Julie’s Got You Covered

Smart Strategies for Better Health Insurance Choices

• Julie Sears • Episode 5

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How Do People Know If Their Current Plan Still Meets Their Needs For The Upcoming Year?

Is your health insurance plan truly meeting your needs, or are you unknowingly paying for inadequate coverage? Join Julie Sears and Sophia Yvette as they unlock the secrets to perfecting your health insurance choices. We promise to guide you through the maze of life changes like marriage, divorce, or children leaving the nest, and how these milestones can reshape your insurance requirements. Whether you’re planning medical procedures or simply reevaluating your healthcare expenses, discover how to ensure your plan remains both effective and budget-friendly, particularly when emergencies strike.

Navigate the constantly shifting landscape of health insurance plans with confidence. Julie and Sophia are here to shed light on why even minor adjustments in the marketplace can lead to major changes in premiums and benefits. We'll help you compare your current plan against others available, ensuring you make well-informed decisions without unnecessary hassle. With our guidance, avoid the pitfalls of hasty online shopping and uncover the best options tailored to your needs. Listen in for expert advice that covers the complexities of open enrollment and keeps you well-covered year-round.

To learn more about Integrity Health Insurance Advisors visit:
https://www.IntegrityHealthInsuranceAdvisors.com/
Integrity Health Insurance Advisors
469-348-4066

Speaker 1:

Welcome to Julie's Got you Covered, the podcast where Julie Sears, founder of Integrity Health Insurance Advisors, takes the fear out of finding the right health insurance. With seven plus years of experience, she's here to make finding the perfect coverage a breeze. Stay tuned for details on how you can snag a free 30-minute consultation.

Speaker 2:

Your life changes and so can your health coverage needs. Here's how to make sure your plan keeps up with you year after year. Welcome back everyone. I'm Sophia Yvette, co-host, slash producer, back in the studio with Julie Sears. Julie, how are you? I'm great. How are you?

Speaker 3:

doing today.

Speaker 2:

I'm doing great also. So, Julie, how do people know if their current plan still meets their needs for the upcoming year?

Speaker 3:

for the upcoming year To determine if your health plan still meets your needs for this next year of enrollment. It really is just going to be taking a look at any life changes that have either happened or are expected to happen in that next year, or any health changes or concerns that you might be having. If you have some procedures that you know are going to have to be done because you're hitting a certain age or that have been bothering you and you're finally ready to take the plunge and get those taken care of, we might want to look at paying a little more in premium and getting a lower out of pocket. It's just going to be a math equation, the math that we thought we weren't going to have to use, that we all, you know, bucked against the system back in the day in school, thought it was useless, but now it actually comes in handy. It's just really breaking down the math to see what makes sense.

Speaker 3:

Life changes, you know, unfortunately people get divorced or get married, have children or have children aging off of their plan. If those things are happening or are going to happen in that next year, then you might be able to make some changes during that open enrollment period that will hopefully impact it a little bit. Less Children going off to college, just those things obviously are hard to anticipate as far as our health goes. But when we know that there might be something or we know one of those life changes is occurring, then we can actually be a little bit more proactive and take a look at what our offerings are and maybe make a better, more informed decision.

Speaker 2:

What specific factors should I consider when reviewing my health plan each year?

Speaker 3:

I tell people to. You know, my first question is what do you typically use your coverage for in a normal year? I know we haven't had normal years so you might have to think back a little bit but in a normal year what does that look like? You know a lot of us it might be a sick visit and then our annual exam. So if your usage isn't very high, then you don't necessarily need something with really low co-pays because you're just going to pay more in order to limit that co-pay that you use once or maybe twice a year, those out-of-pocket costs.

Speaker 3:

As far as emergency room, you know people with children, small children who are in sports or clumsy like my kid was, I try to factor in you're probably going to end up in the emergency room or urgent care a couple times due to sports injuries, banging a head on a stair rail or whatever he did when he was little, all the things. So you know, making sure that you have a decent copay or out of pocket percentage, that coinsurance, for when you do have those, because the likelihood is high, you know. But for a single adult we might just look to see if there's some telemedicine available that offers you some good Teladoc services and then low premiums to go along with it, because you're not really going other than those annual exams.

Speaker 2:

So how often do health insurance plan benefits typically change?

Speaker 3:

On the marketplace, we do see a lot of changes. There are a lot of offerings. I've mentioned before in previous sessions that you know in some areas there could be over a hundred plans offered, and the very slightest difference in one benefit makes it a completely different plan, and the price may not really reflect that. And so it's just my job to help you kind of go through what those little tweaks are and see which one is the best fit. Sometimes you'll get a copay for a service that you may not need and you're paying a little extra for that access, whereas you could get rid of that and maybe pay a little bit less, and so we do see a lot of change on those from time to time. Obviously, they are for profit businesses, so they do make tweaks that benefit them, and I'm just here to help kind of make sure we've got it in the best possible setup for you for that next year.

Speaker 2:

Are there resources to help me compare my current plan with others available in my area?

Speaker 3:

help me compare my current plan with others available in my area. That's me. So I do all the legwork and kind of break it down and try to keep it to the top three or four or five plans you know as many as you want to see and kind of go through what those differences look like and give you the pros and cons. That way you can make an informed decision on what's going to best fit, what your expectations are for next year.

Speaker 2:

What about if I love the plant I have? Can I expect my plant to grow with me like a house plant, or is it more like a pet rock?

Speaker 3:

More like a pet rock. Typically they aren't going to change your plant details too much. The only thing that really changes is that premium every year and sometimes they will tweak that out-of-pocket maximum for the year. This year they did go down just a little bit for the out-of-pocket maximum but the premiums did increase. The base plan for those co-pays and your co-insurance typically stay the same. They don't really expand on the offering too much Private side. Sometimes they will throw in some additional benefits as the needs change of their client base, but for the most part they're more like pet rocks for sure.

Speaker 2:

If I made it through the year without any oops. My insurance doesn't cover that moment. Am I good to go?

Speaker 3:

Yeah, if you've made it through the year and haven't had any claims, then your plan can renew as usual. If you're on the marketplace, I always highly suggest people shop just to make sure that there might not be a better, more cost-effective fit. If the rate and out-of-pocket are staying pretty within your budget and the plan covered what you needed it to cover, I say go full steam ahead and stay put and don't rock the boat.

Speaker 2:

So, julie, just to wrap it all up here, is there any last minute advice you have during this open enrollment season for anyone looking to see if they want to stay with the plan they have or switch over?

Speaker 3:

I am always happy to just kind of give a quick review. It doesn't take me very long, just a few minutes and a few questions, and I can point you in the right direction. Just to make sure that you are properly covered, best piece of advice is do not go online and try to shop. If you have employer coverage, it's typically going to be the best option for the employee. It may make sense to move the family.

Speaker 3:

I've seen a lot this year of people going online and getting bombarded with phone calls just to find out that they're on a really good plan at work and they probably shouldn't have been shopping in the first place. And now they've got a million phone calls a day of someone trying to pressure them into switching plans. I've just lived by the golden rule of do unto others, and so I'm going to make sure people understand that they, if they're on a group plan, they're probably in the best place and hopefully that'll gain me some referrals down the line just by doing the right thing. But I don't want to move someone off of the golden ticket insurance just to find something less desirable, because your employer group plans are definitely going to be the most robust in most cases that you can get. You're going to lose coverage somewhere along the way or pay more out of pocket when you go out on an individual plan.

Speaker 2:

Well, love it, julie. We'll catch you in the next episode. Have a fantastic rest of your day, you as well.

Speaker 1:

Thanks for tuning in to. Julie's Got you Covered. Ready to say goodbye to insurance stress Head to IntegrityHealthInsuranceAdvisorscom or call 469-348-4066. That's 469-348-4066 to book your free 30-minute consultation With Julie. Health insurance doesn't have to be scary. She's got you covered.