When is employer open enrollment?
Your employer chooses the open enrollment dates. They may be different each year, but they’re usually in the fall, or a couple of months before your new plan starts.
If you miss the open enrollment period, you may have to wait until next year’s open enrollment to change your benefits. You can enroll during a Special Enrollment Period if you have a qualifying life event like getting married or divorced or having a child.
How does employer open enrollment work?
Your employer will provide you with guidelines and details about the plans they’re offering. It’s a good idea to review your options carefully. You’ll have a certain amount of time — usually a few weeks — to review plans and make your selections. Contact your employer for open enrollment dates and details.
Things to consider when choosing a plan
Are your doctors, specialists, and healthcare facilities in your plan’s network?
Your costs will be lower when you receive care from healthcare professionals, facilities, and pharmacies in your plan’s network. Some plans don’t cover care from doctors or healthcare facilities that are not in your plan’s network.
Tip: When you’re considering a plan, use our Find Care feature to search for healthcare professionals and make sure they’re in the plan’s network.
Are the medications I need covered?
Plans can cover different drugs. Some plans cover brand name and generic drugs, while others only cover generic drugs.
Tip: Check the plan’s drug list (also called a formulary) to make sure any medications you take are covered.
What will my healthcare needs be in the coming year?
Consider recent or expected changes that may affect your health coverage needs, such as having a baby, getting married, a recent diagnosis, or an upcoming major procedure.
Tip: For minor healthcare needs, a plan with lower monthly premiums could be a good choice to save money. Keep in mind that when you need care, these plans often have higher deductibles and out-of-pocket costs.
If you know you need a major procedure, have ongoing medical needs, or prefer to pay less out-of-pocket when you need care, you may want to consider a plan with lower deductibles and out-of-pocket costs.
What will I have to pay, and what will my plan cover?
Most plans require a monthly premium payment. In addition, your plan has an annual deductible. This is the amount you pay out of your pocket each plan year before your plan starts to share the costs for your care. Once you meet your deductible, your plan pays a percentage of the cost when you receive covered care. This is called coinsurance.
Your plan may also have copays. These are fixed amounts you pay for certain types of care. They can change for different types of care. For example, a doctor’s office visit may have a different copay than when you see a specialist. You may also have a prescription copay.
Check out this glossary of common healthcare terms to learn more about the terms listed here.
Tip: Check the plan’s coverage details to learn about your share of the costs, including premiums, deductibles, copays, and out-of-pocket maximums. Compare these with the other plans you’re considering to help you decide on the best option for you.
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