It's time for a health insurance check-up

A 2009 MetLife survey found that 90 percent of employees plan to keep or increase work benefits as their company's open enrollment season approaches. The survey also showed that 64 percent of American workers plan to spend more time evaluating their options this year because of the current economic conditions. An unexpected medical emergency or prolonged condition can quickly become an overwhelming financial burden. In fact, studies show that medical debt is now one of the leading causes of bankruptcy. If something unexpected were to happen to you or a family member, planning ahead can help you avert a serious financial setback. The best plan of action is to take proactive measures before an injury or illness strikes. To help you make the most of this year’s open enrollment season, perform an annual check-up of your medical insurance benefits by asking the following questions:

Does my plan cover pre-existing conditions? Not all insurance plans cover treatments for ongoing medical conditions like diabetes or heart conditions. Find out if there are limitations to your coverage, what they may be, and whether there is a mandatory waiting period before your coverage goes into effect.

Is my health coverage sufficient? Find out exactly what medical services are covered under your plan, and learn what preventive measures are offered. Ask if there are any limits on medical testing, surgical procedures, outpatient care, mental health assessments or prescription drugs.

What does my plan cost? Research your premiums and co-payments. Explore the difference in cost between using doctors in the network and those outside of the network. Find out if there is a limit to the maximum amount you would be expected to pay out of pocket.

What are my other options? Even if your current insurance plan appears to be adequate, it may be wise to review other options. There are many types of insurance plans that use a fee-for-service system, while Health Maintenance Organizations (HMO) operate on pre-paid services. Another type of insurance is called the Preferred Provider Only (PPO) plan, a combination of fee-for-service and pre-paid services. You may also be able to get group insurance coverage through membership in a labor union, professional association, club or other organizations.

No matter what you decide, do not be tempted to allow your insurance to lapse. Although no one plans to get sick, the old saying that “It’s better to be safe than sorry” is still true today. It is also best to protect yourself by establishing a savings cushion that contains at least three month’s salary in case of emergency. The comfort of knowing that you are prepared for the worst will do wonders for your mental health.

Kim McGrigg is the former Manager of Community and Media Relations for MMI.

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  • The Council on Accreditation (COA) is an international, independent, nonprofit, human service accrediting organization. Their mission is to partner with human service organizations worldwide to improve service delivery outcomes by developing, applying, and promoting accreditation standards.

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