Tips for choosing your health plan during open enrollment
by Christine Paige
Senior Vice President, Kaiser Permanente
Oct 04, 2010 | 354 views | 1 1 comments | 8 8 recommendations | email to a friend | print
Choosing health-insurance coverage is one of the most important health-care decisions Americans make. And for millions of Americans with employer-based coverage, that decision is made around this time every year during open-enrollment season.

What should be a thoughtful decision, though, is often made in matter of minutes – and that’s a mistake. Employees need to carefully evaluate their options when considering health care coverage for themselves and their families, and they should consider these five important steps before making their decision:

1) Review your past health care experiences.

2) Estimate your health care needs for the coming year.

3) Consider what you want from your physicians and health care providers.

4) Determine which online support tools are important to you.

5) Examine all costs involved in maintaining your health – and the plan’s total value.

First, thoroughly review your past health care experiences. Assess your current health plan’s overall value to you and your family. What do you like – and what do you want to change? Are you happy with the level of service and support you receive? In California, we have easy access to independent, online comparisons of health plans’ quality and service. The State of California Office of the Patient Advocate (www.opa.ca.gov) offers ratings of plans based on the quality of care members receive and what members say about their care.

Next, assess your health-care needs for coming year. What has changed for you in the past year, and what changes are coming next year? For example, maybe you’ve developed a chronic condition that will require more doctor visits or prescriptions. Or maybe you plan to have a baby. Review your options based on how you live your life.

Next, evaluate a plan’s care delivery system or network based on your specific needs. Do you want the option of going to a large network of doctors, specialists and hospitals? Do you prefer a PPO? Or do you prefer a health system with a strong emphasis on prevention and where care is coordinated among physicians?

You should also understand the full extent of what a plan offers in terms of online tools. Consumers have more demands on their time, and they want easier and faster access to information so they can manage their health at their convenience. At Kaiser Permanente, for example, members can e-mail their physicians, order prescriptions online, view their test results, and make appointments for themselves and family members at their convenience – at no additional cost.

Finally, consider all your health-care costs and services before selecting your plan. Don’t automatically sign up for the plan with the lowest premium. Look at the total value you are getting in terms of services and costs. How much did you spend on health care in the past year – including premiums, deductibles, co-pays for physicians, hospital stays and prescriptions? And what did you get for it?

Then look at your options for the coming year. For example, what services does the plan provide, and what are the plan’s co-pays for office visits, hospital visits and prescription drugs? What’s the deductible? Once you know the answers to these types of questions, you’ll be prepared to choose the health plan that’s right for you.

It takes time to be an informed health-care consumer, but it’s time well spent.

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smokeandmirrors
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October 05, 2010
The Kaiser Motto "Medicate First, Diagnose Whenever" If this is what want in health care then Kaiser is for you. If you want to see Seven different primary care physicians in Five years who's medical degree's are all from south of the equator then Kaiser is for you.If you want a physician that can not look you in eye but would rather peer hopelessly into a computer screen at your Biometrics collected by an overweight nurses aid and declares regardless of what you came in for is "have you ever considered Bariatric surgery"then prescribing something for a symptom of what you came in for as specified by the computer then it's off to the lab for Blood work that you will Never hear the results of. Heaven help the soul who starts with Kaiser but does not use the Kaiser Pharmacy.After two years of Kaiser "Doctors" prescribing nothing but name brands you switch to Kaiser Pharmacy where your first bill comes to $2400. and they do not stock four out the five prescriptions and that I would need to see two specialist in order to stay on these medications because"DO YOU KNOW HOW THIS AFFECTS OUR BOTTOM LINE" as spoken by the head Pharmacist.As for my bottom line I was not going to change meds that do not cause side effects as the cheaper ones will do because of the effect to Kaiser's bottom line.The chances of seeing a kaiser specialist [this would be a doctor who's first language is English] will take a minimum of three to six month's.If you go in for any kind of shoulder, knee or any type of Physical injury [ unless you are a woman ] you are directed automatically to the Physical Therapy Department which has no appointments available because this is what every Doctor does instead of diagnosing they prescribe drugs just to treat symptoms as specified by the all mighty computer. Kaiser is only concerned about making money and putting up as many obstacles and hoops as they can to make you jump through so you just give up.I would no be alive today at age 49 to write this if I stayed with Kaiser because the tests I needed done are not performed until you reach the age of 50 although I had mentioned more than one symptom I was having with at least four of the seven"Doctors". By the time I would have had this procedure I might have been 51 because it would have taken at least a year of hoop jumping before seeing a specialist that I should have seen before Drugs were prescribed that hid the more telltale symptoms and my BOTTOM LINE WOULD NO LONGER BE AFFECTING KAISER'S.Yes please think about your healthcare seriously. Make sure your doctor looks you in the face and not at a computer. THERE IS A REASON KIASER IS CHEAP....
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