How to ace open enrollment

Most employers will provide a choice between two or more insurance plans. Some plans limit access to certain health care systems. If you’d like to get your care from a specific health care organization, such as Sharp, which accepts almost all health insurance plans, be sure to choose an insurance option that allows that.

Take time to understand key features like premiums, deductibles, copays and out-of-pocket maximums. These factors directly affect how much you'll pay for care throughout the year.

Also review in-network providers, covered services and prescription benefits to make sure the plan fits your health needs and budget.

Once you know which insurance options are available, you’ll want to find a primary care doctor who meets your needs. Your primary care doctor will be your main point of contact. They will get to know you and your health history and coordinate all your care. On sharp.com, you can search for a highly rated primary care doctor using filters, such as insurance accepted, doctor’s office location, languages spoken and more.

• When choosing your primary care doctor, be sure to consider whether you anticipate needing referrals to specialists, such as a heart or cancer doctor. Primary care doctors work within networks of specialists called medical groups. Sharp’s medical groups include Sharp Community, Sharp Rees-Stealy and SharpCare. To be seen by a specific specialist, you’ll need to choose a primary care doctor within the same medical group.

• Think about whether you’ll need hospital care, such as when delivering a baby. Doctors admit patients to specific hospitals, so you’ll want to find a doctor who can admit you to your hospital of choice. You can find Sharp physicians’ hospital affiliations on their sharp.com profiles.

Beyond medical coverage, many employers offer additional benefits that can improve your health and save you money. These may include:

• Preventive care services (often covered at no cost)

• Wellness programs or fitness incentives

• Telehealth visits for convenient care

• Flexible spending accounts (FSA) or health savings accounts (HSA)

• Mental health and counseling services

Review your benefits package carefully so you don’t miss opportunities to use services that support your overall well-being.

Once you’ve decided on your insurance plan, let your employer know your choice. You’ll also need to notify your new health plan company of your primary care doctor choice. They will usually ask for the doctor’s National Provider Identifier (NPI) number on your enrollment form. You can find NPI numbers on Sharp’s doctor profiles.

• After your new insurance plan becomes active, confirm your chosen primary care doctor is listed on the insurance card you receive.

• You can make an appointment with your new doctor if care is needed. However, if you’ve already notified your insurance company about who your new doctor is, a “meet-and-greet” appointment is generally not required.