Open enrollment is the period when you can select your medical and other benefits for the next year. Understanding your health plan options can help you choose what’s best for your family and save money. But we know it can be confusing to sort through.
Your employer’s open enrollment guide provides short summaries to compare plans, detailed information about cost and what’s covered, and a list of benefit contact information all in one place. Also try to attend education sessions from your employer and benefits vendors — they’re a great way to get your questions answered.
What should I consider?
While you can’t predict the future, think about your goals and likely expenses for the upcoming year.
Situations to consider include:
- Growing your family (pregnancy or adoption)
- Childcare support
- Infertility benefits
- Managing a chronic condition
- Planned medical procedures
Comparing costs
It’s important to look at how much you might have to pay under each plan option. Here are the main costs to compare:
- Premium: what you pay each month for the plan
- Deductible: how much you pay before your health plan starts to pay
- Co-insurance: the percent of medical bill that you pay after reaching the deductible
- Co-pay: a set amount you may need to pay for each visit or service
Also note the out-of-pocket max — the most you’d have to pay every year. After that, your health plan pays 100%. This resets every year.
It’s good to know that preventive care is free. (For example, your annual check-up and many recommended screenings.) It will not count against your deductible or co-insurance.
Choosing the right plan
- Higher premium plans: You pay more each month but tend to pay less when you get care. They can be a good option if you or your family needs medical or specialist care often.
- High-deductible health plans: You pay less each month, but more when you need care. They often come with a health savings account, which allows you to save pre-tax money for medical care. These plans can be a good option if you don’t need care often.
Also be sure to look at the health plan’s provider network. If you and your family want to keep seeing your providers or specialists, check if they’re covered by the plan.
Tax savings plans
Find out if your health plan comes with a health savings account or if your employer offers other tax-advantaged accounts that allow you to put aside pre-tax dollars for health or childcare expenses. Those tax savings can really add up. And your employer may contribute money to these accounts, as well.
When estimating your health plan costs, consider your possible tax savings and contributions from your employer.
Common accounts include:
- Health Savings Account (HSA). An HSA is like a personal bank account for medical expenses. The money you contribute is pre-tax, so you’ll get tax savings. The funds roll over every year — it’s your money to save, invest, and use until you retire.
- Flexible Spending Account (FSA). An FSA is an employer-owned account for medical expenses. The money you contribute is pre-tax, so you’ll get tax savings. But the money may expire at the end of the year.
- Dependent Care Flexible Spending Account (DCFSA). A DCFSA is an account for dependent services like preschool, summer day camp, before and after school programs, and child or adult daycare. The money you contribute is pre-tax, so you’ll get tax savings. But the money expires at the end of the year.
Read this article on tax-advantaged accounts and reach out to your Progyny Benefits Specialist if you’d like any guidance or help understanding your benefit options. They’re here for you.
Disclaimer: The information provided by Progyny is for educational purposes only and is not legal advice. Always consult a lawyer for legal guidance.