How to Pick a Health Care Plan that Fits Your Lifestyle and Budget

As the 2013 open enrollment benefit season approaches, consumers say choosing health-care benefits is among the most difficult of life decisions, second only to saving for retirement, according to a recent survey.

According to Aetna’s Empowered Health Index Survey, 88% of respondents blamed the information regarding their benefits being too complicated for their difficulty in choosing the right plan. What’s more, 85% say the information is conflicting and 83% of survey participants say it is difficult to know which plan is right for them.

Of the 15% of respondents who did not have health insurance, 36% reported they didn’t have enough information to shop for it, and 24% are not confident in their ability to choose the right plan.

Complicated information leads to poor health-care choices which cause costly problems. The survey says many Americans continue to dip into their savings and skip recommended medical treatments to cope with the high cost of health care:

• One in five consumers needed to tap their savings to pay for health care during the past year
• Four in ten Americans have skipped a dose of prescription medication or stopped taking it or skipped or delayed a needed medical procedure

Experts claim these challenges will only become more daunting amid escalating premiums and services as consumers remain uncertain about how the presidential election will impact health-care reform.

According to the survey, slightly more Americans, 43%, have an unfavorable opinion of the Patient Protection and Affordable Care Act, (PPACA) than support it, 41%—but  75% of survey respondents believe that all of PPACA’s key elements are important for them, individually, and for their families.

The Aetna survey, conducted in July among 1,500 adults, also looked at a wide range of behaviors demonstrating the degree to which consumers use tools and resources to actively make health plan, physician and other medical choices.

• Four in ten consumers rarely or never track how much they spend on out-of-pocket health care costs, as compared with 57% of consumers who do
• Nearly half of consumers, 45%, rarely or never use websites or computer programs to help manage their health and wellness, as compared with 54% who do
• Eight in ten consumers, 83%, rarely or never use mobile phone applications to manage their health and wellness, as compared with 16% who do

Despite the headwinds they are facing, consumers are working to improve the situation.

• Forty-three percent of respondents say they would be interested in a mobile “app” providing reminders about doctors’ appointments and taking medications
• Sixty-nine percent  want access to their medical records
• Sixty-eight percent want information on medical procedure costs
• Sixty-three percent, 63%, want to compare health care providers based on quality ratings, particularly heartening, says Dr. Wendy Shanahan-Richards, Aetna’s national medical director and co-author of Navigating Your Health Benefits for Dummies; “This tells me consumers are not convinced every provider is the same.”

The Patient Protection and Affordable Care Act requires plans to simplify their summary of benefit choices providing side-by-side comparative information for offered plans, says Mark Cesarano, managing consultant at health-care consulting firm Savitz.

Health plans are responding, and companies like Aetna are taking the lead by continually evolving and enriching their educational materials, interactive tools and resources. For example, Aetna’s Plan for Your Health website  provides educational articles, cost calculators and checklists. Other health insurers are also improving their websites and customer service to provide detailed, yet understandable information to customers.

How to Pick the Right Heath Care Plan

Zeroing in on the services covered under a particular plan and the physicians and hospitals that excel in those services are the best way for a consumer to pick a suitable plan.

Care is expensive with medical claims being the overwhelming driving force of insurance costs, Cesarano says. As much as 73% of self-insured dollars go toward medical claims—which is why access to understandable plan information is important in making consumers more knowledgeable.

Here are tips for choosing the right health-care plan:

Become educated. Avail yourself of all educational tools available, including  health glossaries that define health terms.

Use open enrollment to plan your health year. Know the deadlines to submit forms, attend benefits meetings at which you can ask questions of benefits specialists.

Review last year’s plan. Identifying assets or gaps will serve as a good comparison with the current-year offerings.

Understand your health needs. Knowing specific coverage needs of you or a family member will help identify and eliminate potential health plans.

Track your costs and work these into your yearly budget. This includes premiums and medical expenses.

See your doctor regularly. Maintaining you health can help prevent bigger medical issues down the road. Understand your current health status and discuss how a present condition may require follow-up in medication or care.

Go mobile. Smartphone apps are a cheap way to track your health, look up medical terms and treatments, find a provider, compare costs and much more.