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Daily Dose

Get the 411 on pharmacy news
+ health & wellness tips

Open Enrollment & You: What to Know About Your Benefits

Sorensen, Katherine
On December 7, 2021

It’s about to be that time of year where you get that email from HR announcing ‘Open Enrollment.’ But what does it mean, exactly?

How do you know you’re getting the best benefits at the best price?   

It’s confusing; we get it. Don’t worry—the GeniusRx team has some tips & tricks on what to keep in mind as you make your next benefits selection!  



What is Open Enrollment?

Put simply; open enrollment is the annual period where you’re allowed to either sign up for health insurance if you’re not already covered or looking to switch plans or to make changes to your current health insurance plan for the upcoming year.  

For employer-sponsored plans, open enrollment is usually in the fall. On the government marketplace, it’s generally from November 1 until December 15, but this year it’s been extended a month—from November 1, 2021, until January 15, 2022. If you miss open enrollment, you can still get coverage after January 15 if you qualify with certain life events, like having a baby, turning 26, or losing your job.  

How Can I Save Money During Open Enrollment?

Premiums and plan costs change constantly and can depend on your personal circumstances, the region you live in, how many people are on your plan (and what kind of healthcare issues they’re dealing with), and more.  

Open enrollment is the perfect time to review your current healthcare needs and look into different options that might serve you better. Commonly, you can find a different, more affordable plan that offers similar coverage. Or, you can pay more in premiums to save on your medications, specialized doctor appointments, or surgeries. If you know you have a significant life event coming up, such as having a child or getting a knee replacement, you can compare plans that will best cover your needs and save you money over the year.   

When searching through your plans, you might notice that some offer the ability to open a Health Savings Account (HSA); this account allows you to set aside pre-taxed money out of your paycheck into a savings account that you can later use to pay for a variety of medical expenses. Another great thing? The money rolls over into the next year if you don’t spend all of it—seriously!


Top Things to Know with Your Benefits  

It’s a confusing world out there. We’re here to help you make more sense of it.   

1. Understand the Lingo:   

Premium: This is the amount you and/or your employer must pay for your health insurance or plan every month, quarter, or year.   

Covered service or expense: This is the portion of a medical, dental, or vision expense that your health insurance or plan has agreed to pay for or reimburse.  

Deductible: This is the amount you may owe during a coverage period (usually one year) for covered health care services before your plan begins to pay.   

Coinsurance: This is your share of the cost of a covered health care service, calculated as a percentage of the allowed amount for the service.  

Copayment or copay: This is the fixed amount you pay for a covered health care service. After you’ve reached your out-of-pocket limit, the copayment is no longer charged.   

Annual out-of-pocket limit: This is the most money you would have to pay for covered expenses in a plan year.   

2. Know Your Prescription Costs:  

When you understand how much your insurance covers for the medications you need, you can get a better plan for low-cost alternatives, such as generic medications or affordable pharmacy services like GeniusRx.   

3. Anticipate or Plan for Next Year:  

Having a baby? Planning to get a major surgery or need braces? Knowing these major life events in advance can help you pick plans that provide the best coverage for those types of services or procedures.   

4. Look for Mental Health Coverage:  

Taking care of your mind is just as important as your body. Understanding what plans offer mental health coverage can be helpful. Suppose you notice that the coverage options are not ideal. In that case, you can then plan for outside services to assist you and your family, such as telehealth therapy and medication services like Cerebral.   

5. Think of Convenience:  

For busy families, telehealth services and benefits in your plan could be beneficial for the year ahead. If your plan does not offer free virtual care, you can plan for affordable options when life is too busy to sit in a waiting room.

Make sure to keep your health a priority this Open Enrollment season.

The GeniusRx family is here to help you get and stay well 365 days a year.   If you are looking to get affordable prescriptions and Urgent Care telehealth visits to supplement your benefit plan, you’ve come to the right place.    

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