As open enrollment begins, once again, change seems to be the one constant in health insurance. Several insurance companies announced they are leaving several health exchanges in 2017, including Aetna, United Healthcare and Humana. In addition, other smaller insurance companies, like Scott & White Health Plan are also leaving or reducing their participation in exchanges. How do these changes affect you? Well, that depends on your health insurance, healthcare needs, and where you live.
Your Insurance
If you're lucky enough to have insurance provided by your employer, these changes may not greatly affect you. And if you purchase your insurance through an agent or directly from an insurance company, there may or may not be significant changes. Aetna, United Healthcare, Humana, and many other insurance companies will continue to provide health insurance coverage outside of the exchanges. But if your current health insurance company is leaving your health exchange, you need to choose a new insurance plan. And even if your insurance company is still in your exchange, you may choose to change plans to save money. There are usually several plans available to suit different needs.
As you have probably experienced, changes to your insurance plan, even if you stay with the same company, may affect your health care. Many providers and pharmacies accept multiple types of insurance, so you may be able to keep your doctors and pharmacies, but if a plan no longer covers your providers, you will need to change providers next year or pay out-of-network fees for your medical care.
Your Healthcare Needs
Healthy adults who only see a doctor occasionally and do not take regular medication will of course be least affected by these changes. But, the point of health insurance is to cover necessary medical care. The more care you need, the more important it is to know what care costs and who provides it. Plans do not always cover the best specialists or medications for every condition. If you or your dependents regularly see a physician or need prescription for a chronic health condition, and your doctor or medicine are no longer covered by the plans available to you this year, you might need to change your provider.
Location
Your location determines how much the changes in the health insurance exchanges will affect you and your healthcare. Families in many large metropolitan areas will continue to have a choice of several insurance providers, and that competition is helpful in keeping rates lower. Unfortunately, in some areas, you may only have one option on the exchange. Without competition, it is possible that the sole insurance provider will cut costs by limiting access to providers and what drugs are covered by their plan.
Smart Choices
If these changes in health care significantly affect you or family members you care for by limiting your choices or raising the cost of your health care, here are some smart choices you can make:
Research. Make sure you understand what your plan does and does not cover.
Shop around. Hire a broker to find plans that fit your budget and provide the coverage you want.
Use RefillWise. Insurance isn't the only way to afford needed medicine. RefillWise can save you money on prescriptions not covered by your plan, and in some cases buying a prescription with your RefillWise card may be less expensive than your insurance copay.
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