Business of Well-being

Open Enrollment + Health Reform = Consumer Confusion

This fall's Open Enrollment season - the time when you can make annual changes to your health benefits plan - marks the first time that millions of people may need to make the connection between the new health reform law and their own health benefits. According to a national survey of 1,015 insured adults, almost 70 percent of Americans say they're paying more attention to what health benefits options are available because of the new health reform law.

However, many people may find the process challenging. According to a recent survey health benefits choices can be difficult to understand. More than half of survey participants said reading Shakespeare is easier than reading their health insurance policy. When it comes to health care, 40 percent of survey respondents admit that they don't know what they should be looking for (20 percent) or they don't know what questions to ask (20 percent).

And the new health care reform law leaves people even more bewildered. Almost 40 percent of respondents said they don't know how the new health care reform law will affect their plan, and 25 percent noted that choosing a health plan this year will be harder than last year due to this new law. So what can be done to make the process less-daunting? Here are four steps that people can follow to skip the confusion and get their health plan in shape for the year ahead.

  1. Prioritize. First, think about what's most important to you and your family. Is it the cost of prescription drugs? Is it being able to see out-of-network doctors without a referral? It might even be services like dental or vision exams.
  2. Calculate. Make sure you can afford the premiums. The health reform law passed by Congress in March aims to keep premiums in check. But no one knows for sure what will happen when some of the new rules go into effect in 2014. For now, be sure to pick a plan that's right for your health needs and your budget. Also, estimate last year's medical costs. This will help you plan how much to set aside in a flexible spending account (FSA). Since money in an FSA is exempt from most taxes, you'll get to keep more money from your paycheck each month. And you can use those pre-tax dollars for health care costs. A good thing to keep in mind for planning is that health reform will put a $2,500 annual limit on your FSA by 2013.
  3. Predict. Look ahead to doctors' visits or health screenings. Health care reform may make services like immunizations and health screenings easier to get. See if you can use of any of these options. It's a great way to save money and stay healthy.
  4. Compare. If you have a choice between health plans, find the plan that gives you the biggest bang for your buck. If you have just one option with the health plan at work, or if you buy health benefits yourself, make sure to use all of these benefits that are included. For instance, child immunizations and wellness discounts may not be highlighted. But health care reform may make these types of services easier to get.

Given today's economy, people go to great lengths to save money. Yet, a surprising 44 percent of people surveyed said they would give up $400 before they would spend time reviewing their health plan. Keeping health benefits in order is important - studies show that changes in health benefits can result in big changes to a family's finances. If there were ever a year for consumers to get smart on their Open Enrollment information, this is the year.

Concerns about health care costs increasing, coupled with what can be elusive facts on health reform, equals consumer confusion. And that lack of understanding can be a barrier to better health.The above survey was sponsored by Be Smart About Your Health.

About the Author:

Susan M. Kosman, RN, BSN, MS, is chief nursing officer at Aetna, one of the nation's leading diversified health care benefits companies. Susan provides support to the more than 3,000 nurses who help Aetna members understand their clinical condition, access appropriate care and best use the benefits available to them to manage their overall health. Susan is also the spokesperson for Be Smart About Your Health, a one-stop consumer health benefits educational resource from Aetna designed to help people discover more about their physical and financial health and health benefits.

Launched in 2010, the website allows visitors to think like smart health care consumers, choose the right benefits, track spending, plan health care visits and live well to maintain a healthy lifestyle. The portal also houses recent health information from Aetna InteliHealth, interactive tools and the latest updates on health reform. Be Smart About Your Health promotes a better understanding to help people make more informed health care decisions and to help consumers protect their health and their finances.

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