REST INSURED
Real Simple|October 2023
Ah, open enrollment season the time of year that makes many of us wish we had a PhD in insurance speak. Consider this a crash course.
CHERYL LOCK
REST INSURED

LET'S START WITH A QUIZ. True or false: "Coinsurance" refers to the fee you pay for medical appointments. 

The answer is false. Got it wrong? Lots of folks did: Of 2,000 people surveyed by Forbes Advisor last year, 77 percent missed it. (Coinsurance is the portion of the medical bill you're responsible for after you meet your deductible; your insurer pays the rest. It's not to be confused with a copay, which is what you fork over on the spot for a service.) The survey confirmed that most of us are confused about health insurance. "With a topic as complicated as this, the only thing you can do is take it step by step," says Caitlin Donovan, a senior director with the National Patient Advocate Foundation, a group that lobbies for affordable health care.

We're heading into open enrollment, the period of time when you can make changes to your current health insurance or apply for new coverage. So we asked health care experts to walk us through the process. The first step is knowing your deadline. (If you sign up through work, ask your HR department; if you use the insurance marketplace, visit healthcare.gov.) Mark the date on your calendar, and follow these steps to cross the finish line.

Look at Last Year

Jot down any doctors, services, and medications you used over the last 365 days and note the ones you'll keep. Then go to your insurance member portal to download your claims history and explanation of benefits, says Tasha Carter, Florida's insurance consumer advocate, who helps with the state's health care advocacy and education efforts. "You can't predict every medical expense, but being aware of past trends will help you make informed decisions," she says.

Think About the Future

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