Planning your health insurance next year

Smart Money looks at the coming changes and makes suggestions:

Plan for price hikes
The rising cost of medical care and new requirements of the reform bill are expected to increase employers’ health costs by about 9 percent next year. To compensate, experts say, firms will raise co-pays and deductibles, the amount paid out of pocket before coverage kicks in. According to the consultancy Mercer Health & Benefits, about 20 percent of companies are also considering making employees with more dependents pay a larger share. For people who could be covered under a spouse’s plan, Barry Schilmeister, a partner with Mercer, suggests doing a fresh comparison to find out whether switching might mean more savings.

Is your doctor in?
Many doctors and hospitals are being “very aggressive” in their negotiations with insurers this year, says Dean Hatfield, national health practice leader for Sibson Consulting, so employees shouldn’t assume their current MD and hospital are still in their insurance network. Those who lose a favorite practitioner may want to opt for a plan with good out-of-network coverage. Another change to look out for: In 2011 the pretax flexible-spending accounts used to cover extra health expenses can no longer be used for over-the-counter drugs unless a doctor writes a special prescription.

Check for new benefits
Not all changes will hurt. Hatfield estimates as many as one in five employers will offer plans with incentives designed to keep employees healthy—like waived co-pays for the inhalers that help asthmatics keep their disease in check. Many employer health plans will be required by law to make other consumer-friendly changes as well, including reimbursing patients equally for emergency room care received at both in-network and out-of-network hospitals.