What happens if something happens? Or, medical coverage and 6 tips for Open Enrollment season.

What happens if something happens? Or, medical coverage and 6 tips for Open Enrollment season.

by Chanel Reynolds

We know change is constant, but after the recent election our healthcare coverage system could change A LOT.

Uncertainty can be a no-fun, scary place to be – especially when it comes to access to medical care. It’s Open Enrollment season, so as the December 15th deadline approaches and many of you plan trips or family get-togethers for the holidays, we decided to focus on the medical options and what-ifs to pay attention to right now.

1) What matters?  Most of us don’t have the time to research every plan or comb through each chart to compare them – So, I got honest about what scares the pants off me (being a single parent with a sick kid) and focused on making sure I’ve got the basics and my vulnerable spots (access to expert doctors if something happens and getting seen asap) taken care of.

To-do: Figure out what you really need – There are a lot resources out there, I found this New York Times article super helpful and the ‘3 Things’ overview on the HealthCare.gov breaks it down very clearly.

2) How covered are you? As a widowed single-parent I have to be honest that the only thing that scares me more than dying before my son is an adult is getting so sick I can’t take care of him and not dying for a long, terribly awful, painful, financially-ruinous time.

To-do: Check if you’re covered where you’d want to go – Personally, If I get breast cancer (my current #1 fear), I want to be seen by a black-belt boob-whisperer who has done nothing else but look at breasts all day, every day, for the last 20 years. So, I checked with Seattle Cancer Care Alliance to see if my current plan is covered there.

3) How hard/easy is it? Most parents understand the feeling where you have a 7-minute buffer to do all-the-things-you-have-to, and when your kid is sick everything flies apart into pieces. Even if nothing is wrong, it still sucks to have to schedule an appointment 3 weeks (or months) in advance.

To-do: Find out how/where you can get seen – Ask if your regular doctor or pediatrician offers weekend or evening appointments. Mine did, and I had no idea.

So, even though the future of health insurance feels complicated, some things are getting way easier.

Here are two new things worth checking out:

  • Hell yes for house calls. I downloaded this new At Home app where I can schedule a doctor to come to my home, the same-day, and it’s covered by insurance! When I called the number a very helpful man assured me I wasn’t dreaming and I can also schedule preventive and well child appointments, too. Years ago, when my son wasn’t getting over a bad flu and I had it, too, (and our very old dog was literally dying all over the house every minute) I would have done questionable, if not downright illegal, things to have had that app available.
  • Get an In Case of Emergency contact. Either on your phone’s lock screen or download a free app like ICE, this is a low-tech /high-reward thing you should do. Personally, I have my A-team (best friends, parents, neighbor, babysitter, etc.) along with doctor’s contact information saved on my favorites list and I don’t use a passcode so anyone can access them. After learning the hard way how awful not having the contact info you need when you really need it really is – please trust me on this.

After getting through my list, I asked GYST Co-founder Phil Shigo, what his advice would be, especially since he’s taken on a caregiver and organizer role for an aging parent.

4) Become familiar with the current system. This month, many of us will reconnect with our extended families. If you are one of the 44 million adults who spends several hours each week caring for an aging parent, you should learn about Medicare Advantage. The center for Medicare has great information about these plans that range from Health Maintenance Organizations, Preferred Provider Organizations, Private and Fee-for-Service Plans that may be appropriate for you or a member of your family.
5) Learn how things are likely to change. With the new Secretary for Health and Human Services stepping in, read the new bill for yourself to see how it may affect you and your family. For example, under Mr. Price’s bill, there would be a limit of $8,000 on the amount of tax-free coverage you would receive an individual employee and $20,000 for family coverage.
6) Be an advocate for your colleagues. Read up on tips for 2017 Open Enrollment. If you’re a working adult who is part of a mid-size company or larger enterprise, engage your HR specialist and learn about possible changes to your employer sponsored healthcare program. And heck, if you have concerns, that you and your colleagues raise while talking around the water cooler, write a letter to your congressman.

2 thoughts on “What happens if something happens? Or, medical coverage and 6 tips for Open Enrollment season.

  1. thanks for the info. some of the issues you mention are too scary to think of, but you are right, they have to be taken care of, and at the very least, it is important to know what issues we might face.

    Like

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