Georgia: How to shop for healthcare like you shop for everything else | Senior Living

(BPT) – By Amanda Free, President, Anthem Blue Cross and Blue Shield in Georgia

Think about the last major purchase you made. Chances are, you didn’t simply choose the first option you saw. You compared prices, considered what you were getting for your money and thought about which choice made the most sense for you.

Choosing health coverage deserves the same attention.

For Georgians balancing the costs of housing, groceries, and other everyday expenses, healthcare affordability is another important consideration. And the financial impact can extend well beyond monthly insurance premiums.

According to KFF, 36% of U.S. adults say they have skipped or postponed needed healthcare in the past year because of cost. For Georgia families already managing household expenses, understanding healthcare coverage, and potential out-of-pocket costs can make an important difference.

That’s one reason Open Enrollment is about more than comparing monthly premiums. It’s an opportunity to look at the bigger picture: what you’ll pay for coverage, what you could pay when you need care, which doctors and hospitals are in-network, how your prescriptions are covered, and what resources are available to help you make informed decisions throughout the year.

Whether you’re raising a family in metro Atlanta, managing a chronic condition in South Georgia, or balancing work and family responsibilities in other communities across the state, understanding your healthcare options can help you make choices that fit your needs and budget.

As you compare your options, here are five things to keep in mind.

1. Know the terms that affect what you pay

The monthly premium may be the most visible number when comparing health plans, but it doesn’t tell the whole story.

A plan with a lower premium can look attractive at first glance, but what matters is what you could spend over the course of the year. Deductibles, copays, coinsurance, and the out-of-pocket maximum can all affect your costs when you actually use your benefits.

Instead of asking only, “What will this cost me each month?” consider asking, “What could my healthcare cost me over the course of the year?”

Think about the care you and your family typically use. Do you regularly see specialists? Take prescription medications? Expect a procedure or ongoing therapy? A plan with a higher monthly premium may sometimes offer lower costs when you receive care.

And remember: where you receive care matters, too. Using in-network providers and choosing an appropriate care setting can make a meaningful difference in what you pay.

2. Check the network before you enroll

Most of us wouldn’t subscribe to a streaming service without checking whether it carries the shows we want to watch. Apply the same thinking to healthcare.

Before selecting a plan, check whether the doctors, specialists, hospitals, and health systems you prefer are in the plan’s network.

For Georgians, that’s particularly important given the differences in healthcare access across the state. Someone commuting across metro Atlanta, for example, may want to understand which providers are available near both home and work. In rural communities, where healthcare options may be more limited, confirming access to preferred providers can be especially important.

Don’t assume a provider who participated in your current plan will automatically participate in a new one. Provider networks can differ by plan, even when plans are offered by the same insurer.

Taking a few minutes to check before enrolling can help prevent an unwelcome surprise when you need care.

3. Put your prescriptions on the shopping list

If you regularly take medication, prescription coverage can have a significant impact on your healthcare spending.

Before enrolling, make a list of the medications you currently take and check how each plan covers them. Look at the plan’s drug list, or formulary, as well as its pharmacy network and applicable copays or coinsurance.

You may also want to check whether the plan offers options that could help lower costs, such as home delivery or lower-cost alternatives when clinically appropriate.

Even if you don’t take regular medications today, understanding the prescription benefit can help you know what to expect if that changes during the year.

4. Shop for the healthcare you actually use

There isn’t one health plan that’s right for everyone. The better question is: Which plan fits the way you and your family use healthcare?

Look back at the healthcare you’ve used recently and think ahead to what you might need next year. Consider primary care visits, specialists, behavioral healthcare, ongoing therapies, prescriptions, and any planned procedures.

Then consider something consumers don’t always think about during enrollment: where you receive that care.

For some routine or non-emergency needs, you may have several appropriate options, such as virtual care, a primary care office, an urgent care center, or another outpatient setting. Costs can vary depending on where services are provided.

Understanding those choices and using available tools to compare them before receiving care can help you get more value from your benefits and potentially lower your healthcare costs without sacrificing quality.

5. Don’t stop shopping after Open Enrollment ends

Choosing coverage is only the beginning.

We compare prices throughout the year for flights, hotels, groceries, and countless other purchases. Healthcare shouldn’t be the exception when comparison is possible and medically appropriate.

Many health plans now offer digital tools and support that can help members find in-network providers, understand their benefits, compare care options, and estimate costs before an appointment or procedure.

At Anthem Blue Cross and Blue Shield, we’re focused on making healthcare easier for Georgians to navigate by providing tools and resources that help members make informed decisions about their care.

Through the Sydney Health app, Anthem members can use the Find Care feature to search for in-network providers and compare estimated costs for certain services.

Consumers who used the Find Care digital feature saved an average of $185 and experienced a 32.7% reduction in out-of-network use.

That’s important because lowering the cost of care isn’t only about what happens when you choose a health plan. It’s also about having useful information when you’re making healthcare decisions throughout the year.

A quick Open Enrollment shopping list

Before you choose a plan, see whether you can answer these questions:

• What could I spend over the entire year, not just on monthly premiums?
• Are the doctors, specialists, and hospitals I want to use in-network?
• How are my current prescriptions covered?
• What healthcare needs do I or my family expect in the coming year?
• What resources can help me understand and use my benefits?
• Can I compare estimated costs and care options before scheduling certain services?
• If I need routine or non-emergency care, do I understand the different care settings available to me?

For Georgians, every dollar matters. While no one can predict every healthcare need or expense, understanding your coverage and the resources available to you can help reduce uncertainty and make healthcare decisions less overwhelming.

Open Enrollment gives you the opportunity to choose coverage. But getting the most from that coverage is something you can do all year long.

By understanding your benefits, staying in-network, and using available tools to compare your options before receiving care, you can make more informed healthcare decisions and take a more active role in managing what you spend.

At Anthem Blue Cross and Blue Shield, we believe making healthcare more affordable starts with making it easier to understand and navigate. When Georgians have the information and support they need, they are better equipped to find the right care, at the right place, and at the right time.

To learn more about Anthem coverage and resources available in Georgia, visit anthem.com/healthcareingeorgia.