MED TECH
Things to Consider When Choosing a Health Plan
It will soon be time for open enrollment . Choosing a health care plan can be daunting , as can not knowing which doctor or health care company best suits you or your family ’ s needs . Companies compete to be your provider , inundating you with pamphlets , emails and media commercials . Comstock ’ s talked to some local experts who provide tips for both the employee and employer .
Dr . Bianca Roberts with Dignity Health says the best way to start is to choose your primary care physician . Go through the company ’ s websites and find one that appeals to you . Roberts says doctors at Dignity Health provide not only their health specialities , but also their philosophies of care , personal interests and hobbies so you know more about them .
“ The primary care physician is actually the doctor who will coordinate and manage your overall health . We keep everyone up to date on all their health screenings and manage complex illnesses as well ,” says Roberts . “ It ’ s really important to pick a primary care doctor that you ’ re comfortable with .”
Choosing a doctor becomes easier when you break it down . Do you have a gender preference ? Do you want someone close to your home or place of work ? Or do you take care of a family member and want to be closer to them ? Health care has seen a substantial increase in virtual visits , and if you prefer that , seek out physicians who provide telemedicine .
If you have a medical condition such as heart ailments or cancer , Roberts advises looking around to see which health care company specializes in that treatment . Your physician will also refer you to a specialist in that area .
Costs are a big concern these days . Roberts says you shouldn ’ t just look at costs , but at the value as well . Families who provide health care for their children should also consider a provider ’ s urgent care services .
“ Look at Medicare ratings . Each medical group is rated by Medicare for their ability to not only keep patients out of the hospital , but to manage ( them ) to really provide cost savings by how well they do health screenings and preventive care ,
Dr . Bianca Roberts , Dignity Health
manage blood pressure and other kinds of things to keep a population healthy ,” Roberts says .
Erin Ocheltree is the director of benefits for Bender Insurance Solutions , which designs benefit programs for employers . Ocheltree says it ’ s important for employers to listen to their workers ’ needs when creating health plans for them .
“ Typically , we ’ re thinking first . We ’ re always asking what are your pain points ? What ’ s working well and what ’ s not working for you ? What are your goals — budget , morale , retention of employees or acquiring new ones ?” Ocheltree says .
Bender creates health plans tailored to a company ’ s needs , and these days companies are offering more for workers to retain them , such as providing payments for mental health checkups , therapy or wellness such as gym memberships . The pandemic also changed health care with more people seeking wellness programs and telehealth .
“ I think it ’ s important for employers to know the health and wellness of their employees directly affects how well they perform for the employer . So spending a little bit of money to provide someone something valuable , like a gym membership or some money toward therapy , is a pretty worthwhile investment .”
“ You want to create custom solutions for them ( employers ), so that they ’ re providing benefits to their employees . Every employee can have different needs .”
Companies like Bender that design medical benefits for employers typically offer two or three health care companies for employees to choose from . They also provide enrollment systems to help employees set up their health care accounts .
“ Everyone has a different need when it comes to medical insurance . Someone who ’ s a high utilizer or had an ongoing medical condition is going to want a different plan than someone with young children or someone who ’ s single and doesn ’ t use their benefits as much . It ’ s important for all those people to have coverage ,” Ocheltree says .
Open enrollment is Nov . 1st through Dec . 15th , so take time to find one that best suits you .
- By Judy Farah
PHOTO COURTESY OF DR . BIANCA ROBERTS
52 comstocksmag . com | September 2022