Renewing your health insurance plan can feel like a routine task, but simply keeping the same plan may not always be the best choice. Your healthcare needs, household situation, income, doctors, prescriptions, and even the plan's costs can change from year to year.
For Missouri families, taking time to review your coverage before renewal can help you avoid unexpected expenses and determine whether your current plan still fits your needs.
If you're evaluating health insurance options in Missouri, here are some important things to check before deciding whether to renew.
Review Your Monthly Premium
Start by looking at what you'll pay each month for your health insurance plan in the upcoming year.
Don't assume your premium will remain the same. If you have Marketplace coverage, HealthCare.gov recommends reviewing your renewal information and updating your application because income and household changes can affect the savings you qualify for.
However, don't evaluate a plan based on its premium alone. A lower monthly payment could come with higher deductibles, copayments, or other out-of-pocket costs.
Check Your Deductible and Out-of-Pocket Maximum
Your deductible is the amount you generally pay for covered services before your insurance begins paying according to the plan's terms.
Also check your annual out-of-pocket maximum. This is important because it can affect how much you could potentially spend on covered healthcare during the year.
When comparing health insurance plans in Missouri, consider the overall cost, not just the monthly premium.
Ask yourself:
- Has my deductible changed?
- Has my out-of-pocket maximum increased?
- Are my copays or coinsurance different?
- Would the plan still be affordable if I needed significant medical care?
Make Sure Your Doctors Are Still in the Network
Your preferred doctor or medical facility may not be part of every health plan's network.
Before renewing, check whether your:
- Primary care physician
- Specialists
- Preferred hospitals
- Clinics
- Other healthcare providers
are still included.
HealthCare.gov recommends checking provider directories when comparing Marketplace plans to determine whether your doctors and facilities are covered in-network.
This is particularly important if you or a family member regularly receives medical care.
Review Your Prescription Drug Coverage
If you take prescription medications regularly, don't overlook the plan's drug coverage.
Check whether your medications are still included on the plan's formulary and determine what you'll pay for them under the new plan.
A plan that looks affordable based on its premium could become more expensive if your prescriptions move to a different cost tier or are no longer covered.
Consider Changes in Your Healthcare Needs
Think about what changed during the past year.
Did you:
- Start seeing a specialist?
- Begin taking new medications?
- Plan a surgery or medical procedure?
- Add a child to your household?
- Experience a major health-related change?
Your healthcare needs should play an important role in determining whether your current plan remains appropriate.
A plan that worked well when you rarely visited the doctor may not be the best option if you now expect more frequent medical care.
Update Your Household and Income Information
If you have Marketplace coverage, don't overlook changes to your household or expected income.
HealthCare.gov states that Marketplace savings are based on your expected income and household information for the coverage year. Updating this information can help ensure you receive the appropriate amount of financial assistance.
Changes such as marriage, divorce, a new baby, a dependent leaving the household, or a significant change in income may affect your coverage options.
Don't Automatically Accept Your Renewal
Automatic renewal can help prevent a gap in coverage, but it doesn't necessarily mean your current plan is still your best option.
HealthCare.gov notes that Marketplace plans and prices can change each year, and consumers can compare available plans during Open Enrollment rather than simply accepting automatic re-enrollment.
For Marketplace coverage, Open Enrollment generally runs from November 1 through January 15 each year. Outside that period, changing plans generally requires a qualifying Special Enrollment Period.
Look at the Total Value of the Plan
When comparing plans, consider the complete picture:
Premium + deductible + copays + coinsurance + out-of-pocket maximum + prescription costs
A plan with a slightly higher monthly premium could potentially provide better overall value if you expect to use healthcare services frequently.
The right choice depends on your household's healthcare needs and financial priorities.
Get Help Reviewing Your Health Insurance Options
Health insurance can be difficult to evaluate when you're comparing premiums, networks, deductibles, prescription coverage, and other plan details.
At North Star Insurance Alliance, we believe you shouldn't have to make those decisions alone. Our team provides personalized guidance to help individuals and families understand their options and make informed coverage decisions.
Whether you're reviewing your current plan or exploring different health insurance options in Missouri, we can help you look beyond the monthly premium and consider the protection and value the plan provides.
Review Your Health Insurance Before You Renew
Your healthcare needs and insurance options can change from year to year. Taking time to review your plan before renewal can help you identify changes in costs, coverage, providers, and benefits before they become surprises.
Contact us today if you're unsure whether your current health insurance plan still fits your needs. You can also call us at (314) 579-3278 to schedule a personalized coverage review.
Our team is here to provide straightforward guidance and help you find your North Star in insurance.
Frequently Asked Questions (FAQs)
When should I review my health insurance before renewal?
Start reviewing your plan as soon as you receive your renewal information. For Marketplace coverage, Open Enrollment is generally November 1 through January 15.
Should I choose a health plan based only on the premium?
No. Consider the premium alongside deductibles, copays, coinsurance, provider networks, prescription coverage, and the out-of-pocket maximum.
Can I change my health insurance plan outside Open Enrollment?
Generally, you need to qualify for a Special Enrollment Period based on a qualifying life event. Medicaid and CHIP enrollment may be available year-round for eligible individuals.
What if my doctor is no longer in my health plan's network?
You may want to compare other available plans during the applicable enrollment period or discuss your options with your insurance advisor. .
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