It's that time of year again. For many of us, fall means open enrollment with our health insurance carriers, and it's time to decide whether we keep the plan we have or choose a different one. Depending on your employer, you may even be choosing between different carriers.
It's tempting to click "keep my current plan" and move on. Before you do, it's worth taking a closer look, because what you're paying and what you're actually getting may have changed.
Premiums are going up, and coverage isn't keeping pace
Insurance premiums keep climbing, and what you get for that money is shifting too. We hear it from patients all the time: something they assumed would be covered turned out not to be. A test, a medication or an imaging study they needed ended up costing far more than they expected.
That's frustrating any time of year. It's even more frustrating when you find out halfway through the year, after you're locked into a plan.
Your open enrollment checklist
As you compare plans, look past the monthly premium and check what the plan is actually obligated to cover for the amount you're paying. Here's what to look for:
-
The deductible. How much will you pay out of pocket before the plan starts covering care?
-
Coinsurance. After you meet your deductible, what percentage of the bill is still yours?
-
Copays. What's the flat fee for an office visit, a specialist or urgent care?
-
Prescription coverage. Are the medications you take now on the plan's list, and at what cost?
-
Diagnostic services. How are labs, ultrasounds, mammograms and other imaging covered?
-
Referrals and prior authorizations. Does the plan require a referral to see a specialist, or approval before certain tests and procedures?
-
Out-of-network benefits. Will the plan reimburse any of your costs if you see a provider outside its network?
Think about the care you're likely to need next year, not just the care you needed last year. Planning a procedure, managing a chronic condition or starting a new medication can change which plan makes the most sense.
HSA vs. FSA: which one do you have?
Open enrollment is also when many people choose whether to use a Health Savings Account (HSA) or a Flexible Spending Account (FSA). Both let you set aside pre-tax money for medical expenses, but they work differently.
-
HSA: Available only with a qualifying high-deductible health plan. The money is yours to keep, it rolls over year to year and it stays with you if you change jobs.
-
FSA: Offered through your employer. Funds generally need to be used within the plan year, though some employers offer a short grace period or let you carry over a small amount. Check your FSA deadline so that money doesn't go to waste.
Either way, it's worth planning how you'll use those dollars for the care you know you'll need.
How insurance works at Chinn GYN
This is a question we get a lot, so let's make it simple.
We have chosen to opt out of health insurance networks. Insurance plan rules can turn patients into numbers and women into conditions, with treatment limited by what a billing code allows. We'd rather spend our time on you. As a concierge practice, we can give you longer visits, highly personalized care plans and providers who are focused on your wellness, not on navigating insurance policies.
Here's what that means for you:
-
We bill you directly, not your insurance company. You will never receive a surprise bill from us.
-
Our pricing is transparent and consistent. Your cost is the same no matter what insurance plan you have. We're happy to provide a quote before you schedule, and payment plans are available.
-
We'll help you seek reimbursement. We provide the forms and information you need to submit a claim to your insurance company (often called a superbill). Your plan's out-of-network benefits determine what, if anything, is reimbursed.
-
Your HSA or FSA can help. Purchases and payments at Chinn GYN are generally HSA/FSA eligible, and medical payments may count toward your deductible.
Because your insurance policy is a contract between you and your carrier, it's your responsibility to know your plan's rules, including referral or pre-authorization requirements, deductibles, copays and coinsurance. Open enrollment is the perfect time to get familiar with all of it.
What about the membership?
For medical care, we care for your whole body. That means primary care and gynecology together, through our concierge membership. If you're not sure yet, you can start with an exploratory medical appointment to meet your provider first. At checkout, we'll ask whether you'd like to continue, and if so, we'll help you join the Chinn GYN family.
If you're coming to us for Strictly Surgical care with Dr. Chinn or for aesthetic and wellness services, the membership isn't required.
Make your plan work for you
Choosing a health plan is a big decision, and it deserves more than a quick click. Take the time to understand what you're paying for, what's actually covered and how your HSA or FSA fits into the picture.
And if you're tired of feeling like a number, we'd love to show you what care looks like when it's built around you. Request an appointment or call us at (360) 824-5278. You can also find more answers on our FAQ page.
Frequently asked questions
Does Chinn GYN take insurance? We are out of network with all insurance plans. We bill you directly and can provide the forms you need to seek reimbursement from your insurance company.
Can I use my HSA or FSA at Chinn GYN? Purchases and payments at Chinn GYN are generally HSA/FSA eligible. Check with your plan administrator if you have questions about a specific service.
What is a superbill? A superbill is a detailed receipt with the information your insurance company needs to process an out-of-network claim. We're happy to provide one so you can submit it for possible reimbursement.
How much will my visit cost? Our pricing is transparent and the same regardless of your insurance. We can give you a quote before you schedule, and payment plans are available.
Do I need a membership to be seen? Medical care at Chinn GYN is provided through our concierge membership, and you can start with an exploratory appointment to meet your provider. Surgical and aesthetic services don't require a membership.
