How to Get the Best Value for Your Health Insurance Plans

Welcome to November, with its shorter days, cooler weather and, for many, decisions about choosing a health plan for the coming year.

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Whether you're covered by an employer's insurance plan, you're covered by Medicare or you are self-employed or unemployed, doing homework during "open enrollment" can help you get the best value for your money. You may find that you have more options for 2012.

Overall, employers that offer health care coverage are providing more choices, according to recent data from my agency, the Agency for Healthcare Research and Quality (AHRQ).

Large firms that offer health insurance are more likely to offer workers two or more plans now than they were 10 years ago. Unfortunately, our report also found that the percentage of employees who are offered health coverage is less today than it was a decade ago.

When you know your options and how they work, you can better decide which option fits your personal situation. Your choice may be different depending on whether you have a spouse or dependent children or if you need certain medicines.

Getting Started

To help people covered by Medicare review their options, the federal government expanded its open enrollment period for 2012. Open enrollment continues through Dec. 7, 2011, which is the deadline to pick a new Medicare plan. (You don't have to do anything if you want to keep the one you have.)

Compare your choices using Medicare's Prescription Plan Finder. This tool will help you find and compare the different kinds of Medicare Advantage health care plans (or Part C) and Medicare prescription drug plans (Part D). An online demonstration of this tool is available on YouTube.

If you're self-employed or unemployed, finding a health care plan takes more work. Healthy individuals who can afford out-of-pocket expenses might consider a high-deductible plan. Under these plans, you will have to pay much more yourself before the plan covers any expenses. The advantage is that premiums are lower than other types of coverage. The National Association of Insurance Commissioners offers tips to help you understand and apply for individual coverage.

If you've lost health care coverage because of a job loss, you may be able to continue it for 18 months. You will pay higher premiums, however. A Federal law known as COBRA lets workers who have lost group coverage continue those benefits. More information on how the COBRA law works is available here.

If you are uninsured because of a preexisting condition, you may be able to receive insurance through a temporary high-risk pool created under the Affordable Care Act. The program is funded by the federal government, but states can choose how or whether they want to participate. The program began on July 1, 2010, and ends on Jan. 1, 2014.

Understanding how different health care plans work can make it easier to choose wisely. You may prefer to pay more to get a wider choice of doctors, for example, or to use generic medicines instead of brand-name ones to save money.

Keep in mind that not all health care plans pay for the same services or pay the same amounts for services. (One exception is Medicare, which is required by the Affordable Care Act to pay for certain preventive benefits.)

Next: Understanding how different plans work.  >>