You can plan ahead for care. As hard as it can be, it’s important to step back during open enrollment and think about what your life will look like over the next year, including the care you expect to need. If you are planning a life event, such as a pregnancy, or have a family member with health concerns, assess your plan options with that in mind, and what the balance of premium payments and out-of-pocket costs will look like for you.

You’ll also want to take into account what kind of healthcare consumer you are. Do you go in for frequent check-ups and preventive care, or are you someone who generally only accesses care for emergencies? If you have dependents, which kind of healthcare consumers are they? Review plan options to understand how your healthcare consumption style impacts your monthly premiums and annual overall costs. And remember, preventive care is usually included in a plan’s coverage, so learning exactly what that entails can help you assess the coverage you need.

Healthcare service costs vary. You have more control over your healthcare spending than you think and you might be surprised to learn that prices can vary widely for the same services of the same quality at different locations. If you or a family member needs an X-ray or an MRI, it could cost you $3,000 down the street but just $800 just a few miles away, with no difference in the service provided. Since we know that higher prices do not correlate to improved quality in healthcare, these price variations make it important to plan ahead when you are expecting a major procedure or a big-ticket item, such as giving birth or having a hip replaced. In the case non-emergent care, you likely have lots of options for where you can go for care.

Run a test scenario by visiting a health plan’s website to see where and how they list costs for services that you might obtain and find the most convenient and cost-effective place to get that care. Learn more about available providers and see for yourself how costs can vary. You might even discover that your health plan offers rewards for doing this kind of shopping around for care! There’s a lot more information available than most people are aware—and there is going to be even more information available moving forward given recent mandates around price transparency.

Consider more than the numbers. Your choice in health insurance isn’t just about weighing the dollars for premiums, deductibles, and copays. It’s also about understanding what is available to you through your plan, so that when you do need care, you know where to go and what you can access. For example, does your plan offer you the convenience of telehealth visits or direct online appointment scheduling? Are there easy ways to get in touch with your plan – like online chat, extended phone hours, or email? Are you able to access a wide network of providers with detailed profile information, so that you can find ones you trust? Finding a trusted provider is more important than you might think, higher levels of trust lead to better health over the long term.

Get to know all of the great things your plan has to offer now, so that as you navigate your options during open enrollment, you know what’s available throughout the year when you might need care.

The post Three Things Consumers Should Consider During Open Enrollment appeared first on Kyruus Health.

Below are three tips to consider as you develop your member education programs related to complex benefits information.

1. Put everything in their terms. Too often, health plans get stuck using their own jargon to communicate to plan members. Terms like “imbedded coinsurance” and “out of pocket max” make sense to those of us in the industry, but are you aware of the percentage of people who actually understand the verbiage typically used within payer organizations? This study from policy genius shows that only 4% of Americans could correctly define the following four terms: deductible, coinsurance, co-pay and out of pocket maximum. In order to make information stick with your members and help them comprehend these terms, put everything into language that makes sense to them. A good way to practice is to try explaining the basic tenants of the previous four terms to your family members. When you have simplified them enough for your parents, spouse or even children to understand, make that language universal to your members. You will find that you have created more meaningful and authentic communication as a result.
2. Help members connect the dots with visuals. The effort of attempting to untangle the complexity of health care combined with the structure of benefits often leads to an overwhelming sense of frustration for members. Help them see how all of these insurance terms come together in a meaningful way by including visual elements to simplify ideas and concepts. Providing visual representations allows for a simplified version of complex ideas to be communicated in a format that is more consumable for many people. The use of visualization has been leveraged in many industries, including software development and engineering, where tools like concept maps and mind maps are often used.
3. Keep it consistent. Through the use of consistent terminology and definitions across all your health plan communication, members feel a level of comfort that leads to trust and understanding. The continuity of terms, tone and tenor provides familiarity and acceptance while eliminating confusion and frustration for members. I recommend a full audit of your communications to ensure consistency. You’d be surprised how often health plans confuse their members through the use of different terms for the same concepts.

If you are seeking to educate members about complex benefit designs, leverage these three best practices to help navigate them to a better understanding of the complete picture.

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