Open Enrollment—Is It That Time Again?

By The Insurance Management Team            

Updated on 09/04/14

Is it already time for open health insurance enrollment? For a number of kidney disease patients, the resounding answer is yes. This is the time when employers, Medicare Advantage plans, COBRA administrators and individual exchanges offer you the opportunity to review your benefits, make changes to your coverage as applicable, and more specifically, make changes with your health insurance. All of your benefits could be potentially affected (benefits include medical, dental, vision, short- and long-term disability options, life insurance elections and long-term care plans).

Maintaining your health insurance is important

Insurance plans can be very complicated and changes to your insurance may have a substantial effect on dialysis coverage. It is important to understand your insurance plan and options before making any health insurance changes.

You are not in this alone! DaVita has a dedicated resource: the Insurance Management Team (IMT). The IMT is ready and available to assist you with your questions and to help you make an informed decision for yourself, your family and your future. Please contact your DaVita center social worker or call one of our DaVita insurance management specialists at 1-855-5-DIALYSIS.

This is also a time to consider enrolling in DaVita Rx®, a full-service pharmacy specializing in kidney care that will allow you to have your medicines delivered to your home or your center. Call 1-888-328-4827 to enroll or request more information.

Consider the following when making decisions about your health insurance:

  1. Who will be affected by open enrollment? It may affect you and your spouse or dependent’s benefits. These benefits may include: medical, dental, vision, short-term and long-term disability options and other coverage selections.
  2. What should I look for? Watch for information about your current coverage and coverage options for the upcoming year, which may be provided to you via mailings or handouts from employers, Medicare Advantage plan carriers, COBRA administrators or individual exchanges.
  3. When is open enrollment? You may have a small window of opportunity (sometimes only a week or two) where you have to make decisions that will affect you and your dependents’ health insurance coverage for the next year.
  4. Where can I obtain information? Look for materials on your open enrollment choices to come to you at work, via email or to your home. Sometimes you may even have to go online to your employer’s, COBRA administrator's or individual exchange's website to review your options and make your elections.
  5. Why should I be concerned? Changes in plans can directly affect your:
  • Out-of-pocket costs and co-pays
  • Prescription coverage
  • Access to care (e.g., which doctors, providers and hospitals you can go to)
  • Coverage for you, your spouse and other dependents
  • Annual and lifetime benefits
  • Ability to obtain other insurance coverage in the future

Listed are frequently asked questions to consider:

How do I know when my open enrollment dates are?

Usually your employer or COBRA administrator will send out emails, letters and memos to all employees eligible for benefits. You can also ask your human resources (HR) and/or benefits manager directly. If you are currently enrolled in an Individual Health Exchange, you will need to contact the insurance carrier or visit www.medicare.gov.

How long is open enrollment?

It could be anywhere from more than a week to two months, depending on the companyor COBRA administrator. The open enrollment window for individual exchanges occurs November 15, 2014 through February 15, 2015.  Most companies and COBRA administrators have annual open enrollment, so you only have that timeframe for open enrollment amendments.

Where do I go to change my benefits?

Larger employers and COBRA administrators have websites where you go to make your elections; be aware of both pre-tax and post-tax deductions. You can also call your HR department, benefits manager or COBRA administrator or fill out paper applications.

How do I know which benefits to choose?

If you’re confused, talk to the company benefits manager/coordinator, COBRA administrator, Marketplace representative or speak to an insurance management team member to review your options. Each benefit choice could affect your out-of-pocket costs, access to certain types of care, prescriptions, ability to obtain other insurance coverage and coverage for your family. Sometimes the less expensive option could be more expensive in the long run.

I have health insurance but why should I pick disability, long-term care plans and other options?

These other plans could help you financially cover certain types of losses during periods of illness, injury, permanent disability or a catastrophic event.

Can I switch plans or make changes to my plan outside of this open enrollment time?

Oftentimes, companies (employers, COBRA administrator, individual exchange) may allow you to add or remove dependents or significant others because of a qualified life event change such as marriage, divorce, birth of a new baby, death or change in employment status (i.e., part-time to full-time). Speak to your benefits manager for more company-specific information or COBRA administrator if on a COBRA policy or on individual exchange.

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