Q&A: Choose wisely during open enrollment

A few weeks remain in the annual enrollment period for making changes to your current health plan and selecting providers you will access starting Jan. 1, 2022. Make sure you have done your homework and are satisfied with your choices. We asked Martha Gonzales, president of CHM Insurance Services, to explain why open enrollment is a good time to review your health insurance options.

Why is it important to review your coverage during open enrollment each year?

It’s important that you do an analysis or review of what your current utilization has been. Have there been any significant changes in your patterns of care? Are you taking new medications? Have your needs changed? Has there been a decline in vision or hearing? Are you OK with hearing and vision coverage? If you are extremely happy with your plan and everything has stayed fine, it’s OK to say ‘I’m going to stay put.’ You don’t have to make changes. But after open enrollment closes, it’s difficult to make changes.

How do I ensure I can keep my Providence physicians?

Always confirm that your doctors are still in the group. Never assume your doctors will stay in the network. At CHM Insurance Services, we do a free needs assessment for anyone who calls our office. We take a look at doctors and affiliations to make sure they have a relationship with Providence.

What happens if I choose a plan that doesn’t list all my preferred doctors?

If you are choosing a Medicare HMO, you are required to stay in the HMO network. Medicare Advantage PPO patients have out-of-network access, but it involves a higher cost. With Medicare supplemental insurance, you can choose any doctor.

Why are plans that include access to Providence physicians a good choice?

Providence Little Company of Mary Medical Center Torrance has been named a World’s Best Hospital three years in a row, and Providence Little Company of Mary Medical Centers San Pedro and Torrance both have earned “A” grades from the Leapfrog Group for patient safety for many years. The Providence doctors are board-certified. Their commitment to using quality measurements is exceptional. Providence uses electronic health records, which helps minimize errors. When you pick a Providence doctor, you’ll be able to see specialists close to home.

Why is it important to consider which hospitals are under my plan?

Your medical group is going to determine what access you have to hospitals, convalescent homes, skilled nursing homes and diagnostic facilities. When you choose the Providence network, you’ll have access to a quality hospital like Providence Little Company of Mary Medical Centers.

Are there any new significant changes in Medicare options?

Premium costs are inching up. Medicare is now recognizing coverage for acupuncture. Also, many of the plans are making provisions for covering telehealth visits.

For more information on selecting Providence physicians during open enrollment, go to ChooseProvidence.org or call 844-992-1257.