Health Insurance Blog and Resources

Medicare is how many U.S. citizens over 65 receive health insurance. Because Medicare works differently from employer-sponsored insurance and private insurance, it can take some time to orient yourself. Medicare offers hospital insurance, medical care insurance, and prescription drug insurance in three plans. For additional coverage or assistance paying for Medicare copayments and deductibles, people can purchase Medicare supplement insurance. This supplemental insurance is often referred to as Medigap. Before enrolling in a Medigap plan, you should understand the cost and benefits of these plans. Here are five essential questions to ask about Medigap: What is Medigap? What does Medigap cover? What is the best Medigap plan? How much do Medigap plans cost? When should I enroll in Medigap? What is Medigap? Medigap offers additional cost-sharing for out-of-pocket expenses incurred by Original Medicare (Parts A, B, and D). This additional cost-sharing is helpful because Original Medicare cost-sharing places a larger burden on policyholders than other private health plans. “What many people don’t realize before enrolling in Medicare is that Medicare is not free and Original Medicare only covers 80 percent of medical expenses – leaving you responsible for the remaining 20 percent of expenses. This form of supplemental coverage is additional insurance to help alleviate the financial burden of covering remaining costs that Medicare won’t cover. For example, Medigap plans are extremely beneficial when it comes to covering costs of chemotherapy and dialysis,” says Danielle K. Roberts, Medicare Supplement Accredited Adviser and Boomer Benefits Cofounder. The additional cost-sharing assistance is also beneficial when people need extensive medical care. “Medigap insurance covers medical expenses Medicare doesn’t cover such as co-pays and deductibles, as well as foreign travel emergencies. The main thing is a major healthcare hospitalization, illness, or injury where the costs are so high that even if Medicare is covering a majority of the costs, the fees are overwhelming. These are “gaps” in Medicare coverage. Admittance into long-term facilities such as nursing homes or hospice can be very large costs,” says Ted Chan of CareDash.com. The health coverage offered by some Medigap plans also include coverage for health services in foreign countries and is great for people who plan on traveling or living abroad during retirement. Do you need Medigap if you have Medicare Advantage? For people with Medicare Advantage plans, Medigap is not available. Medicare Advantage plans work like employer group plans, so they vary company to company and can offer more comprehensive coverage. Expert insight Troy Baccus, Medicare Life Group Owner“The first decision with regard to Medigap is deciding between a Medigap plan and a Medicare Advantage plan. A Medicare Advantage plan will be similar to most employer plans, meaning it'll be an HMO or PPO with co-pays and deductibles. A Medigap plan, on the other hand, has no networks and will work at any hospital that accepts Medicare. For those who decide to go the Medigap route, we recommend choosing a Medigap plan after becoming familiar with the deductibles within each of the plans.” Kumar B. Goel, Lighted Road Insurance President and CEO“Traditional Medicare does not cover everything. For example, it does not cover outpatient prescription drugs or provide dental, vision or hearing benefits (exceptions apply). Medigap Plans do not cover these benefits either. If you are looking for a plan with additional benefits like these, Medicare Advantage may be a better choice for you instead of Medigap.” Back to Question List What does Medigap cover? Medigap currently has 10 plan options: Plan A, Plan B, Plan C, Plan D, Plan F, Plan G, Plan K, Plan L, Plan M, and Plan N. The plans are mostly consistent nationwide. “Except for Massachusetts, Minnesota, or Wisconsin which have their own versions or variations of the plans, the plans offered are the same across states. Whatever the state, you should review carefully to see what suits your needs,” says Chan. All Medigap plans cover the following: Coinsurance and hospital costs (Medicare Part A) up to 365 days once Medicare benefits are used up Coinsurance or copayment (Medicare Part B) First 3 pints of blood Hospice care coinsurance or copayment (Medicare Part A) These benefits are covered fully by Plans A, B, C, D, F, G, and M. Plan K offers 50 percent coverage for Part B coinsurance or copayment, first three pints of blood, and Part A hospice care coinsurance or copayment. Plan L offers 75 percent coverage for those same three benefits. Plan N offers full coverage for all benefits with the exception of copays up to $20 for some office visits and $50 copay for emergency room visits when you’re not admitted to the hospital. All Medigap plans except Plan A offer coverage for the Part A deductible. Plans K and M cover Part A’s deductible at 50 percent. Plan L offers 75 percent coverage for this benefit. The other plans (B, C, D, F, N) cover Part A’s deductible fully. Only Medigap Plans C, D, F, G, M, and N offer coverage for health care during foreign travel. Only Plans C and F offer coverage for Medicare Part B deductible. Since new Medicare enrollees are not able to receive this coverage, Plans C and F are not available to new enrollees. Plans C and F offer full coverage for the Part B deductible. Only Plans F and G offer full coverage for Part B excess charges. An excess charge occurs in cases when a medical provider is allowed to charge more than the Medicare-approved amount. “Some states have rules that override Medicare to the benefit of the consumer. For example, Pennsylvania, Connecticut, Massachusetts, Minnesota, New York, Ohio, Rhode Island and Vermont forbid or restrict Medicare Part B Excess Charges,” says Matthew Claassen, CMT, CEO and Independent Broker of MedigapSeminars.org. Keep your state’s Medicare rules in mind as you choose a Medigap plan. Plans K and L have annual deductibles. None of the other plans have deductibles. People interested in Plan F can choose a Plan F High Deductible Plan option (HDHP) option. Medicare enrollees who choose this option will have an annual deductible. Plan F and C are not available to people enrolling in Medicare for the first time after 2019. See Medicare.gov for further information. Back to Question List What is the best Medigap Plan? The best Medigap plan depends on your circumstances and the kind of coverage you need. Working with a licensed life insurance agent can help you consider all the factors necessary to make an informed decision. Expert tips Danielle K. Roberts, Medicare Supplement Accredited Advisor and Boomer Benefits Cofounder“When deciding which Medigap plan is best for you (A, B, C, D, F, G, K, L, M, or N) you should keep in mind the premium, how often you’ll use your plan, and what kind of coverage you want in case you get diagnosed with a severe illness. Plan F, G, and N are the most popular. When you decide on which plan you want, the only thing you need to look for now is the best premium and average rate increases from each carrier in your area. Since a Medigap plan’s coverage doesn’t change from carrier to carrier, you should just worry about finding the lowest premium with the best average rate increases.” Andrew Vasta, NJ Medicare Brokers LLC Owner“When choosing which Medigap plan, people should consider on average how many times they go to the doctors and the difference in the premium between the plans. Many people choose between Plan G and Plan N. Plan G has no out of pocket costs after the deductible while Plan N has a lower monthly fee but $20 copayment every visit to the doctor.” Matthew Claassen, CMT, CEO and Independent Broker of MedigapSeminars.org“Because a person can apply for a Medicare supplement plan up to six months before it starts coverage, most seniors will start to receive an abundance of cold calls and mailers starting about 7-months before the month they turn 65. This can be overwhelming. Some people turn off their phones or get spam blockers. This is a major issue to people turning 65. Most of these cold callers are from call centers that don’t even employ full time permanent agents. They just cold call and sell. This is not where you are going to get your best advice or even accurate advice. Buyer beware.” Troy Baccus, Medicare Life Group Owner“Make sure to work with an experienced agent who is seasoned in the Medicare insurance industry. A good agent will have complete knowledge about enrollment windows, be able to provide accurate quotes, and ultimately provide a smooth on-boarding process while enrolling in Medigap.” Back to Question List How much do Medigap Plans cost? Several expenses factor into a health plan’s cost: monthly premiums and copays or coinsurance, depending on the policy’s terms. It’s important to consider all of these factors when considering the cost of a Medigap plan. Premium cost Medigap premiums are priced one of three ways: Same rate for everyone, regardless of age Rate based on age when enrolled in plan and remains consistent Rate based on age, but increases with age It’s a good idea to ask how the insurance companies you’re considering determine their rates. It can help you compare premiums for plans across companies. Expert insight Ted Chan, CareDash.com“Typical costs are $200 to $600 depending on the tier of plan. Since the plans are standard (the only difference is cost), it is recommended you shop around, with a focus on reliable providers who you are confident will cleanly service your plan. Reputable insurers offer the plans, and you should recognize the plan being sold (e.g. Aetna, Blue Cross). Don't let a broker push a plan on you.” Andrew Vasta, NJ Medicare Brokers LLC“Medigap policies are standardized so a Plan N with one company is the same exact coverage as a Plan N with another company; however, the monthly premium can be drastically different. Any time someone gets a rate increased they should shop the market to see if they can lower their costs.” Travis Price, Licensed Medicare Supplement Agent ifixmedicare.com“Another great Medigap tip would be to talk to an Independent Medigap Agent. The truth is, insurance companies move in and out of the Medigap market constantly. Furthermore, some companies do not sell direct to consumer and are much less expensive than companies like AARP (United Healthcare) and Blue Cross Blue Shield.” Total cost The total cost of a health plan includes the amount you spend on copayments and coinsurance. These cost-sharing expenses can be harder to estimate and can come up suddenly. Know the total cost of your Medicare Part A and Part B plans, and compare those costs with the Medigap plan’s premium rates. Expert insight Kumar B. Goel, Lighted Road Insurance President and CEO“Medigap Plans typically have higher premiums with minimal cost-sharing compared to Medicare Advantage Plans. This is to be expected since they help pay for Medicare cost-sharing. If you are bothered by deductibles, copays, and coinsurance and would rather pay a consolidated monthly premium, Medigap may be for you. But do the math before deciding.” Back to Question List When should I enroll in Medigap? For guaranteed acceptance, it’s best to enroll at the same time you enroll in Medicare Part B. While there are other circumstances that permit guaranteed issue outside of the window when you enroll in Medicare Part B, it can be a good idea to enroll during your Medigap first open enrollment period. If you delay enrolling, you’ll have to go through an approval process for underwriting. Underwriting is the process insurance companies use to determine the risk of insuring the applicant. It often involves a health questionnaire and can involve a medical exam. In some cases, coverage may be denied because of health circumstances. If you opt for a Medicare Advantage plan instead of Original Medicare, you’ll still be eligible for a guaranteed-issue Medigap open enrollment period. “There are a few other situations where guaranteed issue is applicable. One is if you are on Medicaid Advantage and move, or the Advantage plan stops offering services,” says Chan. There are some exceptions that allow guaranteed acceptance outside of the open enrollment period. “Some states like Connecticut and New York have perpetual Open Enrollment periods. A person can enroll in a Medicare supplement or switch supplements at any time without ever being asked a medical question. Other states have rules that provide an Annual Special Enrollment to switch Medicare supplement plans without underwriting,” says Claassen. Learn more about Medigap guaranteed issue rights. Expert tips Adam Hyers, Hyers and Associates, Inc“For most consumers, the time to get a Medigap (Medicare Supplement) policy is when they first enroll in Medicare Part B. That can happen at age 65, but many people defer their Medicare Part B enrollment because they have qualifying group insurance at work (more than 20 people.) Still, others enroll in Part B before age 65 due to disability. These folks especially want to explore their Medigap options at that time as it may be difficult to get a plan later.” Danielle K. Roberts, Medicare Supplement Accredited Advisor and Boomer Benefits Cofounder“The best time to enroll in a Medigap plan is during your one-time Medigap open enrollment period. This period begins the day your Part B is effective and ends 6 months later. This is considered the best time to enroll in Medigap plans because during this time you don’t have to answer any health questions and therefore, don’t have to worry about getting turned down for coverage. If you miss this time, you will likely have to answer health questions, and can be denied coverage due to preexisting conditions.” Ted Chan, CareDash.com“As a patient advocate, I recommend it enrolling during the Medigap open enrollment period for anyone who has the means and could be overwhelmed by a large, unexpected medical bill. Otherwise, you should reconsider your circumstances and whether Medigap makes sense every open enrollment period. However, getting it right away protects you against developing a pre-existing condition and being denied coverage.” Back to Question List In sum Understanding your Medigap coverage options and your current health situation will help you find a plan that meets your coverage needs. It's also important to keep possible future health concerns in mind as you pick your plan. Keep your financial situation in mind as you evaluate premium costs and the overall costs of a Medigap plan each year. This will help you make smart budget decisions about choosing Medigap coverage. Working with an independent Medicare agent can help you evaluate your options and understand the enrollment rules for Medigap and Medicare. Understanding these rules will help you make informed decisions about Medigap enrollment.

Updated January, 2020. In general, people can only enroll in a health insurance plan during Open Enrollment. Medicare also has its own Annual Enrollment Period and its Initial Enrollment Period varies depending on your birth date. However there are some exceptions, including Medicaid, CHIP, and qualifying for a Special Enrollment Period (SEP). If you qualify for a Special Enrollment Period, you have a certain amount of time to make changes to your health insurance plan or enroll in a new one to ensure that you maintain the health insurance coverage you need. Here are some of the most common questions regarding Special Enrollment Periods (SEPs): What is a Special Enrollment Period? What qualifies as a Special Enrollment Period? What are my health insurance options? How do I apply for a Special Enrollment Period? What is a Special Enrollment Period for Medicare? What is a Special Enrollment Period? Special Enrollment Periods (SEPs) let you make adjustments to your health insurance coverage or enroll in a new plan outside of Open Enrollment under certain circumstances. These circumstances are referred to as a Qualifying Life Event. Having missed Open Enrollment does not make you eligible to apply for a Special Enrollment Period. Special Enrollment Periods typically last 30-60 days, which allows plenty of time for you to look at your health coverage options and make the necessary insurance coverage adjustments. “Don't forget about deadlines, and keep in mind that they're different for employer-sponsored plans versus individual market plans. For employer-sponsored plans, you'll generally have 30 days, whereas in the individual market, you'll have 60 days (some qualifying events trigger a special enrollment period both before and after the event, whereas others are only after it),” says Louise Norris, licensed agent and author of Insider’s Guide to Obamacare’s Special Enrollment. Whether you receive health insurance from your employer or purchase your own separately, you may qualify for a Special Enrollment Period as your life changes. If you purchase health insurance independently, you can work with an insurance agent or use online tools that make it easy to explore all your options before you make a change. “Never buy from an agent who only has one product. You need someone who can shop around effectively and give you options. Never call the health insurance marketplace on your own without guidance from an agent. The customer service reps are not agents, and you may not understand the rules and regulations they have,” Maria Townsend, Insurance Advisor, says. HealthCare.gov shows all of the group health insurance plans created by the Affordable Care Act. After you complete a questionnaire, it will include any subsidies you qualify for in the listed premium quotes. If you don’t want to buy a Marketplace plan, you can view covered benefits and costs (monthly premiums, deductibles, out-of-pocket expenses, etc.) offered by multiple companies by looking at a comparison website. A few health insurance comparison websites are HealthMarkets, HealthCare.com, and GoHealth.It’s a good idea to be careful when shopping online. Some websites are designed to generate leads for health insurance providers and sell customer information to multiple insurance companies, instead of just connecting the customer to the company and plan they requested. If you can’t see price estimates and plan details before providing contact information, it may not be the best resource.Townsend says, “I would stay away from the insurance sites that sell off your info for a price comparison, and later get 100 calls from different reps. Those sites never check your medications or doctor network to even know if it's a plan that meets your needs personally. I recommend sites like FreeInsuranceGuru.com, where you can chat, call, or even video chat with an agent licensed in your area and your information isn't sold.” Back to Menu What qualifies as a Special Enrollment Period? A Special Enrollment Period occurs when you experience a Qualifying Life Event. These events are life changes like Losing current health insurance Moving Getting married Having a baby or adopting Income changes Gaining Tribe membership Gaining U.S. citizenship Release from prison Starting or ending Americorps service You can also qualify for a Special Enrollment Period if the company you enrolled with made an error in the information they provided or breached their Marketplace contract. If you experience a qualifying event, you can make changes to your insurance coverage, like adding people to your current health plan. Keep in mind that even if you have a Qualifying Life Event, other rules still govern Special Enrollment Periods.Norris says, “In the individual market, keep in mind that most special enrollment periods now require that you had coverage prior to the qualifying event, so they serve as an option to change coverage rather than go from being uninsured to having coverage. So while getting married or moving to a new area used to allow a person to gain coverage after being uninsured, that's no longer the case (for marriage, at least one spouse must have had coverage prior to the marriage, although the other could have been uninsured). Some individual market rules limit enrollees' ability to use special enrollment periods to upgrade their coverage during the year. All of this is opposed to open enrollment in the fall, when anyone can sign up or change their coverage, regardless of their prior insurance status.” Back to Menu What are my health insurance options? For the most part, Special Enrollment Periods allow people to add a person to their current plan or enroll in a new plan. If you’re enrolling in a new plan, you can enroll in An employer-sponsored plan A Marketplace plan A private insurance plan Research to learn the health insurance plans available to you and what they cost. If you’re losing insurance coverage because you left a job and are starting a new one, it’s a good idea to enroll in some kind of health insurance plan. Most employers have a waiting period before new employees can enroll in health insurance.  To ensure that you have coverage during the waiting period, you can buy temporary health insurance, enroll in a Marketplace plan, be added to your spouse’s employer plan, or extend your employer’s health insurance coverage using COBRA.“Nobody needs a qualifying event to enroll in a short-term plan, as they're available year-round but with medical underwriting. However, it's also common to see short-term plans being marketed to people who are aging off their parents' health plan or losing access to an employer-sponsored plan when they quit their job. In both cases, the person is actually eligible for a SEP in the individual market (where there's no medical underwriting, pre-existing conditions are covered, and the plans include essential health benefits coverage), but people sometimes enroll in short-term plans because they aren't sure what other options they have,” Norris says.Short-term health insurance plans are an option that’s always available. They can be a good choice, but don’t offer the complete coverage that standard health insurance plans offer.If your spouse has insurance through their employer, you can also be added to their plan. “The qualifying event that triggers COBRA eligibility (and the SEP in the individual market) will also trigger a SEP that would allow the person to join their spouse on the spouse's employer-sponsored health plan (assuming the spouse has such coverage and the plan offers spousal coverage). But as noted above, that SEP only has to last 30 days, whereas it's 60 days in the individual market and there's a 60-day window for COBRA,” Norris says. What is COBRA Insurance? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It is the legislation that allows former employees to continue health insurance coverage from their former employer for a certain amount of time until they find new coverage up to 18 months.  Individuals who use COBRA coverage must pay the employer’s contribution and an administrative fee in addition to the monthly premiums. Norris says, “If you're being offered COBRA, take your time to compare individual market plans and COBRA — you don't want to jump into either option without understanding all the details, but you've got 60 days to make your decision.” When choosing between enrolling in a new plan or COBRA, research your options. Townsend suggests, “Reach out to an experienced insurance agent, who can provide you many options and speak to you intelligently about what options they have for you verses the COBRA route. Go online and shop if you enjoy shopping online!”Evaluating the costs and benefits of using COBRA versus another health insurance plan will help you make the best decision for your circumstances. The nice thing about using COBRA is that the coverage can be retroactive if you enroll later during your Special Enrollment Period.Norris offers a few scenarios in which COBRA may be ideal: “You're in the middle of a complicated course of treatment and don't want to have to worry about switching providers, dealing with a new drug formulary, etc. So a person going through cancer treatment, for example, might be better off with COBRA than with switching to the individual market. You've already met or nearly met your out-of-pocket maximum for the year. If you switch to a new plan in the individual market — even if it's from the same insurer that offers your group benefits — you'll have to start over with your out-of-pocket expenses. Your income is too high for premium subsidies and you're fairly certain you're going to have access to a new employer-sponsored plan soon. In that case, keeping COBRA will be less complicated than having to enroll in a new plan only to switch away from it again in the near future when you switch to the new employer-sponsored plan.” However, there are a few reasons why enrolling in a new plan might be better. “An individual market plan might be much less expensive, especially if you qualify for premium subsidies and/or pick a plan with higher out-of-pocket exposure than the one you had through your employer. Premium subsidies are available this year to a family of four with MAGI as high as $100,400, whereas there's no financial assistance available to offset the cost of COBRA. Depending on the specifics of the plan you had through your employer and the options that are available in the individual market in your area, you might find that you can pick an individual market plan that has a provider network and/or drug formulary that work better for you,” says Norris. If you’re eligible for COBRA and Medicare, you might want to enroll in both or opt for Medicare. “One serious mistake I see people make with COBRA is when they are also eligible for Medicare. They elect COBRA, but do not enroll in Medicare Part B. Medicare says you need to enroll in Part B even when electing COBRA and over age 65. Failing to do so can cause a lifetime Part B premium penalty because of a late enrollment fee,” advises Adam Hyers, owner of Hyers & Associates Insurance Agency. How do I sign up for COBRA? Employers are required to offer information on COBRA and enrolling in COBRA to their employees. Your employer’s human resources department can answer your questions and help you access coverage through COBRA. Back to Menu How do I apply for a Special Enrollment Period? For the most part, it’s not a matter of applying for a Special Enrollment Period, it’s a matter of enrolling in a health insurance plan or making adjustments to your coverage.If you have a qualifying life event, talk to your employer’s human resources department. The human resources team will help you through the process--whether you are enrolling in a different plan, making adjustments to add coverage, or using COBRA.If you don’t have insurance through your employer, contact your health insurance company. They will tell you what documentation they need and help you with the changes you need to make.If you’re choosing a new health insurance plan, research your options online. You can view your options by looking directly at company websites, looking at comparison websites, or looking at Marketplace plans on HealthCare.gov. Representatives from these websites can also help with the enrollment process.Getting advice from a licensed independent agent is always a good idea, especially if you’re working directly with a company. “I always stress the importance of sitting down with a licensed, non-biased insurance agent who can provide information on coverage and price on various policies from an array of carriers so you can find the policy that best meets your needs and budget. Whether you are enrolling in ACA or COBRA, understanding what is and is not covered and what the cost will be to you (and your family, if applicable) is very important,” says Chris Mason, Senior Vice President of Sales Distribution for HealthMarkets. If you are required to give documentation to show that you qualify for a Special Enrollment Period, do not send the originals. Make copies to send in and keep the originals for you records. Back to Menu What is a Special Enrollment Period for Medicare? Medicare Special Enrollment Periods are slightly different from regular Special Enrollment Periods, although the concept is the same. There are a few more situations that allow for a Special Enrollment Period. The length of the Special Enrollment Period also varied based on the circumstance that triggers it. Start dates also vary.Many of the Qualifying Life Events that trigger a Special Enrollment Period also trigger a Medicare Special Enrollment Period. However, some circumstances are distinct to Medicare.For example, you qualify for a Medicare Special Enrollment Period if you have an opportunity to purchase other non-Medicare coverage or if your current Medicare plan changes its Medicare contract. More information regarding Qualifying Life Events and corresponding Special Enrollment Period details, can be viewed on Medicare.gov.Understanding how Special Enrollment Periods work will help you be prepared, use the time offered to understand your options, and make sure that you have the coverage you need. For more information on Special Enrollment Periods, check out Health Insurance Marketplace’s Guide. Back to Menu

Updated February 2021. Most of the advice published about health insurance focuses on how to choose an insurance plan that meets your needs. This article focuses on choosing a health insurance company. Specific plans and costs discussed in this article may vary depending on your location, age, and other demographic information. If you’re considering plans from any of these three companies, this article will help you better understand what each health insurer offers and which insurance carrier may be best for you. We'll cover: Best Company user ratings and reviews Aetna vs. Cigna Kaiser Permanente vs. Aetna Kaiser Permanente vs. Cigna Best Company user ratings and reviews (Ratings as of February 3, 2021) Although each insurer has a fair number of 4- and 5-star reviews, each company also has a fair proportion of 1-star reviews. Aetna has 29 percent 1-star reviews. Cigna's is higher at 40 percent. Kaiser Permanente has 34 percent 1-star reviews. Negative reviews are common in the health insurance industry. For all health insurance reviews received by Best Company in 2020, 24 percent were 1 star. In 2019, 41 percent were 1 star. Since we considered reviews from all years for Aetna, Cigna, and Kaiser Permanente, it's hard to say exactly how these companies compare to annual industry findings. However, the proportions of 1-star reviews each insurer has don't stand out considering industry patterns. As you consider good and bad reviews about health insurance companies, keep in mind that insurers offer a wide variety of plans. Plans have different network structures, cost-sharing rules, and coverage restrictions. Health insurance plan offerings can also vary by location, so consider where the reviewer is from as you read reviews. Everyone's medical needs are also different, which can affect how plan members experience the insurance provider. If reviewers share details on why they had difficulty, that can help you know what questions to ask and decide whether or not to buy from an insurance company. Complaints about Aetna, Cigna, and Kaiser Permanente have similar themes. Reviews mention issues with claims, coverage denial, and difficulty resolving problems. These similarities show that the difficulties are common across these insurers. Choosing one over the other doesn't necessarily mean you'll avoid these problems. Aetna ratings and reviews As of February 3, 2021, Aetna had a 6.6/10 overall score and a 3.4/5 star rating based on 189 user reviews. Customer Review: Natalia Correa MDTribe from Miami, Florida "I had this insurance previously with one of my employments. I had a copay but I was able to go to the ER and outpatient. After my $40 copay, it covered everything else such as immunizations and routine lab work." 29 percent of Aetna reviews had a 1-star rating. Complaints include: Poor experiences with customer service Costs Claims denial Issues with filling prescriptions and the delivery process Pre-authorization delays Difficulty with the website Concerns with the network of providers Difficulty getting forms to fill-out 58 percent of Aetna reviews had a 4- or 5-star rating. Praise includes: Good communication around claims Satisfaction with customer service Satisfaction with coverage Quick claims process Satisfaction with the cost and value of plan Aetna Customer Reviews Learn more about Aetna's health insurance offerings and how it compares to other insurers by reading our expert review and customer reviews. Learn More Cigna ratings and reviews As of February 3, 2021, Cigna had an overall score of 7.7/10 and a 2.8/5 average star rating based on 204 user reviews. Customer Review: Melinda Olson from Goodyear, Arizona "Cigna has provided us with great insurance and to see the doctors we like. Customer service helped us figure out issues we had." 40 percent of Cigna reviews had a 1-star rating. Complaints include: Cost Coverage denial for treatment, tests, or prescriptions Customer service Approval process for pre-authorization Coverage restrictions Incorrect billing Poor organization Poor ability to resolve client issues Claims denial 44 percent of Cigna reviews had a 4- or 5-star rating. Praise includes: Good experiences with coverage and claims processing Satisfaction with provider networks Easy to use mobile app and website Satisfaction with customer service Cigna Customer Reviews Learn more about Cigna's health insurance offerings and how it compares to other insurers by reading our expert review and customer reviews. Learn More Kaiser Permanente ratings and reviews As of February 3, 2021, Kaiser Permanente has an overall score of 7.4/10 and a 3.2/5 average star rating based on 200 user reviews. Customer Review: Fay Falatea from Kaneohe, Hawaii "Me and my family have been insured by Kaiser Permanente for 13 years. The Drs I had were great and customer service from the receptionist was always pleasing. Was sad when I had to change to another insurance." 34 percent of Kaiser Permanente reviews had a 1-star rating. Complaints include: Poor customer service Difficulty resolving issues Dissatisfaction with Kaiser Permanente care providers and care facilities Coverage restrictions and denials Claims denials Scheduling difficulties Issues with prior authorization Cost 53 percent of Kaiser Permanente reviews had a 4- or 5-star rating. Praise includes: Convenience of all care providers in one facility Caring doctors and providers Network satisfaction Online portals Coordination between care providers Kaiser Permanente Customer Reviews Learn more about Kaiser Permanente's health insurance offerings and how it compares to other insurers by reading our expert review and customer reviews. Learn More Back to Menu Aetna vs. Cigna While Cigna has a higher overall score on Best Company, Aetna has a higher user star rating and a lower percentage of 1-star reviews. Remember that negative reviews across these companies hit on similar themes. Reading through each company's unique reviews can help you understand what to look out for with each company and make a better, informed decision for yourself. Since Aetna does not offer individual and family health plans, Cigna is the way to go if you're buying your own medical plan. Consumers seeking student health insurance coverage, Medicaid, or CHIP will find options from Aetna. Cigna and Aetna are also similar in their Medigap and Medicare plan offerings. The biggest difference is the inclusion of additional programs. Businesses of any size can find their needs met from either Aetna or Cigna. Both companieis also offer international health plans. Cigna has targeted offerings for NGOs. It's worth comparing cost specifics for domestic plans and cost specifics, coverages, and regions for international plans to find the best deal. Cigna Health Insurance Learn more about Cigna's offerings to see if it's a good fit for you. Learn More Back to Menu Kaiser Permanente vs. Aetna When it comes to Best Company user reviews, Aetna and Kaiser Permanente are fairly similar. However, Kaiser Permanente has a higher overall score. Aetna has a slightly lower percentage of 1-star reviews, which gives Aetna a slight advantage over Kaiser Permanete. Concerns reported in both companies' one-star reviews were similar, so read the most recent customer insight on their respective Best Company profiles. As Aetna does not offer individual and family health plans, Kaiser Permanente stands out. Remember that Kaiser Permanente only offers coverage for care received by the providers it employs, which is similar to a network-only health plan structure. Aetna stands out for its plan perks and offering of international insurance. While Kaiser Permanente stands out of its offering of Charitable Health Insurance. With Medicaid and CHIP, the biggest difference between the two is the states available. If both companies offer Medicaid and CHIP in your state, it's worth doing further research into what distinguishes the offerings of each company. Kaiser Permanente's and Aetna's Medicare plans are also similar. What makes Aetna stand out with its Medicare offerings are the perks and Medigap products. Employers seeking domestic health insurance for their employees can find good plans from both Aetna and Kaiser Permanente. However, if global health insurance is necessary, Aetna is a good option because Kaiser Permanente focuses on domestic health insurance. Kaiser Permanente Customer Reviews Learn more about Kaiser Permanente's offerings to see if it's a good fit for you. Learn More Back to Menu Kaiser Permanente vs. Cigna When it comes to ratings and reviews, Kaiser Permanente and Cigna are similarly rated on Best Company in the overall score and user ratings. If you're choosing between these companies and comparing similar plans, read the most recent reviews and complaints on their respective Best Company profile pages to make an informed choice. While Cigna could provide more general information about the plans it offers independent buyers, it also offers a nice variety of supplemental health insurance plans that are great for people seeking additional coverage for specific situations. Cigna is also a great choice for purchasing independent international health insurance. Kaiser Permanente stands out for its Medicaid, CHIP, and Charitable Health Insurance offerings. For consumers interested in this kind of health insurance, Kaiser Permanente is the clear choice. If you're considering Kaiser Permanente, keep in mind that their health plans only cover care received at its medical facilities by the care providers it employs. This is different from the distinct provider network structures that other companies like Cigna offer. If you're interested in a more traditional network structure, like a Preferred Provider Network (PPO) that offers both in- and out-of-network coverage, Cigna may be a better option. Both Cigna and Kaiser Permanente offer Medicare Advantage plans. The biggest differences between the two are the additional programs that are included with some plans. Cigna also offers Medigap insurance, which is great for consumers looking for additional cost-sharing help. Kaiser Permanente and Cigna both offer a nice selection of employer-provided health insurance plans. Employers who are choosing between the two should contact each company directly to compare pricing and coverage. Cigna also offers international insurance. Those seeking international insurance would need to work with Cigna when choosing between the two insurers. Kaiser Permanente Customer Reviews Learn more about Kaiser Permanente's offerings to see if it's a good fit for you. Learn More

Guest Post by Dr. Indra CidambiWith the spread of the drug epidemic from urban to suburban and even rural areas, addiction in the workplace is not uncommon anymore, and it is a serious issue. Not only is the loss of productivity from alcohol and drug abuse significant, it has negative implications for safety in the workplace, both of which raise business costs. Over 77 percent of illicit drug users are employed1 and business leaders need to know how to address substance abuse by their employees effectively.To get a handle on the scope of the issue, consider this: in 2013, roughly 25 million2 Americans, or 9.4 percent of the population, had used an illicit drug in the past month and 33 million3, or 12.7 percent of the population, were classified as suffering from alcohol use disorder. It also appears that no profession is immune: dependence on drugs and alcohol among nurses is roughly 10 percent4, in-line with the general population; as per a 2016 study, 1 in 5 lawyers5 reported that their use of alcohol or drugs was problematic sometime in their lives; in law enforcement, 1 out of 4 police officers6 on the street have a problem with drugs or alcohol; and, a survey7 of teachers discovered higher abuse rates of alcohol, amphetamines, and tranquilizers than the national average. Extrapolating the numbers above it is safe to say that at least 1 in 10 employees in the workplace is impacted by substance abuse. Drug and alcohol abuse negatively impacts productivity and safety in the workplace and drives up costs. Alcoholism alone is responsible for 500 million lost work days8 each year.Signs of substance abuse among employees, while not obvious, can be spotted with some informed observation. General signs (depending on the kind of work) include an unkempt appearance, inappropriate clothing (long sleeves in hot weather), frequent bathroom breaks, perennially sniffy or runny nose, mood swings, isolating from colleagues, volunteering for overnight or holiday work (especially among nurses), higher than normal absenteeism or tardiness, poor job performance and workplace theft.It is important to realize that addiction is a disease, not a moral failure, and treatment is needed. Although it took time, addiction is now largely recognized by the treatment community as a chronic disease and quitting requires more than good intentions and a strong will. Drugs change the brain in ways that make quitting hard and, therefore, treatment is needed. Fortunately, treatment options have widened to include ambulatory detoxification (for all substances of abuse) and medication assisted treatment (MAT) which have delivered better results. Nevertheless, it is not easy to have this conversation with an employee.The best approach would be to first document each instance where the employee’s behavior was unusual. If possible, include it in the employee performance records as well. Then approach a professional alcohol and drug counselor or a physician who specializes in addiction, not only to make sure you are on the right track, but also to get educated on treatment options. If you utilize the services of an Employment Assistance Program (EAP), you may want to hand over the documentation to them and let them address the issue with the employee and help him or her obtain treatment. If you have to do it yourself, approach the employee as a concerned colleague rather than as an overbearing boss. Detail the instances where you have noticed behavior that was off and delve into the causes of such behavior. Explain why such behavior is impacting workplace productivity, safety, or morale. Make the employee understand that you believe that addiction is a disease that needs treatment. Show that you want to work with the employee and offer support if he or she wants to address the issue through treatment. Educate the employee about the treatment options available and explain that it is possible to live sober. Hopefully, the employee will choose to leverage the support and seek treatment. Addiction is a chronic disease that usually does not spontaneously remit over time. Treatment interventions are needed. If the employee is not amenable to seeking treatment, the issue has to be dealt with under company policies and other disciplinary rules. Indra Cidambi, M.D., Medical Director, Center for Network Therapy, is recognized as a leading expert and pioneer in the field of Addiction Medicine. Under her leadership, the Center for Network Therapy started New Jersey’s first state licensed Ambulatory (Outpatient) Detoxification program for all substances nearly three years ago. Dr. Cidambi is Board Certified in General Psychiatry and double Board Certified in Addiction Medicine (ABAM, ABPN). Dr. Cidambi is the Vice President of the New Jersey Society of Addiction Medicine. Notes: National Household Survey on Drug Use National Institute on Drug Abuse (NIDA) JAMA Psychiatry National Council of State Boards of Nursing The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys; Krill, Patrick R. JD, LLM; Johnson, Ryan MA; Albert, Linda MSSW Police On-Duty Drug Use: A Theoretical and Descriptive Examination – Kraska, Kapeller;  On the Front Lines – Hepp. A 1990 study by the Journal of Drug Education, which surveyed 500 teachers in Texas U.S. Department of Labor

Guest Post by Dr. Bruce Pinker February is Women's Healthy Heart Month for a very good reason: According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for females in the United States. According to the American Heart Association, nearly 80 percent of cardiac events can be prevented through education and lifestyle change. Genetics plays a role, but diet and exercise are major factors that have been proven to help reduce heart disease in women, as well as in men.As a board certified podiatrist and foot surgeon, I see many patients each day who suffer from foot pain that prevents them from running or walking. Without exercise, many run the risk of diminishing health. Regular exercise can promote cardiac health and overall wellness. Getting my patients back into pain-free activity is my number one goal. Plantar fasciitis One of the most common foot ailments is plantar fasciitis. An inflammatory condition affecting the bottom part of the foot, usually in the inferior heel region, it is often caused by overuse.  Due to excessive stress on the plantar fascia ligament, which spans from the heel to the toes, it stretches and snaps back, much like a rubber band. Regular stretching exercises can be performed to prevent it, coupled with the usage of supportive footwear, but this disorder sidelines millions of individuals every year. Whether or not you are very active is not necessarily a factor, as it affects people of all different ages and activity levels. Prolonged standing or walking can lead to plantar fasciitis. In many cases, a heel spur accompanies this painful foot condition.Various successful approaches can address plantar fasciitis, and most are conservative.  Physical therapy and orthopedic strappings are usually very beneficial, especially in cases diagnosed in early stages. Cortisone injections can be helpful, as well, and custom orthotics are usually instrumental in providing long-term relief. Custom orthotics can retrain the plantar fascia ligament, maintaining a proper arch that does not overstretch or contract. In the more challenging cases, high energy shockwave therapy (ESWT) or surgery can be performed.  Approximately 90 percent of all cases of plantar fasciitis can be successfully treated conservatively, based on my experience. Upon the onset of inferior heel pain, it is best to roll your foot over a frozen 20 ounce water bottle several times. If this attempt is not successful in reducing pain, it is important to see a podiatrist for proper evaluation. Bunion deformities and hammertoes Bunion deformities are also a common foot concern. A bunion deformity, referred to as hallux abducto valgus, is a structural foot condition, often caused by improper biomechanics. Some may be born with a bunion deformity, but most are acquired, often subject to the footwear that is worn; narrow or pointy-toed shoes and high heels are known to lead to bunion deformities if worn frequently. As the great toe points toward the second toe, and the first metatarsal points inward, excessive stress is placed upon the great toe joint. The stress leads to the growth of the typical "bump" right near the great toe as the ligaments stretch on the inside of the joint, and tighten on the outside. Tendons in the great toe region provide unbalanced forces that further the deformity.  As the "bump" enlarges, it presses against a nerve, leading to discomfort. While wearing shoes, the nerve can become sandwiched between the bones and the footwear, causing pain and difficulty walking. Some bunion deformities, if mild, can be addressed conservatively, with physical therapy, orthopedic strappings, and oral anti-inflammatories or Tylenol.  However, most bunions need to be surgically corrected for long term relief. Several bunion procedures are available, most requiring three to four weeks of healing, in my experience. They are performed as an outpatient procedure, and the correction lasts for many years. It is best to avoid footwear that puts the feet under unnecessary stress. However, rest assured, most bunions can be addressed successfully, either conservatively, or surgically. Most bunion surgeries are covered by health insurance plans.Often accompanying bunion deformities is the hammertoe. When a toe is contracted, it may point upwards at the first joint, and then downward at the second joint, thus illustrating a hammertoe. Improperly fitted footwear can cause hammertoe deformities. Pain usually develops on top of the toe, as it contacts the toe box of the shoe that is worn. The skin can thicken on top due to shoe irritation, and in some cases, can become a wound. The wound can get infected, leading to potential complications. The discomfort can be debilitating, so most hammertoes need to be corrected. Some can be treated conservatively with toe covers or spacers, but definitive correction through surgery is usually necessary, also performed as an outpatient procedure.  These procedures are typically covered by health insurance plans, and recovery time is usually just two to three weeks. Neuromas Neuromas are inflammatory conditions of the nerves in between the toes. Commonly brought on by tight or narrow footwear that is worn repetitively, neuromas can also be addressed conservatively and surgically. Most patients elect for cortisone injections to start, usually performed in a series. If unsuccessful in providing relief, custom orthotics can also be utilized.  Surgery is reserved for the more challenging cases, and usually results are long-lasting. Recovery from neuroma surgery is usually two to three weeks, performed as an outpatient procedure, and often covered by health insurance plans.                      Your feet need to last a lifetime, so taking good care of them is vital. Realizing that exercise is important for promoting cardiac health, it is essential to address foot pain when it occurs. Keeping your feet healthy can be pivotal for improving your overall wellness and heart health.  Don't let your feet break your heart! Dr. Pinker is a professional foot and ankle health and wellness speaker who delivers many original seminars annually, such as “Diabetes & Your Feet: The Winning Combination,” “Exercise Safe to Lose Weight,” and “Keep On Running.” He is a graduate of the New York College of Podiatric Medicine (NYCPM) in New York City. Dr. Pinker strongly believes the fusion of fashion and function is essential for footwear today, as the modern man and woman needs to look great and feel great. This is his motivation for his company: Dr. D-LuCS: Doctor Designed Luxury Custom Shoes. 

The new year often begins with motivation to make changes that will improve life. New Year's resolutions can be about education, finance, health, or more personal goals.According to a 2019 poll by Branded Research, 38 percent of U.S. consumers made a New Year's resolution in 2019.The age groups with the most people making resolutions are ages 18-24 (with 59 percent making resolutions), ages 25-34 (with 48 percent making resolutions), and ages 35-44 (with 45 percent making resolutions).The most common primary resolutions were health-related, with 28 percent overall with a primary fitness-related goal and 25 percent overall with a primary diet-related goal.Health goals were followed by finance-related goals, which 18 percent of U.S. consumers reported as being their primary goal.Of those who made a resolution, only 28 percent report that it is very likely that they will keep them. About 38 percent say somewhat likely, and 34 percent say not likely.If you've been struggling to keep your New Year's resolutions, you're in good company.We've compiled some expert tips on keeping your motivation going throughout the year so that you can stay excited about your goals and keep them. 1. Remember why If there are some resolutions that you're having difficulty keeping, it's a good idea to evaluate why you set that goal in the first place. Declan Edwards, founder of BUCoaching.org, says, “Revisit why the resolution matters in the first place. Human behaviour is driven by feeling. We rarely do what we logically know is good for us, we do what we feel like doing and one of the best ways to tap into feeling is to revisit our why.” There may be many reasons that you set a certain goal, and these reasons can be powerful motivators. John Gilmer, PhD, Vice President of Research and Development at Active Iron, says, “If you have something that you are passionate or firm about changing, decide why, because this, not the resolution, will drive you when you hit the wall and want to quit.” Whether or not you set a goal for the sake of having New Year’s resolutions, there may be additional reasons why you want to achieve that goal. Dannie De Novo, author, attorney, coach, entrepreneur, and podcast host, agrees. She says, “My best advice is to remind yourself often of why you made your decision. Take a piece of paper, write out your resolution in big letters at the top, and under your resolution list all the reasons why you are going to accomplish it. Make these statements positive. Then put that paper somewhere you will see it every morning, like your bathroom mirror. Make yourself read it and really reflect on the reasons why you started on this journey and why it is so important to you to continue.” 2. Evaluate barriers It’s now February, so you may have already encountered some obstacles along the way in your quest to keep your New Year’s resolutions. Instead of getting frustrated with yourself, focus on what you’ve learned about those obstacles and make a plan to overcome them. Gilmer says, “Eliminating obstacles is imperative, or you will constantly be tempted. Granted, this is easier done if you are cutting fat from your diet than if you are a smoker trying to quit, but no matter the gravity of the resolution, removing triggers is essential.” Some obstacles are harder to get rid of than others. In some cases, it may work better to make flexible plans. Eric and Ryan Johnson, founders of HOMAGE say, “When it comes to your training and nutrition, forecast ahead. By planning out your calendar at the beginning of the week, you won’t be caught off guard by any surprises. This will help you make the necessary adjustments to keep you on track.”  “For example, if you know you have a dinner scheduled for Thursday night, you can adjust your nutrition from Monday to Wednesday, so when Thursday comes around, you can enjoy yourself without any unnecessary guilt. The same goes for your training; if you have a particularly busy day scheduled, you can make it a rest day for training rather than stressing out how you’ll be able to fit it into your day,” they say. Other times, it can be just as effective to make small changes to your surroundings. Itamar Shatz, author of Solving Procrastination, says, “Making changes to your environment can help you pursue your goals. For example, if your goal is to drink more water instead of coffee, placing a glass of water next to your bed can help you make sure that that's the first thing that you drink in the morning when you wake up, which will make it easier to stick with your resolution. Similarly, you can also take a water bottle to work with you, and refill it throughout the day, in order to help make sure that you stay dedicated to your goal even when there are many temptations around.” 3. Make a plan Matt Edstrom, CMO of GoodLife Home Loans, says, “One of the best ways to make and stick with your New Year’s Resolutions is to create short term plans for your long term goals. Goals that you’ve planned to stick to for a full 52 weeks are going to seem incredibly daunting, especially if they have to do with something like food, something that we all interact with on a daily basis. Start new goals at the beginning of each month. Having new goals each month will help keep you motivated, hold you accountable, and keep you on track.” Chris Beavers, senior personal trainer at Ultimate Performance, agrees and recommends even shorter timeframes. He says, “Set bite-sized performance goals every week. Set a series of smaller and more achievable performance goals along the way to achieving your bigger goals. This is a great way to keep your training fun and challenging, and keeps you motivated as you achieve smaller wins on the way to your ultimate goal.” For some goals, you may need to break the steps down even further. Edwards says, “Success is driven by habits, not by giant leaps. If your resolution is to become healthier and fitter this year, your first step is not to go to the gym five times per week (especially if you weren't already doing that). Your first three steps would be to set the alarm in the morning, get out of bed when it goes off, and then get dressed in your gym gear. By the time you're out of bed and dressed, you're incredibly likely to follow through on the rest and show up to the gym. The decision to skip the workout is usually made while you're still in bed.” As you make your plans, it’s important to set achievable goals. Dan DeFigio, author of Beating Sugar Addiction for Dummies, says, “Be realistic so you don’t succumb to all-or-nothing thinking. If you make unrealistic promises or set unattainable intentions, you’ll most likely fail quickly, and end up right where you used to be. Instead, make yourself a more doable promise, such as “I will put exercise time in my calendar three days per week,” or “I will limit myself to one dessert each weekend.” 4. Set reminders There are many kinds of reminders — alarms, schedules, posters, lists, ect. You have to figure out what works best for you. Edstrom says, “A visual reminder can be a document where your goals are written down or a dream board or an item that reminds you of what you’re working towards. A visual reminder will help you stay motivated and remind you of the reasons why you set the goal in the first place. Don’t pick a visual reminder that’s going to point out what you don’t have yet in your life.” Hassan Alnassir, founder and owner of the kids’ toy business Premium Joy, agrees. He says, “If you want to stay motivated and retain the new year's resolutions, an effective trick is to always keep the end result in mind. Try to consistently imagine what difference it will make and how it will feel when you have finally achieved your health goal. Visualizing the outcome will help push you to keep going and take action toward accomplishing your desire.” For more specific reminders, Milana Perepyolkina, international best-selling author, says, “The best way to keep a resolution is to add it to your calendar. Treat it the same way you would treat an important appointment. Create one resolution per month and add it to every weekend (delete it after completion). Share your resolutions with social media; this will improve your accountability.” These reminders can be as frequent as you need them to be.  Eric J. Anderson, co-founder and Organizational Development Manager at ElMejorTrato.com, says, “Dedicate a special time to keep that resolution. Make it your time of day. For example, the first thing you do every day. If it is something very difficult to achieve, and you carry it out first, then the day is won. You have already beaten yourself.” There are also apps that can help remind you of your goals and keep track of your progress.  Lydia Noyes, health and wellness reporter for HighYa.com, uses HabitHub. She says, “This ultra-simple app lets you track the days that you complete predetermined goals, and multiple days in a row start to create visually appealing streaks. After a few days with this app, I started to get excited about how long I could make my streaks go, so sleeping in and skipping yoga started to have a higher mental and emotional cost than getting up and doing it. As simple as it sounds, this app truly changed my brain's approach to morning yoga and made me commit.” 5. Track progress and create rewards “Not seeing results from all your hard work in the gym often kills off that initial New Year motivation, and it's easy to just quit and fall back into bad habits. So, if you don't consistently track your progress, you won't be able to see the progress you're making,” says Beavers. Finding a way to track your progress will help you see the results of your efforts every day. It can be easy to focus the success of a goal based on results. However, that can lead to frustration and diminishing motivation. DeFigio says, “Two important tips for keeping resolutions: 1. Resolve ACTIONS, not OUTCOMES. For example, a common New Year’s resolution is to “lose weight”, or even more specifically “to lose 20 pounds.” These are worthy goals, but they are too diffuse because you are looking to an OUTCOME, not resolving to DO something. You have resolve to do the ACTIONS required to get the outcome. It’s better to resolve “not to eat after 7:00 pm”, or to promise yourself that you’ll bring healthy snacks to work, so you’re not at the mercy of whatever’s in the break room. These are ACTIONS that you can reliably perform that will get you where you want to go.”As you determine what to keep track of and how to measure progress, make it something that is in your control. You can keep track just for yourself or even share it with a friend. Gilmer says, “If you are accountable to someone, you will not only be more responsible, but more engaged as well. Studies show that accountability may be the single most important thing in goal setting and resolution. In addition, having some accountability will also ensure support, which is an equally important part of making important changes.” As you hit your smaller goals and make progress, plan ways to celebrate. Christian Koshaba, personal trainer and owner of Three60Fit, says, “People are so caught up with the end goal, they forget about the mile markers along the journey. This will make your wellness endeavor more of a lifestyle, rather than an end goal. Celebrate and be proud of your accomplishments, no matter how small. Find rewards to treat yourself with. A weekend vacation, a new outfit, trendy haircut, etc.” Celebrating even small successes also increases motivation.Maggie Schott, CEO of McKeating Solutions, says, “Our brains are engineered to reward us for accomplishments. When we achieve a goal or celebrate an accomplishment, our brains release those "good feeling" chemicals.  When we fail, not so much.  So our minds become patterned to seek out accomplishments.  When they're too few and far between, we can become discouraged.  Creating micro goals or mini wins, will help to give us this release and fuel us to keep working towards our overall goals.” 6. Deal with failure As you plan to celebrate your progress, it’s also a good idea to deal with failure in a constructive way. One way to do this is to practice self-compassion.Edwards says, “When you fall off the bandwagon with your resolutions, it’s all too easy to end up blaming yourself and calling yourself a failure. This just demotivates you from trying again. Try speaking to yourself more like you would speak to a close friend if they had fallen off the bandwagon with their resolution. Maybe January didn't go to plan, but don't throw out the remaining 11 months of the year just because one month didn't play out how you thought it would.”Another way to confront failure is to focus on the present and what you can do now.De Novo says, “Not dwelling in the future is as equally important as letting go of the past. Do yourself a favor and stop thinking three to six months down the road. Set your attention on today. What can you do in the present moment to help further your goal? What can you achieve today in the furtherance of your resolution?” Looking for more tips on keeping your New Year's Resolution? Check out: "New Year's Resolutions: Don't Give Up"

For many people, the holiday season means shopping, decorating, and wrapping gifts. These activities can cause foot and back pain, and in some cases may lead to injury. Below are a few suggestions from experts on avoiding foot and back pain this holiday season: Foot pain Dr. Bruce Pinker, DPM, AACFAS, FAPWCA, DABPM, a podiatrist and foot surgeon, says, “I see many patients with foot pain this time of year. One of the most common foot pain conditions is called plantar fasciitis. It is typically brought on by overuse — excessive walking or standing, or even running or jumping. Think of those waiting on line at airports or retail stores this time of year. With improper support in footwear, overuse worsens this condition. The pain can be so severe that it can prevent individuals from walking.” If you’re doing a lot of in-store shopping or participating in outdoor holiday activities, you’ll want to take especially good care of your feet. Fortunately, there are some simple ways to prevent this pain by being kind to your feet. Pinker says, “To prevent it, one should stretch the feet regularly. Rolling feet over a frozen 20 oz water bottle is helpful. One should also wear supportive footwear.”Neel Anand, MD, professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Spine Center, also recommends wearing good shoes.  “Make sure you’re wearing a comfortable pair of shoes with cushion and support for your feet when you shop because it will provide the same cushion and relief for your lower back,” he says. If your foot pain worsens despite these preventative measures, there are other ways to treat it.  “In most cases, plantar fasciitis can be treated conservatively by physical therapy, stretching, orthopedic strappings, cortisone injections, or anti-inflammatory meds. Many also benefit from custom made orthotics. Some, in the more challenging cases, require shockwave therapy (ESWT) or surgery,” Pinker says. Back pain Over the holidays, many people do a lot of bending and lifting as they shop, decorate, and wrap presents. Carrying shopping bags for long periods of time strains your back. “Getting in a good stretch before and after a shopping trip will loosen up your muscles and relieve some stress and stiffness, making you less prone to the post-shopping soreness that can lead to further injury,” Anand says. Another way to avoid shopping-induced back strain is to do all of your shopping online. Then, everything is delivered to your front door. Just be careful as you lift the boxes and take them inside. With decorating or any kind of bending and lifting activity, Anand says, “Be mindful not to bend at the waist when lifting those heavy boxes or string of lights. ALWAYS bend at the knees, and try to avoid twisting when you have your hands full.” Another common holiday activity that is hard on your back is wrapping gifts. Many people wrap gifts on the floor. However, doing so is not good for your back.  “Set yourself up at a table with a comfortable chair instead of sprawling out on the floor (this will prevent you from hunching) and wrap only a few gifts at a time allowing yourself plenty of breaks in between,” Anand says.

Being healthy over the holidays isn't about missing out, it's about finding the best ways to enjoy food, drink, and company. We've taken a holistic approach to gathering holiday health suggestions from experts. We've got tips on mental, emotional, and physical health, as well as food and drink consumption. Following these tips and suggestions will help you get the most out of the holidays this year and enjoy them safely. Mental and emotional health Stress managementThe holidays are often a time of festivities, joy, and celebration. There are many social activities to enjoy, and it is easy to feel over committed.Caleb Backe, health and wellness expert for Maple Holistics, warns, “Don’t forget to plan your schedule realistically this holiday season. While ‘tis indeed the season to be jolly, make sure you leave yourself time to rest as well as party. Know when to say ‘no,’ so that you can really enjoy your holidays to the fullest.”While extroverts may thrive on social interaction and engagement, introverts may need to carve some space out for themselves. Kristine Tatosyan-Jones, MD, ABIHM, who practices family medicine in the Nashville area, says, “Introverts especially tend to get very drained during the holidays when they are traveling and constantly around family. It can be very helpful to spend some alone time, ground yourself, and relax.” If you know you'll need a break from social activities, plan ahead for ways to take a break. "Having music, a podcast, or a book on tape can allow you to be physically present while taking a mental break. Especially if you’re an introvert, having a way to pull yourself out of a loud and hectic environment can be a great tool," recommends Lauren Cook, a clinician with a Master's of Marriage and Family Therapy.Family gatherings and visits with old acquaintances can also bring a lot of unnecessary and unneeded judgment into your life.Kelly Flagg, owner of Kelly Flagg Lifestyle: Fitness and Wellness for Women, advises, “"Don’t let the comments and judgments of others get to you. The same goes for judgmental family members during the holidays. Remember: they don’t live in your life. The holidays can be a time when we allow other people's opinions to define our feelings, but we don’t need to. Remember, you’re in control of how you respond.” One way to reduce stress is to maximize your time with the people you like. Tatosyan-Jones says, “Social support and spending time with friends and family who are positive and nurturing can help with decreasing stress, so choose wisely who you visit during the holidays.” Carve out time for other stress management practices. Kelly Donahue, PhD, mind-body coach, consultant, and speaker, recommends, "Maintain meditation, mindfulness, yoga, or whatever keeps you calm. If you don't have a regular practice to help with stress, it's not too late to start!" Gratitude can also help you find calmness and change your prespective of your surroundings.  "Taking a moment to focus on something for which you are grateful, like the fact that you have family who care enough to squabble, that you have the ability to fly through the sky to see loved ones, and that you can slow down and use the time in the long line to take a few deep breaths. These little moments of gratitude can shift your perspective and help you see the good around you," says Donahue. Focus on yourselfThis may seem like counterintuitive advice for the season of giving, but it’s more about not comparing your holidays to someone else’s. Steven Reigns, M.A., licensed psychotherapist and founder of Therapy for Adults, counsels, “Remember that social media can give false impressions that everyone else is having a great holiday season filled with friends, presents, cable knit sweaters, and hot chocolate. Don’t fall into the trap of comparing your life with the lives you see on Instagram.”    While there is plenty of cultural emphasis on spending the holidays with others, there is no need to feel badly about not having holiday plans or spending them alone — especially if that’s what you want.  Reigns adds, “Sometimes people, out of holiday loneliness, will agree to spend time with people or activities they aren’t fond of. Agreeing to things one doesn’t enjoy is an abandoning of the self. Leaving or ignoring one’s true desire for the sake of company compounds lonely feelings. Spend time with people you truly enjoy spending time with.” Take ownership of your holiday experience and only do the things that you want to do. Physical health Avoiding sicknessWhile holiday traditions are often a break in routine, it’s also important to keep some of those routines going. Dr. Christopher Dietz, Area Medical Director of MedExpress, says, “When people get together during the holidays, germs that cause illness often spread easily through personal contact, food, and shared spaces. Simple habits can make a substantial difference by building your immune system and reducing contact with germs.”  For example, Dietz advises, “To help keep germs at bay, always cough and sneeze into your elbow, and teach kids to do the same. Arielle Levitan, MD, co-founder of Vous Vitamin LLC, has three tips for keeping germs at bay. She says, “Hand washing never can be overstated. I advocate for real hand washing, not antibacterial gels and the like.”Dietz agrees: “I always remind my patients to get plenty of sleep and wash their hands regularly, especially before eating or preparing a meal. It’s also a good idea to wipe down frequently touched surfaces, like TV remotes, phones, doorknobs, and faucets.” Dr. Susan Besser of Mercy Medical Center suggests getting the flu shot: “You all should have had your flu shot by now, but if you didn’t, go ahead and get it because some protection is better than none. Remember it’s not just for you. You are also protecting your friends and family from the flu.”Levitan also recommends immunizations, like the pertussis vaccine and the flu shot, and taking vitamins. She says, “In addition to a daily multivitamin, taking some extra vitamins when feeling run down or particularly at risk of developing an illness can be helpful. We like a combination of extra vitamin C, D, and zinc for these times.”For those interested in consuming foods with these vitamins naturally occurring, Isabel Butler, company nutritionist at Spoon Guru, says, “Dairy products are a good source. For vegans, soy milk is a good alternative. It’s also a good idea to drink plenty of orange juice. Salmon is a good source of vitamin D, but for anyone following a vegan diet, oatmeal is good breakfast choice while mushrooms are great for lunch or dinner.”Prevent food poisoningCandess Zona-Mendola, a food and water safety advocate and editor of MakeFoodSafe.com, says, “The days after holiday meals show the highest rates of food poisoning we see during the year. Most of these illnesses can be prevented with a meat thermometer. Remember a turkey is done when its internal temp reaches 165 degrees F. Check the temperature in the innermost part of the thigh and wing and the thickest part of the breast.” Whether you’re hosting or celebrating on your own, make sure you’re preparing and handling food properly. “When the meal is over, be sure to store food in the freezer or refrigerator promptly; food should never be left in the "danger zone" for longer than 2 hours; the danger zone is between 40*-140* F, where bacteria are most likely to rapidly grow,” says Diana Gariglio-Clelland, a registered dietitian for Balance One Supplements. MedicationsSticking to a schedule can also help you if you have prescription medications. Caitlin Hoff, a health and safety investigator at Consumer Safety, says, “Many medications encourage users to consume the medication at the same time each day for best results. While this may not be a difficult thing to remember in everyday life, the holidays often disturb our routines and can make it harder to stay on schedule with these smaller daily tasks. Set a timer on your phone to remind you to take your medication if you are out and about, or if you are at a holiday event, maybe ask a friend to help remind you.” Keeping on track with prescription medications is important for maintaining health. Some medications have adverse reactions or become less effective when combined with certain foods and drinks. Hoff says, “You can easily avoid an adverse drug event by understanding what can and can't be consumed while taking your prescription medications.” No one wants to deal with a preventable trip to the ER, especially over the holidays. SleepMost of us know we need to get more sleep, but FOMO (the Fear Of Missing Out) keeps us awake. FOMO is especially strong over the holiday season, but missing out on sleep has a negative impact on our bodies. Dr. Kristine Arthur, MD, an internist at MemorialCare Orange Coast Medical Center, advisess, “Don’t skip sleep. Take advantage of this time to get some extra zzzzs. Studies show that the immune system suffers from lack of sleep.” Sleep is an important process because it helps our bodies heal and maintain our immune systems. "When we sleep, our cells enter the regeneration/reparation mode and mend all the damage done to them during the day. It’s essential to provide our body with enough resting time to be able to engage in the defense against the germs, pollution, and stress during the day," says Dr. Nikola Djordjevic, MD, medical advisor at LoudCloudHealth. Leon Turetsky, a certified personal trainer, corrective exercise specialist, and founder and CEO of BackIntelligence.com agrees: “Just by having the discipline to go to sleep at a specific time every night will give you a cut off time at night, so that you don’t go down the rabbit hole of bad habits and indulgences. This will allow you to enjoy your holidays in a sustainable and healthy way.” Keep your immune system strong so your body can effectively fight aggressive germs by getting some sleep. Sticking to a schedule of sorts will also make transitioning back to school or work much easier come January. Staying activeFollowing normal exercise routines can be challenging with all the added events that occur over the holidays, but any kind of physical activity brings benefits.Flagg suggests, “Go for a walk and get some exercise. Even if it’s just a mellow 15 minute stroll around the neighborhood, a walk can help with digestion and improve blood sugar levels."Movement is also a good way to deal with stress. “Getting into the fresh air can help reduce stress, improve blood pressure and blood sugar and keep weight under control,” says Arthur.Heart attacksLinzy Cotaya, APR, Communications Manager for the American Heart Association, says, “The holidays are the time of year when many heart attacks happen. People tend to be more stressed, getting sick, veering from the traditional eating habits, etc. It is labeled as peak heart attack season.” Pay attention to your body and any abnormalities. The American Heart Association has some useful tips on its website about making heart-healthy food choices, spending time outdoors, and taking care of blood pressure. Food and drink consumption Alcohol consumptionAnother important way to stay healthy and out of the ER over the holidays is to practice safe drinking habits.Dr. Indra Cidambi, who is board certified in general psychiatry and double board certified in addiction medicine and founder of Center for Network Therapy, recommends alternating alcoholic beverages with non-alcoholic beverages. She recommends, “I like to spice my alcohol-free beverages up by creating mocktails for easier and more festive drinking, not to mention, they significantly reduce peer pressure as they look like booze-filled treats.”Another tip is to combine drinking with eating. “Be sure to fill up with a protein and vegetable heavy meal before getting to the party to avoid drinking anything on an empty stomach — this only exacerbates the effects of alcohol,” Cidambi says.Dr. Kyle Varner, an internal medicine physician, agrees: “Remember to keep the alcohol to a minimum. Nothing exacerbates family tensions quite like excessive drinking. You'll stay healthier and enjoy the holidays more by keeping the alcohol consumption to a minimum.” Try having a cocktail without the alcohol to help lower your consumption. You can also look for other drinks. "If you’re drinking alcoholic beverages over the holidays, try to replace it with glasses of water. Your body needs water, not alcohol!! Water is essential for regulating your body functions optimally including your heart, brain, and muscles. It also helps to balance your blood sugar level," suggests Tyler Sellers, Total Shape CEO and editor-in-chief. For everyone’s safety: don’t drink and drive. Use public transportation or get an Uber or Lyft instead of driving yourself home. Food choices and dietary restrictionsMany holiday traditions revolve around good food and special treats, but sometimes people feel bad about consuming these traditional foods. Butler says, “Don’t feel guilty for joining in and enjoying the food. Listen to your body and when you feel full, that’s the time to stop as no one wants to feel sick. When choosing food make sure to include plenty of vegetables or salads on your plate to help balance out a meal.” In general, it’s healthier to limit sugar and fat intake. This is especially tricky over the holidays. Bonnie Taub-Dix, a registered dietitian nutritionist, says, “Choose foods that are unique to that particular holiday, instead of filling up in foods you can get any time of year.” Holiday parties can also be tricky to navigate for vegans, vegetarians, and others with dietary restrictions or food allergies. If you’re a host, do some internet exploring to find creative recipes and substitutions for your guests. Dietary restrictions are not as difficult as some may think; they just require more creativity. There may even be healthier ways to prepare holiday favorites that are just as tasty, except for maybe mac and cheese. Varner says, “I like to substitute mashed potatoes for mashed cauliflower to drop the glycemic index and minimize the damage. The entire holiday meal can also be cooked with minimal fattening carbohydrates. This can go a long way to preventing holiday weight gain.” There’s no need to make the party’s entire food selection based on one guest’s dietary needs, but it is a nice gesture to include one dish that meets those requirements. For those with special diets, there are things you can do to ensure that you can enjoy the holiday party food as much as everyone else. Taub-Dix says, “If you’re going to someone else’s house, volunteer to bring a dish that you are comfortable with eating and that meets the needs of your diet.” When it comes to dental health, there are a few things you can do to be nice to your teeth. “A healthy hack for your teeth is to chew gum for 20 minutes following meals or even snacks. According to the American Dental Association, chewing gum for 20 minutes after a meal/snack can help prevent decay by increasing saliva flow that neutralizes oral acidity levels and washing away food that is clinging to your teeth,” says Bill Chase, SVP of Marketing at DentalPlans.com. While chewing gum is an easy way to help keep your teeth happy, remember your dental hygene and be mindful of what you eat. "Take the time to brush and floss. Watch that you don't eat too many sticky, gooey treats, or have too many sugary, acidy drinks," advises Dr. Mike Golpa, Director of G4 by Golpa. Applying these suggestions will help you enjoy the holidays with reduced stress, good health, and tasty food. 

Updated September 10, 2021. Enrolling in health insurance is an important financial decision. Health insurance can save you money on your health care, which offers good financial protection. This season, make sure you are making the best choice for your health and financial planning. Below are some pitfalls that you’ll definitely want to avoid: Not knowing open enrollment dates Open Enrollment for health insurance coverage for the calendar year 2022 is November 1, 2021 to December 15, 2021. Don’t miss it!“Unless you have special circumstances, you will not be able to purchase a new plan or switch out of your existing plan if you miss these important deadlines,” says Dr. Nicole Rochester, MD, private health advocate, and CEO of Your GPS Doc, LLC. Some employers have a different enrollment period. Your employer’s human resources department should be reaching out to share that information with you, if it hasn’t already.A Special Enrollment period allows you to enroll in health insurance at a time aside from Open Enrollment. These occur if you have a qualifying event, like getting married, having a baby, or moving to a new state. Lingo confusion Dr. Sam Kina, Senior Vice President of Economics and Data Science at Picwell, says, “Few people understand basic terms, like deductibles, coinsurance, copayments and out-of-pocket maximums. Learn these concepts before comparing your options.”Health insurance lingo can be confusing and intimidating, especially if it’s your first time purchasing health insurance. Make sure you know the terminology so that you can better understand health insurance plans and make a good choice.BestCompany’s health insurance guide has a vocabulary section that can help clarify health insurance terms. Misunderstanding the coverage Most health plans have rules about what health services they cover, especially when it comes to pre-existing conditions. Meghan Nechrebecki, MSPH, Founder and CEO of Health Care Transformation, says, “Make sure the services you know you will need are covered by the insurance plan. This can be found in the Evidence of Coverage document.”Reading the Evidence of Coverage document will help you understand what medical services are covered and help you determine if a health plan is right for you.Health insurance plans also have networks. Seeking health services from in-network providers is often cheaper than seeking them from out-of-network providers.Suzanne Garber, executive producer and director of PBS documentary “GAUZE: Unraveling Global Healthcare,” says, “It’s important for individuals to check the in-network status of all of their current/regular doctors (primary care, pediatrician, gynecologist) along with any that might be necessary in the year ahead (obstetrician, orthopedist, cardiologist, physical therapist, etc).”Some plans don’t offer out-of-network coverage. When you look at a health insurance policy, consider how much you travel in addition to whether your current doctors are covered.Good coverage doesn’t necessarily come with lower premiums. Adam Hyers of Hyers and Associates, Inc. says, “Consumers must be aware of discount plans sold today that are not actual insurance. The rates are attractive, but the coverage is very flimsy and generally won’t pay much for a serious health incident.” Misunderstanding the cost The real cost of health care and health insurance can be tricky to pin down. Suzanne Garber says, “The lack of transparency in U.S. health care makes an educated decision about selecting a health care plan very difficult and is one of the reasons we advocate for published pricing of every procedure by every health care practitioner — most other countries mandate this already.”The amount health insurance saves you can also be difficult to understand because it depends on the medical services received and the negotiated prices agreed upon by insurance companies and health care providers. These negotiated prices vary depending by insurance company and health care provider.Garber says, “Take the time to crunch the numbers and estimate what health care will really cost you based upon what your usage has been in the past and what risks or major events are likely to come up in the new year.” Understanding what you’ll need in 2022 and what that might cost will help you look at more than just the monthly premium.Rochester says, “If you don't read the information about the deductible, copays, and coinsurance, you may end up with huge medical bills that could have been avoided by paying a little more each month in premiums.”You should also consider what out-of-network services will cost. Garber says, “Don’t overlook the maximum out-of-pocket or not properly estimate any out-of-network provider charges (usually from specialist visits), which can add up quickly.”Taking time to understand the monthly premium, in-network and out-of-network costs, and out-of-pocket expenses, like copayments and deductibles can help you evaluate the value of a health insurance plan. Coinsurance The health plan you are considering may have coinsurance instead of copays. This means that you would have to pay a percentage of the bill instead of a fixed copayment amount.“Another pitfall that individuals fall prey to is the difference between a set contribution (whether co-pay or out-of-pocket) versus a percent contribution,” says Garber.Coinsurance is a two-edged sword in health insurance plans. In some instances it may be beneficial, in others it may be detrimental.Garber says, “For example, it may look that the better option for “Emergency Room” may be a co-pay of $500 instead of 20 percent, as ER visits can be quite costly. However, if an insurance company has a contracted rate with the hospital, they may receive a discount, which may then be passed on to you. An example of this is a recent ER visit, which cost ~$700. The insurance company had a 50 percent discount, which left the remainder $350, of which I owed $35—a much better deal than had I opted for the $500 co-pay option.”Nechrebecki disagrees. She says, “Avoid coinsurance! This means you have to pay a percentage of the bill instead of a defined amount. Medical bills these days can be massive and unexpected.”Understanding the difference between coinsurance and copayments will help you evaluate the cost of a health insurance plan. Health Savings Accounts vs. Flexible Spending Accounts Some health insurance advisers recommend Health Savings Accounts (HSAs) in addition to a health insurance plan. These funds are tax-deductible and can be used for medical expenses not covered by insurance. Shobin Uralil, Co-founder and COO of Lively, says, “Instead of picking the same health plan from last year, which will likely cost you more this year, consider switching to a High Deductible Health Plan (HDHP). HDHPs will likely lower your monthly premiums and get you exclusive access to a health savings account.”If you’re at a relatively healthy point in your life, choosing an HDHP to allow greater investment in an HSA could be a good option. Kina says, “Once you pay your premiums, you never get that money back, even if you don’t use any medical care. Instead, consider taking the premium savings from switching to a low deductible plan and putting it in an HSA.”Be sure to be strict with your budget and put the money you are saving by choosing a lower premium into your HSA. This can be a smart money move for paying future health care costs not covered by insurance.“HSAs are like a 401(k) for healthcare. Because HSA money is yours for life, next year, you will already have health savings to fall back on," adds Uralil.Flexible spending accounts (FSAs) are also a great option to consider along with purchasing a health insurance plan. The difference between an FSA and an HSA is that the funds in an FSA must be used within the year or the money is lost. The money in FSAs is also not tax-deductible.Knowing the dates and understanding health insurance terms, the cost of plans, and the coverage they provide will help you make sure you have coverage and choose the best health insurance policy for you. Looking for more advice? View our article "4 Ways to Prepare for Open Enrollment" and Important Things to Know section.

Updated September 10, 2021. Open Enrollment for 2022 health insurance coverage is just around the corner. It starts November 1, 2021 and continues through December 15, 2021. You won't want to miss it. If you do, you will be unable to enroll in health insurance for 2022 unless you qualify for a special enrollment period.Health insurance can help defray the costs of medical care. Many employers make health insurance available to their full-time employees. If your employer offers health insurance as part of a benefits package, you should be getting information from them about how to enroll during open enrollment.If you do not have health insurance through an employer, you can purchase health insurance independently through government-run exchanges or by working directly with health insurance companies. Navigating the health insurance industry can be daunting, especially for those purchasing health insurance independently for the first time. Following the tips below will help you purchase health insurance confidently. Do your research This suggestion almost goes without saying. Before making a choice as significant as choosing a health insurance policy, you should understand your options and what kind of health insurance coverage you need.“It is important to spend some time researching the various options each year to find the one that is best for you,” says Dr. Nicole Rochester, MD, physician, private health advocate, and CEO of Your GPS Doc, LLC.Many resources are available to give you more information about health insurance. HealthCare.gov is a great resource with information about the laws governing health insurance. Some states have their own online health insurance marketplaces. Through the marketplace websites, you can see health insurance options and see if you qualify for a government subsidy or a government health insurance program, like Medicaid.It may also be useful for you to talk to an independent health insurance broker or financial planner to receive personalized advice about purchasing health insurance. Consider your health needs Do an assessment of your health needs to better understand what kind of coverage you should purchase. Health Care Transformation founder and CEO Meghan Nechrebecki, MSPH, says, “Weigh your options by writing down your expected utilization in the coming year (all clinic visits, prescriptions, potential emergency room visits, surgeries, hospitalizations) and then calculating the expected costs based on the deductible, premiums, coinsurance, and copayments.”Taking into account how you used your health insurance this year can help you predict your health needs for 2022.Nechrebecki adds, “You might want to also take into consideration the what-ifs (what if I get in a car accident, etc.), not just expected utilization.”In addition to considering potential unexpected events, it’s a good idea to think about how your or your family’s health may be different now than in previous years. “No one likes change, and health insurance is incredibly confusing. As a result, most individuals merely auto-enroll in the same health insurance plan year after year, without doing research to ensure that plan is still the best option for them and their family,” says Rochester.It’s also a good idea to think about your current doctors. Adria Gross, founder of MedWise Insurance Advocacy and New York State-licensed insurance broker and consultant, suggests asking: “Are your medical providers, doctors, therapists, hospitals, and medications on the health insurance plans available to you?”If you travel frequently, you may want to make sure your insurance plan has out-of-network coverage. Some health plans have strict rules about out-of-network coverage. Other plans don’t offer out-of-network coverage.Taking the opportunity to review your health needs and this year’s use of health insurance benefits will help you better predict the kind of coverage you need for 2021. It will also help you evaluate your health insurance options better. Know what’s affordable Gross recommends answering these questions as you review the cost of a health insurance policy: What is your current income and your monthly expenses? What health insurance subsidies are offered through your state? What are the copays and deductibles? How much is the premium? As you look at your current expenses, think about ways you can shift your budget to purchase health insurance or pay for an unexpected medical bill. Nechrebecki adds, “Make sure to weigh your options by adding up the upfront costs (premiums) with backend costs (deductible, coinsurance, and copayments) of expected utilization.”Understanding the full cost of health insurance and the cost of medical bills will provide a better picture of the costs and savings of your health insurance.Investigating your options for purchasing health insurance from state-run marketplaces — including what subsidies you qualify for — can also help you find more affordable insurance. Understand your options Considering all of your options when enrolling in health insurance is important, even when you’re not purchasing health insurance independently for the first time.“It is possible that your health or that of your spouse, domestic partner, or children has changed over the years. As your health needs change, the insurance plan you've had for years may no longer be the most cost-effective. In addition, the plans themselves change,” says Rochester.Health insurance plans and their availability change year-to-year. Changes to health insurance law, government policy, or company changes affect your options for health insurance.Options within the United States include the following: Government-provided health insurance (Medicaid, Medicare, CHIP, and others) On-exchange plans (sold on state-run marketplaces) Off-exchange plans Government-provided Health Insurance The government provides health insurance to certain qualifying groups: Veterans Children Elderly (65+) Low-income individuals and families People in these groups and meet other requirements can receive health insurance through the government. The Veterans’ Affairs Office takes care of U.S. military veterans. Medicare is for elderly U.S. citizens. Original Enrollment in Medicare occurs during the time that an individual turns 65. Open Enrollment for 2022 began October 15, 2021 and will continue until December 7, 2021.Medicaid plans are available to low-income individuals and families. Some insurance companies offer these plans. CHIP (Children’s Health Insurance Program) provides coverage for children whose families do not qualify for Medicaid. People enrolling in Medicaid or CHIP do not have to enroll during open enrollment; they can enroll at any time.On-exchange Plans (Marketplace Plans)On-exchange plans are sold on government-run health insurance websites. These plans have to cover basic health services, like preventive care, maternal and child care, mental health, and emergency room visits. Marketplace plans can have lower premiums for those with pre-existing conditions or come with government subsidies.Jack Glasker, Designated Partner at Affordable Healthcare Solutions, LLP, says, “Determining whether marketplace coverage makes sense depends on your income, which is roughly calculated as the adjusted gross income of the policyholder and all others who file on the policyholders tax return. If the resulting income falls below 400 percent of the Federal Poverty Level, you could qualify for an Advance Premium Tax Credit (APTC) that lowers the cost of your monthly premiums for insurance coverage.”An Advance Premium Tax Credit is an advance of the next year’s tax return that can be applied to your health insurance premium payment. Any difference between the amount of money you used for an APTC and the amount of money you were supposed to use will be reconciled when you file taxes.Even if you don’t qualify for an APTC, it still may be beneficial to enroll in a marketplace plan. “If your income is below 250 percent of the FPL, cost-sharing, like help paying copays, coinsurance, and deductibles, on silver-level plans also exists,” says Glasker.Off-exchange PlansOff-exchange plans are still required to cover essential health services like on-exchange plans. However, off-exchange plans do not have to meet all of the requirements that on-exchange plans do.In some circumstances, an off-exchange health insurance policy may be less expensive. Off-exchange options can be found by contacting insurance companies directly.As will all health insurance policies, make sure that you understand the specifics of your health insurance coverage and the cost before making the final decision to enroll. Health insurance is an important expense, and you want to be confident in your choice.Need more Open Enrollment tips? Check out these articles: Pitfalls to Avoid During Open Enrollment 4 Things to Look for In a Health Plan