During Open Enrollment, Choose Providence.

Open Enrollment is a limited period each year to enroll in or make changes to your health insurance plan.

Whether you’re signing up for the first time or reviewing your current coverage, this is your opportunity to:

• Add or remove dependents
• Confirm your current plan still fits your needs
• Switch health plans

Timing depends on your type of coverage:

• Covered California: Open Enrollment usually runs from November 1 to January 31.
• Employer-sponsored plans: Your company sets dates to sign up or make changes, typically in the fall. New or adjusted coverage usually takes effect on January 1.
• Medicare: Annual enrollment runs from October 15 - December 7.

Outside of this timeframe, plan changes are only allowed if you qualify for a Special Enrollment Period.

Changes to your health plan generally aren’t allowed after Open Enrollment – unless you experience a qualifying life event that makes you eligible for a Special Enrollment Period.

A Special Enrollment Period is a 60-day window when you can enroll in or make changes to your plan outside the standard Open Enrollment Period.

Common qualifying life events include:

• Birth or adoption of a child
• Change in marital status, like marriage, divorce or death of spouse
• Gaining U.S. citizenship or legal residency
• Loss of other health coverage
• Moving to a new area or ZIP code

If any of these scenarios apply to you, contact your HR department, insurer or state marketplace to start the process of updating your plan.

Most people choose between two types of plans: HMO and PPO. Each has different rules, benefits, costs and levels of flexibility:

• Health Maintenance Organization (HMO): You’ll choose a primary care provider (PCP) who coordinates most of your care. You’ll need a referral from your PCP to see specialists, and you must use providers in your plan’s network. HMOs usually have lower monthly premiums and out-of-pocket costs than a PPO.
• Preferred Provider Organization (PPO): You won’t need a referral to see specialists and can often go out-of-network if needed. PPOs offer more flexibility but generally have higher costs.

If you prefer to manage your care independently and want flexibility in choosing doctors, a PPO may be a better fit.

If keeping costs down is more important, an HMO might be the way to go.

When you choose a plan that includes Providence, it ensures access to our full network of hospitals, clinics and trusted providers.

Here are simple ways to verify whether Providence is in-network for the plan you’re considering:

• Ask your HR representative during employer Open Enrollment
• Call your insurance provider’s member services line
• Use the provider directory on your health plan’s website

Remember, even if you select a PPO plan, you’ll save more when using in-network providers. Always confirm in-network status before selecting or renewing a plan.

Choosing the right plan isn’t just about the premium. Here are key factors to evaluate when comparing plans:

• Added benefits: Some plans offer extra support like virtual visits, behavioral health care, wellness incentives or access to digital tools. These features can improve convenience and value.
• In-network providers: Are your current doctors, specialists or preferred hospitals covered by the plan? Staying in-network helps you avoid higher costs.
• Total cost of care: Understand all elements of cost, including:
• Co-pays and co-insurance, the amount that you’re responsible for paying when you visit a provider
• Deductibles, the cost that you pay before your plan starts covering services
• Out-of-pocket maximum, the most you’ll pay in a year regardless of the care that you receive
• Premiums, the amount that you pay monthly
• Your expected needs: Think about any planned procedures, medications or family changes in the year ahead. Are prescriptions covered? Does the plan support maternity, mental health or chronic care?

Review these details to help choose a plan that works for both your health and budget.