Educate yourself about health-plan options

It is open-enrollment season at your work.

Take some time to educate yourself about the various health-plan options your employer offers.

When selecting a plan, according to the Agency for Healthcare Research and Quality, compare:

• Premiums. Avoid basing your decision only on the premium. Lower premiums typically mean care comes with higher out-of-pocket costs through deductibles, co-insurance or co-payments.

• Coverage/benefits. Read the materials you receive with the following questions in mind: What type of doctor visits, surgeries and hospital care are covered?

Is there a drug benefit? If so, how much does it cover and what will it cost you? Are dental and eye care covered? Are there limits on what you pay or what the plan will pay for?

• Review last year's coverage and costs. Determine if it was typical, what your out-of-pocket costs were, and if it was a good plan for you after all.

• Find out if your doctor, hospitals and other providers are in your plan's network. Decide if you are willing to see other providers, and if you aren't, how much it will cost you to go out of the plan's network for care?

• Look for ways to save money under the plan. Check to see if you can get cheaper prescription drugs if you order them by mail.

If you have diabetes or another chronic illness, find out if the plan lowers co-payments on medicines to keep your condition in check.

• Other things to consider: Access to after-hours and emergency care or exclusions and limitations. When do you need prior approval to ensure coverage for care?

-- Tammie Smith