INDIANAPOLIS — Open enrollment season is here. According to the CDC, nine out of ten adults struggle to understand their personal and health insurance needs, which can cost them billions of dollars.
Local health insurance provider Managed Health Services takes calls from adults with questions about basic healthcare terms.
- A person's network is the group of doctors that have a contract to provide services through your health insurance.
- A premium is the amount you pay for coverage every month.
- A deductible is the total amount you pay for covered services before the insurance plan starts to pay.
- A co-payment is the fixed amount you pay for a covered service before and after you reach the deductible.
- Then once you've reached your deductible, coinsurance is the percentage of the costs of covered service you're required to pay.
- Finally, the out-of-pocket maximum is the cap on the amount you must pay in a plan's year.
"When you're making your insurance decisions, it's important that people understand their options, right? We want people to feel confident, empowered, but it's complex," said MHS CEO and President Kevin O'Toole.
O'Toole said the most common mistake is not understanding which doctors are in your plan's network.
If you're not confident, O'Toole recommends contacting an insurance broker or visit MHS, also known as Ambetter in the marketplace.
Marketplace open enrollment starts Nov. 1. Medicare open enrollment for adults 65 and over ends Dec. 7.
O'Toole said Medicare is complicated. While those who are eligible will receive information in the mail, he said it's important to start doing research before reaching your 65th birthday.
October is Health Literacy Month. According to the CDC, if Americans improve their knowledge, it could prevent nearly 1 million hospital visits in our country and save more than $25 billion per year.
MHS covers around 450,000 Hoosiers. For more information, you can call MHS at 1-877-647-4848 or visit their website.