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.
raven
Our system is weird. I retired from the university system and they give us a set amount of money to buy health care but we have to buy at least one thing through the AON retiree system. My wife, on the other hand, is pre-medicare so she stays on the university system insurance until she turns 65. I have to login to my account to update her policy. I’m trying to figure out how to get her access in case I check out and she has to do it herself.
raven
I have to say that the AON site seems really helpful. You enter your info, provider, prescriptions, frequency of specialist visits and they display different policies with ratings attached to each in the form of a dial. I’m going with the mutual of omaha because it is rated at 98 for me.
FelonyGovt
Was wondering why I’m getting bombarded with junk mail advertising Medicare supplement plans again, that explains it.
TinRoofRusted
My mother and aunt both live in GA and have been texting me since yesterday about their Medigap plan. Both have F which is being discontinued for new enrollees this year. So they can keep their plans for now or move to another. I have told them this multiple times but both are worried they will lose their coverage. They want me to tell them what to do but I feel like I can only lay out their options and they should make the decision. Both are still mentally sharp and usually very decisive. Why this is causing so much angst is a bit of a mystery. So I have said stick with F for this year and watch the premiums.
TinRoofRusted
@FelonyGovt: maybe that is their issue. Scary mail about it being discontinued. My mother maybe texts me once a week. Aunt Faithie only on my birthday. It has been constant since yesterday. Ugh.
raven
@TinRoofRusted: Have you or they looked at this?
GeorgiaCares is a public-private partnership, administered by the Georgia Department of Human Services (DHS) Division of Aging Services (DAS). GeorgiaCares provides free, unbiased and factual information and assistance to Medicare beneficiaries and their caregivers with health and drug plans. GeorgiaCares is the State Health Insurance Assistance Program (SHIP) for Georgia.
dnfree
Last year I went to an agent to evaluate Medicare part D drug plans, because I have one fairly expensive drug. (You see it advertised on TV.) He picked a plan, and then in January I got prescribed another drug you see on TV. My drug costs blew right through the donut hole and into catastrophic coverage. I feel very fortunate I can afford the medications, but things sure didn’t go according to plan.
TinRoofRusted
@raven: Hi. No but I just sent it to Mom – thanks so much. I work for a BCBS company so they think I know everything about any insurance. The fact that I work in IT and therefore am not well versed in plan offerings does not seem to matter to them.
raven
@TinRoofRusted: Don’t I know how that works! I worked in faculty development and instructional design and everyone thought I was their IT guy!
taumaturgo
The greedy profits before care healthbedammed system march on. Folks, does it have to be this cruel and inhumane?
Brachiator
Having health insurance is mandatory for California this year. With the pandemic I don’t know how well the public got this information. Or whether the number of those who cannot afford health insurance rose sharply.
Zelma
I do believe I have the absolutely most expensive Medigap plan in the world, top of the line AARP. I chose it when I was living in two places and I needed its portability. I’m keeping it because when anyone in Cape May County has something serious, they are sent to Philadelphia. I’ve had it since 2008, through two major and a number of minor health issues. Never had a co-pay or a problem. I just feel lucky that I can afford it. I’ve looked at less expensive plans occasionally, but decided that my peace of mind is worth the higher premium. Frankly, everybody should be able to have the same coverage. It shouldn’t be this confusing.
burnspbesq
My biggest goal is to find a Medicare Advantage plan that pays at least a reasonable amount of the cost of my insulin and CGM system (Dexcom G6, and G7 when it hits the market next year). I will be pleasantly surprised if such a thing exists.
grammypat
And ….. with perfect timing, the Medicare site is down:
We’re currently making updates to Medicare.gov.
Check back again soon.
le sigh