Latest / Silver FM 100.6 / It's open enrollment season. Here's how to make the best decision for you

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It's open enrollment season. Here's how to make the best decision for you · Silver FM 100.6

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  Speaker 2: You're listening to Life Kit from NPR. Hey everybody, it's Marielle.
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  Speaker 2: It is open enrollment season. That time every year when
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  Speaker 2: many of us have an opportunity to enroll in a
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  Speaker 2: new health care plan, whether that's through an employer or
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  Speaker 2: on your state's health care exchange. Now, I think a
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  Speaker 2: lot of us put this off until the very last
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  Speaker 2: minute because it's so complicated. There are all these terms
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  Speaker 2: that you may or may not understand. Every health insurance
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  Speaker 2: plan has its own wrinkles and caveats, and it's hard
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  Speaker 2: to know exactly how much you'll end up spending. You know,
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  Speaker 2: there's just a lot going on.
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  Speaker 3: So we hopscotch.
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  Speaker 4: So we double dutch. We jump around and we stay
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  Speaker 4: informed and we... look at our personal situation, we look
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  Speaker 4: at our options, and we figure out what the best
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  Speaker 4: choices are to the best.
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  Speaker 5: Of our knowledge.
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  Speaker 2: That's Cindy George, the Senior Personal Finance Editor at GoodRx.
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  Speaker 2: So on this episode of Life Kit, we'll do our
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  Speaker 2: best to help. We'll give you some definitions, explain the
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  Speaker 2: different types of health care plans, you know, HMO, PPO,
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  Speaker 2: that sort of thing. We'll talk about tax savings, and
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  Speaker 2: then we will help you put it all together and
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  Speaker 2: do the math to compare your options.
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  Speaker 8: This week on Wait, Wait, Don't Tell Me, we talk
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  Speaker 8: with our panel, Josh Gobelman, Dulce Sloan, and Faith Saley,
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  Speaker 8: about the journalists who were banned this week from the
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  Speaker 8: Yeah.
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  Speaker 3: Austin Tice is an American journalist who disappeared over a
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  Speaker 3: decade ago. while reporting in Syria. And for years, we've
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  Speaker 2: OK, here we go. First up, some definitions. There are
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  Speaker 2: terms you'll see as you're looking at health insurance plans.
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  Speaker 2: One is premiums.
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  Speaker 4: Your premium is what you pay every month as the
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  Speaker 4: cost of having a health plan. So your health insurance
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  Speaker 4: costs you something every month, just like your car insurance
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  Speaker 4: or other kinds of insurance. There's a monthly payment. That
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  Speaker 4: would be your premium.
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  Speaker 2: If you have an employer, your premiums will get taken
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  Speaker 2: out of your paycheck. Now keep in mind, the plan
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  Speaker 2: with the cheapest premiums won't necessarily be the cheapest over
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  Speaker 2: the course of a year. Premiums are just the upfront cost,
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  Speaker 2: but other costs will get added on as you go
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  Speaker 2: to doctors and need services. Another word you'll see is copay.
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  Speaker 2: That's a set dollar amount you pay every time you
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  Speaker 2: see a specialist, for instance, or get an x-ray. Another term, deductible.
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  Speaker 2: That's how much you pay out of pocket before your
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  Speaker 2: health plan starts reimbursing you or paying your doctors directly
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  Speaker 2: for your care. Under some plans, there are services that
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  Speaker 2: aren't subject to the deductible. So your insurance starts paying
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  Speaker 2: for those right away. And the amount of the deductible
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  Speaker 2: will depend on your plan. But.
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  Speaker 4: Kaiser Family Foundation did a study... and found that for
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  Speaker 4: individuals in employer-based health plans, about a third of individuals
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  Speaker 4: have a deductible that's $ 2, 000 or more.
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  Speaker 2: Now, a deductible is different from an out-of-pocket maximum.
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  Speaker 4: The deductible is the beginning. The out-of-pocket maximum is the end.
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  Speaker 4: So a deductible is everything you pay up front before
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  Speaker 4: cost sharing begins. An out-of-pocket maximum is where you reach
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  Speaker 4: the end of the tunnel... And then your health plan
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  Speaker 4: takes over.
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  Speaker 2: That is until the next plan year, usually in January.
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  Speaker 2: One other definition we want to go over is coinsurance.
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  Speaker 2: Sometimes under your health insurance plan, you don't pay a
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  Speaker 2: copay for, let's say, a specialist visit. Instead, you pay
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  Speaker 2: a percentage of the bill and the insurer pays the rest.
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  Speaker 2: That's the case with Medicare.
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  Speaker 4: Traditional Medicare is typically Medicare pays 80 percent. The insured
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  Speaker 4: Medicare enrollee pays 20 percent of a covered service. after
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  Speaker 4: you meet your deductible. So we're always talking about a
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  Speaker 4: percentage when we talk about coinsurance.
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  Speaker 2: And this is why open enrollment can be so maddening
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  Speaker 2: because it just feels like we shouldn't have to do
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  Speaker 2: this to estimate so specifically what our healthcare is going
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  Speaker 2: to be and also make these guesses like, okay, so
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  Speaker 2: my coinsurance is 10%, but what's the actual bill going
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  Speaker 2: to be for this thing? I just want to acknowledge
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  Speaker 2: that here. It's not a good system, but here we are.
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  Speaker 2: All right, next up, Cindy and I talk about the
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  Speaker 2: different categories of health insurance plans you might be offered.
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  Speaker 2: What are some different health plan types? They're often acronyms
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  Speaker 2: like HMO or PPO or HDHP.
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  Speaker 4: Yes, it's all so confusing, isn't it? It's alphabet soup.
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  Speaker 2: Yeah. Well, let's start with the HMO. What is that?
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  Speaker 4: So an HMO is a health maintenance organization. And a
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  Speaker 4: health maintenance organization is a tight network or a narrow
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  Speaker 4: network of providers, which means that you'll have to stay
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  Speaker 4: in network for your care to be covered by your plan.
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  Speaker 4: An HMO typically requires you to refer all your care
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  Speaker 4: through a PCP or primary care provider. An HMO is
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  Speaker 4: going to have lower monthly premiums. which means what you
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  Speaker 4: pay every month is lower than maybe other plans. And
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  Speaker 4: HMO is less likely to have a deductible. That means
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  Speaker 4: that your insurance plan begins cost-sharing when you access care,
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  Speaker 4: and you don't have to fully pay for a certain
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  Speaker 4: amount of care before your insurance begins cost-sharing.
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  Speaker 2: Okay, and then what's a PPO?
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  Speaker 4: So a PPO is a Preferred Provider Organization. which means
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  Speaker 4: that unlike an HMO, you aren't restricted to your coverage
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  Speaker 4: or even to a specific service area. So you typically
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  Speaker 4: have greater flexibility and choice about your providers. You also
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  Speaker 4: don't need a primary care provider or PCP to refer
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  Speaker 4: you to specialists. The PPOs also typically have higher premiums,
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  Speaker 4: and they're more likely to have a deductible.
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  Speaker 2: Okay. The acronym HDHP, it stands for High Deductible Health Plan.
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  Speaker 2: What is that?
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  Speaker 4: So a high deductible health plan is health insurance that
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  Speaker 4: begins with how much you pay out of pocket before
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  Speaker 4: any cost sharing. So that means all of the care
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  Speaker 4: that you access before you meet your deductible, you pay for. Now,
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  Speaker 4: with all the plans that we're discussing, the caveat on
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  Speaker 4: all of these things is will be preventive care. Your mammogram,
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  Speaker 4: your well woman exam, your well baby exam, that's considered
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  Speaker 4: preventive care. And thanks to the Affordable Care Act, if
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  Speaker 4: you have a qualified health plan, you are able to
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  Speaker 4: access that preventive care without meeting a deductible, without paying
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  Speaker 4: your copay, or without coinsurance. Which means it brings you
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  Speaker 4: value in having paid those premiums and having a health
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  Speaker 4: plan Because there are services that you are able to
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  Speaker 4: access with no out-of-pocket costs.
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  Speaker 2: And then with a high deductible health plan, so you pay,
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  Speaker 2: you have to meet this deductible first before most things
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  Speaker 2: will be covered. And then what happens after that, after
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  Speaker 2: you hit the deductible?
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  Speaker 4: So your plan begins cost sharing. So after you meet
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  Speaker 4: your deductible, you'll begin to access more care. You'll have
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  Speaker 4: co-pays and co-insurance. But there is a limit to how
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  Speaker 4: much you pay out of pocket. When you reach those
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  Speaker 4: limits for either an individual or family, your plan picks
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  Speaker 4: up 100% of your cost through the end of the
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  Speaker 4: calendar year.
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  Speaker 3: Okay.
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  Speaker 2: And then with a high deductible health plan, the premiums
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  Speaker 2: are much lower than other plans, right?
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  Speaker 4: Typically. That's the advantage of them is that it gives
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  Speaker 4: you the peace of mind of having a health insurance plan.
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  Speaker 4: But if you need to use it, you need to
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  Speaker 4: understand that you'll be responsible for a minimum amount before
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  Speaker 4: you get relief from cost sharing.
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  Speaker 2: So a high deductible health plan can be useful for
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  Speaker 2: people in multiple different kinds of situations, I think. But
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  Speaker 2: one of them is if you don't think you'll really
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  Speaker 2: use your health insurance much and you just want to
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  Speaker 2: pay the bare minimum, but you want to have coverage
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  Speaker 2: just in case of anything.
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  Speaker 4: Absolutely.
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  Speaker 2: Okay, now the other thing. you'll want to consider as
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  Speaker 2: you're choosing a health insurance plan are the tax benefits.
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  Speaker 2: You can get a tax break for some of the
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  Speaker 2: money you spend on health care, but the way you
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  Speaker 2: do that and how much of a tax break you
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  Speaker 2: get is going to depend on the type of health
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  Speaker 2: insurance plan you have. It's time for a couple more acronyms.
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  Speaker 2: Stick with me here. HSA and FSA. Both are a
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  Speaker 2: type of tax savings account.
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  Speaker 10: So you can contribute money into this account throughout the year,
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  Speaker 10: use it for eligible expenses, and the money that you
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  Speaker 10: contribute to this account helps to reduce your taxable income.
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  Speaker 2: That's Akiva Ellis, co-founder and financial coach at The Bemused
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  Speaker 2: and a certified financial planner.
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  Speaker 10: So let's say, for example, that you have a salary
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  Speaker 10: or compensation of $ 50, 000 for the year, and you decide
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  Speaker 10: that you're going to put $ 1, 000 into your FSA for
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  Speaker 10: the year. The amount of income that's actually going to
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  Speaker 10: be reported for tax purposes will be $ 49, 000. It goes
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  Speaker 10: to reduce the amount of income that is subject to taxation.
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  Speaker 2: You can use HSAs and FSAs to pay for doctor's
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  Speaker 2: visits and prescription drugs, sometimes over-the-counter drugs and other medical services.
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  Speaker 2: You generally can't use them to pay for premiums, though,
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  Speaker 2: with some exceptions for HSAs.
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  Speaker 10: There's a whole list of eligible expenses that you can
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  Speaker 10: access online. from the IRS just to make sure that
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  Speaker 10: you are following all of the rules.
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  Speaker 2: But HSAs and FSAs are different in a few notable ways.
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  Speaker 2: Let's start with an HSA, a health savings account. You
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  Speaker 2: are only eligible for one of these if you sign
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  Speaker 2: up for what the IRS considers a high deductible health plan.
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  Speaker 2: We talked about those earlier. In 2026, individuals can contribute
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  Speaker 2: up to $ 4, 400 to an HSA. In 2027, That'll bump
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  Speaker 2: up to $ 4, 500. And the money will not be taxed.
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  Speaker 2: It either comes straight out of your paycheck before taxes,
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  Speaker 2: or you can put it into your account and get
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  Speaker 2: a tax deduction in April. Now, your HSA account belongs
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  Speaker 2: to you.
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  Speaker 10: If you leave the company, if anything changes, you have
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  Speaker 10: that money.
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  Speaker 2: It is yours to keep. And the money in it
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  Speaker 2: rolls over every year. Another thing that's nice about HSAs,
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  Speaker 2: once you hit a certain threshold, you can start investing
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  Speaker 2: your money. And actually, some people use these accounts as
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  Speaker 2: another form of retirement savings because the money isn't taxed
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  Speaker 2: going in or coming out. Also, if you do choose
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  Speaker 2: a high-deductible health plan, your employer might put money into
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  Speaker 2: your HSA for you as an incentive. Because when you're
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  Speaker 2: on a high-deductible plan, that can save your company money too.
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  Speaker 2: After the break, we talk about another tax-saving plan, the FSA.
• 12:35
  Speaker 5: Before Bernie Sanders or AOC. a man named Michael Harrington
• 12:39
  Speaker 5: tried to market socialism to the American public.
• 12:43
  Speaker 6: Tens of millions of Americans are poor, miserable, in body.
• 12:47
  Speaker 7: And in spirit.
• 12:48
  Speaker 5: On NPR's ThruLine, how the founder of the DSA created
• 12:52
  Speaker 5: a modern political movement. Listen to ThruLine in the NPR
• 12:56
  Speaker 5: app or wherever you get your podcasts.
• 12:59
  Speaker 11: This fall, there are a lot of movies and TV
• 13:02
  Speaker 11: shows on tap for you to see. And we're as
• 13:04
  Speaker 11: excited for all of it to arrive as you are.
• 13:07
  Speaker 11: On Pop Culture Happy Hour, we've got a guide to
• 13:09
  Speaker 11: what's worth keeping on your radar. Listen via the NPR
• 13:13
  Speaker 11: app or wherever you.
• 13:14
  Speaker 2: Get your podcasts. The other kind of tax saving plan
• 13:19
  Speaker 2: we're going to talk about is an FSA, a flexible
• 13:22
  Speaker 2: spending account. You can't contribute quite as much money to
• 13:25
  Speaker 2: an FSA. As of the recording of this episode, the
• 13:28
  Speaker 2: IRS has not released the limit for 2027, but the
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  Speaker 2: limit for this year is $ 3, 400. And unlike with an HSA,
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  Speaker 2: this is kind of a use it or lose it situation.
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  Speaker 10: So with an FSA, you have to use the money
• 13:39
  Speaker 10: you put in in that same plan year. Now, your
• 13:43
  Speaker 10: employer may offer you a grace period of up to
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  Speaker 10: two and a half extra months to use the money
• 13:48
  Speaker 10: in your FSA, you know, going past the end of
• 13:51
  Speaker 10: the year, December 31st. So if you see that your
• 13:54
  Speaker 10: employer doesn't give you that option. They are not doing
• 13:57
  Speaker 10: anything mean or anything that is not above board. They
• 13:59
  Speaker 10: do not have to offer these options to you.
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  Speaker 2: Also, your employer owns your FSA account. So if you
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  Speaker 2: leave your job, you forfeit any leftover money that you
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  Speaker 2: put into it. With an FSA, you typically have to
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  Speaker 2: decide during open enrollment how much you're going to put
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  Speaker 2: into it for the full year. That's not true of HSAs.
• 14:17
  Speaker 2: And that requires you to do some guesswork and some math.
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  Speaker 10: So you want to take a look at what your
• 14:23
  Speaker 10: anticipated health care expenses might be for the upcoming year, right?
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  Speaker 10: You want to say, okay, how much is my deductible
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  Speaker 10: for my health insurance plan? Because I can use the
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  Speaker 10: money in my FSA to help go toward my deductible, right?
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  Speaker 10: Those out-of-pocket expenses that I'll have to have before my
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  Speaker 10: health insurance really starts to provide coverage.
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  Speaker 2: If you think, though, that you won't use medical services
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  Speaker 2: much at all, the most you should put in there
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  Speaker 2: is whatever amount rolls over.
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  Speaker 10: Because it is use it or lose it, you don't
• 14:53
  Speaker 10: want to overfund it. So you want to be conservative
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  Speaker 10: while also making sure you're taking into account all of
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  Speaker 10: the expenses that you might foresee in the future.
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  Speaker 2: Okay, we've learned a lot. We've gone through a lot
• 15:03
  Speaker 2: of definitions. It's time to put it all together. Let's
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  Speaker 2: do the math. Now, say you work for a company.
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  Speaker 2: You get that email with the benefits guide, the packet
• 15:13
  Speaker 2: or PDF that lays out all the different health plans.
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  Speaker 2: You're going to take out a piece of paper or
• 15:18
  Speaker 2: open up a spreadsheet and make a column for each
• 15:21
  Speaker 2: health care plan you're considering. Next, you're going to put
• 15:24
  Speaker 2: the cost of each plan's premiums in the columns. So again,
• 15:28
  Speaker 2: just using a round number, if the premiums were $ 10
• 15:31
  Speaker 2: per paycheck and you have 26 paychecks a year, that'd
• 15:35
  Speaker 2: be $ 260 for the whole year. Next, you're going to
• 15:39
  Speaker 2: try to estimate what else you might spend on health
• 15:41
  Speaker 2: care services under each plan. On a separate sheet of
• 15:44
  Speaker 2: paper or in a Word document, Start making a list
• 15:48
  Speaker 2: of what medical procedures or visits you expect to have
• 15:51
  Speaker 2: next year. You know, do you see a therapist every week?
• 15:54
  Speaker 2: Write that down. Do you go to the dermatologist twice
• 15:57
  Speaker 2: a year? That's two specialist visits. Do you take medication?
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  Speaker 2: Write that down too. Ask yourself questions like.
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  Speaker 4: Do I anticipate needing a surgery? Do I anticipate having
• 16:07
  Speaker 4: a baby? Or my partner having a baby?
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  Speaker 2: If you log into the online portal for your current
• 16:13
  Speaker 2: health insurance plan and click on Claims, you can see
• 16:16
  Speaker 2: what services you use this year, and that might help
• 16:18
  Speaker 2: as you're making this list. After you've compiled the list,
• 16:22
  Speaker 2: you're going to calculate what those services would cost under
• 16:26
  Speaker 2: each plan you're considering, and you'll want to take into
• 16:29
  Speaker 2: account any deductibles, co-pays, and co-insurance, and whether the providers
• 16:34
  Speaker 2: are in-network or out-of-network. Then you're going to subtract any
• 16:38
  Speaker 2: tax savings from an HSA or an FSA. To estimate
• 16:41
  Speaker 2: your tax savings, Akiva says take a look back at
• 16:44
  Speaker 2: your last tax return.
• 16:46
  Speaker 10: Look to see how much you actually ended up paying
• 16:48
  Speaker 10: in taxes and do the math, right? What percentage was
• 16:52
  Speaker 10: that of my income for the year? And that will
• 16:55
  Speaker 10: help you get a general gauge as to how much
• 16:57
  Speaker 10: you might save going forward.
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  Speaker 2: So let's say that after all your tax deductions, you
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  Speaker 2: were paying taxes on $ 50, 000 of income and your tax
• 17:05
  Speaker 2: bill was just a hypothetical round number here, $ 10, 000. That
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  Speaker 2: means you paid about 20% in taxes. And that's the
• 17:13
  Speaker 2: percentage you can expect to save on any money you
• 17:15
  Speaker 2: put into an FSA or an HSA this year. Keep
• 17:19
  Speaker 2: in mind, if you just got a huge raise or
• 17:20
  Speaker 2: you lost your job, your tax rate may change. Next,
• 17:24
  Speaker 2: if you have a high deductible plan, subtract from the
• 17:27
  Speaker 2: cost any money your company is putting into your HSA account.
• 17:32
  Speaker 2: Then compare the total cost for each plan. But before
• 17:36
  Speaker 2: you make a final decision, think about other factors besides cost.
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  Speaker 2: Like if you have an HMO. You might need to
• 17:42
  Speaker 2: get a referral every time you see a specialist. Maybe
• 17:45
  Speaker 2: the hassle isn't worth it to you. Or with a
• 17:47
  Speaker 2: high deductible health plan, you might be responsible for paying
• 17:50
  Speaker 2: a bunch of medical bills in full until you hit
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  Speaker 2: your deductible. And you may not like the way that
• 17:54
  Speaker 2: feels or the extra paperwork it adds. And just remember,
• 17:58
  Speaker 2: if you get confused, that's because this stuff is way
• 18:01
  Speaker 2: more complicated than it should be. And that's our show.
• 18:08
  Speaker 2: If you liked this, do us a quick favor. make
• 18:11
  Speaker 2: sure to tap the follow button so you never miss
• 18:13
  Speaker 2: an episode. This episode of Life Kit was produced by
• 18:17
  Speaker 2: Claire Marie Schneider. Our digital editor is Malika Garib, and
• 18:20
  Speaker 2: our visuals editor is CJ Rikalan. Megan Cain is our
• 18:23
  Speaker 2: senior supervising editor, and Lauren Gonzalez is our executive producer.
• 18:27
  Speaker 2: Our production team also includes Andy Tegel, Margaret Serino, and
• 18:31
  Speaker 2: Sylvie Douglas. Engineering support comes from Patrick Murray and Phil Edfors.
• 18:36
  Speaker 2: Fact-checking help from Candice Kortkamp. I'm Marielle Segarra. Thanks for listening.
• 18:46
  Speaker 12: Opera singer Gabriella DiLaccio always loved Mozart, Beethoven, Vivaldi. But
• 18:52
  Speaker 12: then she discovered she didn't know the works of thousands
• 18:55
  Speaker 12: of female composers.
• 18:57
  Speaker 1: It's not about taking people off the list.
• 19:00
  Speaker 3: It's putting more people on the list.
• 19:01
  Speaker 12: Tracking down the women missing from music. That's on the
• 19:05
  Speaker 12: TED Radio Hour podcast. Listen on the NPR app or
• 19:08
  Speaker 12: wherever you get your podcasts.
• 19:11
  Speaker 13: This election season, let the NPR Politics podcast save your
• 19:14
  Speaker 13: time and your sanity. We'll help you understand key races,
• 19:17
  Speaker 13: which polls you can safely ignore, and what might happen
• 19:21
  Speaker 13: if power shifts in Congress. Our short daily episodes come
• 19:24
  Speaker 13: out every afternoon, so you can spend less time scrolling
• 19:27
  Speaker 13: through each chaotic news cycle. Make NPR Politics your hub
• 19:30
  Speaker 13: for midterm election coverage. Follow our podcast on the NPR
• 19:33
  Speaker 13: app or wherever you get your podcasts.
• 19:35
  Speaker 9: This is Tanya Mosley, co-host of Fresh Air. I spoke
• 19:38
  Speaker 9: with Palestinian activist Mahmoud Khalil about the Columbia protests and
• 19:42
  Speaker 9: his 2025 arrest. While in ICE detention, he missed the
• 19:46
  Speaker 9: birth of his son and had to listen to his
• 19:48
  Speaker 9: wife give birth over the phone.
• 19:50
  Speaker 3: I can never forgive those who stripped that moment from me.
• 19:56
  Speaker 9: Listen on the NPR app or wherever you get fresh air.