It's The Most Stressful Time Of The Year: Open Enrollment

The end of the year is always a stressful time in our household--and not because of reasons you might assume. It’s not holiday stress from Thanksgiving or Christmas that makes me want to pull my hair out with worry. On the contrary, the holidays bring me to life because it’s what I wait for all year. However, when open enrollment for medical insurance rolls around every ounce of joy and peace is drained from my body.

Choosing insurance with CF

During open enrollment, families and individuals choose which health insurance plan they will use for the upcoming year. There are many different types of medical insurance such as public sources (Medicare, Medicaid, and Health Marketplace) or private sources (commercial plans offered through an employer). To top it off, each insurance plan has various levels of coverage and exceptions. Add CF (and other expensive chronic conditions), specialty medications, and expensive doctor visits to the mix, and it’s enough to make you go crazy!

Before open enrollment closes, I have a daily anxious feeling brewing in my mind over all the details of the various plans. I’m so worried while picking health insurance to make a mistake that could be costly for our family. Even worse, I’m anxious something will go wrong even after crossing the I’s and T’s and I’ll end up losing a medication or service I rely on.

Questions to ask yourself

It can be hard to know which insurance plan will best suit your needs with CF. With so many options and a need for high levels of coverage, no wonder it isn’t simple. There are a couple of key questions you should ask yourself when looking into a plan.

1. What are the overall costs including premium, deductible, co-pays, and co-insurance? Is the plan a high-deductible plan? Is there high co-insurance on services?
2. Are my CF clinic and specialty doctors in-network? How often are you seeing a provider?
3. Does it cover ALL my medications, including vitamins? If not, are they covered elsewhere?
4. Can I use secondary insurance, co-pay assistance, or grant in addition to this plan? If more than 1 insurance, what is the coordination of benefits?

Not sure if you can figure this out on your own? I seriously don’t blame you--better yet, I am you! I'm in the same boat. It’s time to ask for help.

Asking for help

If you are feeling completely overwhelmed at the thought of picking a health insurance plan, you don’t have to carry the burden alone. There are people around you whose expertise and knowledge can make all the difference.

CF clinic social worker

Give your clinic a call and ask to speak to the CF social worker for specific insurance questions. They would be happy to help and have local knowledge on insurance companies, co-pay assistance, and special programs that can lower costs in your area. Our clinic social worker is always willing to help solve an issue that can be a barrier to our care.

Cystic Fibrosis Foundation Compass

Every year, I call Cystic Fibrosis Foundation’s 1-800-COMPASS to speak to a case manager about my insurance choices. I cannot say enough good things about every case manager I have worked with. After an initial phone call to gather information, your case manager will help you pick an insurance plan that best fits your needs.

They are so knowledgeable about insurance coverage in the context of CF--especially ensuring expensive medications are covered, proper coordination of benefits with more than one insurance, coverage of specific services and treatments, and keeping costs low overall. I highly, highly recommend Compass as a terrific insurance resource. Make sure to contact them with ample time as they tend to get busy around this time of year!

Is Open Enrollment a stressful time for you? Share your tips for choosing insurance!