to what they’ll charge for specific procedures. You should also call before your procedure to verify the care providers are in-network. If you plan to visit a doctor or hospital outside the network, learn up front how your costs will differ from those of an in-network care provider – sometimes the difference can be substantial. 

3. Don’t forget about other benefits. Specialty benefits such as dental, vision, accident or even critical illness plans are often cost-effective options and cover annual teeth cleanings and eye exams or provide financial benefits for unexpected situations. Many vision plans also offer reduced pricing on frames and lenses.

If you need help with making sense of your health plan options, there’s plenty of free, in-person assistance to help Milwaukee residents select – and renew – health care coverage. From Nov. 1 through Jan. 31, residents can sign up for health care help through the Milwaukee Enrollment Network by dialing 2-1-1.

The Milwaukee Enrolment Network’s focus in this open enrollment period will be on outreach to low-income consumers and individuals who may have language or other barriers to signing up.

Adults with income below 100 percent of the federal poverty level ($11,670 per year for an individual) and children and pregnant women in households with income under 300 percent of the poverty level ($71,550 for a family of 4), may enroll anytime in BadgerCare Plus.

Starting Nov. 1, consumers can learn more about eligibility for enrollment in the marketplace as well as BadgerCare Plus, by visiting Healthcare.gov or calling the Health Insurance Marketplace national call center at 1-800-318-2596 (open 24 hours, 7 days a week).