What I want you to pay attention to are (mostly) health insurance deadlines.  Right now, those deadlines are:

• Medicare (December 7th) (additional time if you’re on Medicare Advantage)
• Federal marketplace health insurance (December 15th)
• Open enrollment at work (varies, but often mid-December)

Special note about Medicare:  For those on Medicare, you want to make sure you have the Part D (drugs) plan that makes sense for you.  Much has changed for 2025, and you want to make sure you’ve considered all your options.

Don’t go without health insurance

There are few things that cause stress in families – particularly in families with children or elders – than not having health insurance.  

Don’t let this be you.

Shopping for health insurance is not fun.  There’s no two ways about this.  In some twisted way, being “forced” onto Medicare or into taking your employer’s one crappy health plan becomes a godsend because you don’t have to sort through so many options, so much new vocabulary, so many nuances, and so many decisions.

If you don’t have an option of Medicare or your employer’s one crappy health plan, you now have to delve into the morass.  And you might be kicking yourself for procrastinating.  

Embrace the morass, get help, and get it done.

Medicare – the Mini Morass

Medicare is for those over 65 who have qualified and those with particular health conditions.  

Most of you know who you are, but some might be surprised that even though you’re working, your employer wants you to get on Medicare.  

During open enrollment, those of you on Medicare need to make decisions about:

• Whether to keep traditional Medicare, switch to a Medicare Advantage plan, and vice-versa.  
• Whether to get a Part D (drugs) plan.  (Potential lifetime penalties for getting it “late.”)
• Whether to keep the same insurer for your Medigap plan. (What Part B doesn’t cover.  Potential lifetime penalties for signing up “late.”)
• Whether to keep the same insurer and same plan for Part D.  
• Whether to pick up coverage for eyes and teeth.

While you do not need to make decisions about your Medigap plan if you are on traditional Medicare, this is a good time to consider those options.  More often than not, clients default to renewing whatever plan and insurer they had last year.  Not fatal.  But this is a chance to look at (1) premiums, (2) service levels, and (3) benefits and decide whether you like what you have. This is your opportunity to consider all these options simultaneously rather than throughout the year.

Consider:

• Whether to keep the same Medigap plan.  (Careful of medical underwriting if you change plans, depending on the state where you reside.)
• Whether to keep the same Medigap insurer.  (You can keep the same plan, for instance, Plan G, but change from one insurance carrier to another.)

If you have preferred/favorite doctors, make sure they will take Medicare. If they do, generally, any Medigap policy will work. You can also change Medigap policies at any time.

Getting help.  Your federal government means well, but its execution often leaves much to be desired.  There are great free and paid resources to help you navigate Medicare and Medigap plans, get signed up, and make changes.  

Marketplace Health Insurance

What gets most people’s attention about the marketplace insurance options is (1) premium increases and (2) health changes.  Otherwise, much like with other types of insurance, most people default to what they had last year.

If premiums have become unmanageable or your health circumstances have changed, you might reconsider what plan to take.  

Unlike with Medicare, though, I find the availability of help to be sorely lacking.  Often, you are left with searching the marketplace online and then calling individual insurers to compare plans.  This is a very tangled web of deductibles, copays, coinsurance, tiers of drugs, and in/out-of-network considerations.  

If you are eligible for premium credits, make sure you are entering the income you will receive in the same year you are receiving the insurance.  In other words, put your predicted 2025 income into the system for your choice of insurers for 2025.

Employer insurance options

Much like the Marketplace, private employer insurance can be challenging.  With any luck, there will be some appealing options right off the bat.

Consider:

• How many people need coverage on your plan?  Just you or you and the spouse and kids?
• How much will your employer help with premiums?  For no one?  Just for you?  Just a stipend?
• How much did you use your coverage last year? Could you get a more basic plan?  Might you need more coverage?
• If you have a kid at college, might it be better to use the college’s plan or yours?

What about dental and vision coverage?

I strongly encourage you to read the fine print and run the numbers.  For the amount you pay in premiums, you need to figure out whether paying out of pocket would have been worth it.  

Not all procedures (like dental crowns) will be covered in the first year.  When they are covered, the coverage is often minimal.  Two cleanings might be covered yearly, but your dentist might want you to come in every four months.  

Vision insurance may cover frames, but the lenses might cost you a fortune.  

Rarely have I run the numbers and thought dental or vision insurance was worth it.  And always ask for a discount if you are paying in “cash” or are “self-pay.”  It never hurts to ask.

Health Insurance is Manageable

You can do this. Don’t just default to last year’s plan.  Don’t just follow what your officemate is doing.  Take the hour or two it will take to make good, conscious decisions for your family. 

If you have any questions or need support, contact us.

Lanning Financial Inc. is a registered investment adviser. Information presented is for educational purposes only and does not intend to make an offer or solicitation for the sale or purchase of any specific securities, investments, or investment strategies. Investments involve risk and unless otherwise stated, are not guaranteed. Be sure to first consult with a qualified financial adviser and/or tax professional before implementing any strategy discussed herein. Past performance is not indicative of future performance.