We’re in the middle of the Open Enrollment Period (OEP) season for health insurance.
Medicare opened their gates last week.
The ACA Marketplaces will open up on November 1st.
Many employers either have already (hi Duke!) or will soon be opening up their health insurance enrollment period for January 1 start dates.
I just have a few things to say about this.
- Take a deep breath.
- Accept that good enough instead of optimal is going to be good enough.
- Look for help
Medicare and the ACA open enrollment periods are several weeks long. Most employer OEPs are at least a week if not more.
Insurance is fundamentally confusing. A good chunk of my current research agenda is predicated upon that sentence. I am convinced that if I had to buy either an ACA plan or a Medicare Advantage plan to cover my family for 2021 that I would not make the optimal choice except by random chance. I am very confident that I will avoid hideous choices. I am confident that I can make a good enough choice. And I know that I spend way more time than it is healthy thinking about both insurance design and choice architecture. With that caveat, if I am convinced that I am unlikely to make an optimal choice, please give yourself grace in being happy to make a more than good enough choice.
Making good enough choice is easier in some choice environments than others. Duke offers four health plans. The HR department did a lot of the work in curating the choice set so that everything that I faced last night before registering my choices was very distinct and clearly different. There is a basic HMO plan with the network basically being any facility with “DUKE” in its name and any clinician employed by Duke. That is the lowest premium and lowest actuarial value plan. Given that my family is healthy, we have assets to cover a deductible expense and my familys’ PCP office is another six minutes walk past my morning coffee stop, this is a damn good deal for my situation. I chose the same plan that I’ve had since 2017.
Other choice environments are messy. Dozens of plans with a wide variety of networks and benefits are on the ACA exchanges. Dozens of plans with a wide variety of networks and benefits are on the Medicare Advantage choice menu. Depending on your situation and needs, some plans are obviously horrendous for you. Others might be good enough.
And trying to figure out Good Enough from Really Good can be tough. This is where getting help can matter. Individuals who are Medicare eligible can access help through brokers and agents. Be careful of agents who are “captive” which means they can only sell a single insurers’ products. Medicare pays flat commission so the incentive for an agent who has been around for a couple of years and is likely to be around for a while is to build a relationship by offering good advice that does not screw you over so that in future years, the agent gets a decent residual commission for the renewal. ACA plans offer variable commissions by product and insurer so the incentives for a market with a lot more fundamental churn in it are messier. But look for help. Go to navigators. Go to the Area Agency on Aging. There is nothing wrong in asking for help.
So take a deep breath, take your time and take some grace while seeking help.