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Published on August 29, 2024

6 Tips to Keep in Mind on Health Insurance Right Now

Whether buying health insurance independently, receiving from a job, or qualifying for Medicare or Medicaid, now is an important time to review options as 2025 approaches.

“This time of year, fall especially, is important time to make sure you explore all your options,” said Tina Church, director of patient financial services, MyMichigan Health. “Insurers are doing what is necessary to stand out to potential members in a variety of different ways. That is why it’s important to ask yourself question’s such as, ‘What is most valuable to me and my family?’ ‘What is the cost?’ ‘What is the premium?’ ‘What is the co-pay? ‘Do I want a low deductible plan?’ ‘What are the out-of-pocket maximums?’ ‘Do I have coverage when traveling?’ Identify your priorities, top needs and select a health insurance plan that aligns with what works best for you and your family.”

MyMichigan offers six important tips to keep in mind on health insurance right now:

  1. Review changes and weigh options carefully. Review changes to your insurance each year. If you have Medicare, or you’re going to become eligible this year or next, weigh your options carefully. Open enrollment is a good time to review options. Remember key points to be aware of that may impact where, when, how to receive care. Who is in network? What facilities are included? Are there any plan policy exclusions? The exclusions determine what is not covered by the insurance, such as GLP-1 medications, cosmetic surgery, alternative treatments, behavioral health, telehealth. In addition, be sure to review insurance plan referral processes. Do services require authorizations? Are there site of care requirements? Is your insurance plan invested in your health and wellbeing? What quality of care will the member be receiving with their coverage? Does it promote proactive prevention of chronic diseases?
  2. Verify all your providers participate in the plan being considered. It’s important to be sure the plan you are interested in is one your providers participate in. This should be done prior to enrollment. Next, we recommend that patients double check their preferred provider is accepting new patients. Locally, checking the MyMichigan website at www.mymichigan.org/doctors or calling MyMichigan Health Line toll-free at (800) 999-3199 as a source for MyMichigan participants is an option, as well.
  3. Act now to buy own insurance. Confirm with your employer or insurer when their Open Enrollment takes place. If purchasing health insurance directly, the healthcare.gov website is the place to go to find out what insurance plans are available. The site offers users the change to compare options and find out what insurance options will cost you, both in monthly premiums, copays or deductibles.
  4. Evaluate employer options. A lot of organizations and employers are facing higher costs for health insurance for 2025 and they may change the options they offer or the monthly costs to employees. Each insurance plan may have different benefits related to costs. Co-pays may differ. Select a plan that aligns with your needs.
  5. Consider how, when, and where care is received. Patients should be aware of what facilities and providers are included in the network of a health plan and what treatments may be excluded from that plan. It is also helpful to know what services may require an authorization or when a referral is needed to see a provider. Learning about the insurance plan’s policies may help patients to understand this.
  6. Research the ratings of different health plans. There are a variety of different ways that insurance plans are rated. Take a look at the health plan’s quality report card and patient satisfaction ratings to gauge the quality of care existing members receive and how happy their customers are with their care. Evaluate the efforts that health plan is delivering to keep improving their quality score and the satisfaction of members.

“We encourage you to begin exploring your options now so you can make an informed decision before your Open Enrollment period begins,” said Church. “Health insurance can be confusing. If you have questions, don’t be afraid to ask. Free assistance is available from MyMichigan Health experts to review choices and get questions answered.”

Those with questions or more information can contact MyMichigan Health’s team of financial counselors Monday through Friday from 8 a.m. to 4:30 p.m. by calling (844) 832-1956 or emailing patient-financial-services@mymichigan.org.