It’s November 1(ish) and the email hits your inbox—open enrollment is officially beginning. So what exactly does that mean? Don’t worry, we’re here to break down everything you need to know about open enrollment period and how you can use insurance at Parsley Health.
Open enrollment is the time each year when you can choose your health insurance plan for the next year. If you work for a mid-sized or larger company, your employer will offer a health insurance program that you can choose to participate in or opt-out of. If you are self-employed or your employer does not offer health insurance, you are able to purchase your own health insurance through the Affordable Care Act or independent health insurance companies.
Typically it takes place between November 1 through December 15, but it can vary based on your employer. Most health insurance plans will begin on January 1 of the following year, but this can also depend on the program offered by your employer. If you’re unsure of the dates of open enrollment at your company, you can always contact your human resources department or insurance provider. Outside of the open enrollment period, you must have a qualifying life event, like a marriage or loss of other insurance, in order to make any changes to your health plan.
You can review your health insurance options during this time and choose what makes the most sense based on your current medical needs. For people under 30 with no major ongoing medical costs, high deductible plans may make more sense, because they have a lower monthly cost. The downside of a high deductible plan is the high out-of-pocket cost during major medical events.
You’ll also be able to choose if you want to set up a flexible spending account (FSA) or health savings account (HSA). Both FSA and HSA are pre-tax savings accounts you can use to pay for out-of-pocket medical expenses. Employees contribute to their accounts and sometimes the employer may also contribute.
Your employer may offer a FSA if you have a group health plan. You choose the amount you want to contribute for the year and it gets deducted from your salary before income taxes. This saves you money on taxes. FSAs are “use it or lose it,” so if you don’t use the money in your account at the end of the year, you lose it.
You’re eligible for a HSA if you have a high deductible health plan and you don’t have a FSA. It also has special tax-advantages, because money is not taxed when you earn it and put it into your HSA. It is also not taxed as it grows in your account or when you take money out of it to pay for your medical expenses. Unlike a FSA, HSA balances can grow from year to year and can even be invested.
At Parsley Health, we don’t accept insurance directly because we offer a new model of care where we spend over an hour with you in your first visit, compared with the 19 minutes a year most people spend with their primary care provider. We prescribe nutrition, sleep protocols, mental health practices, physical fitness, supplements , and offer in-depth diagnostic testing. We even include health coaching in your membership. There is no service like this today that is covered by insurance. We hope to one day change this here at Parsley Health, but until then, there are a few options that can help you pay for your care at Parsley Health by using your health insurance benefits.
Surveys suggest that around 30 percent of our members use an FSA/HSA or out of network reimbursement to pay for Parsley Health services. Because an FSA or HSA allows you to pay for medical expenses with tax-free dollars, if you fall into the 24 percent tax bracket, for instance, and pay for an annual Parsley membership upfront ( $1600) using FSA/HSA, the effective membership cost would actually be around $1216. That’s a savings of $384 just by using an FSA/HSA.
Parsley Health is an out-of-network provider. If your insurance plan covers or reimburses for out-of-network provider visits, this means you can submit invoices to your insurance company after each doctor’s visit and they usually cover part of the cost, depending on your exact insurance plan. Typical out-of-network reimbursement will refund the member anywhere from 40-70% the cost of the membership.
Every member at Parsley Health is supported by a team of Care Managers that work with members to coordinate their care. From lab and diagnostic testing and purchasing supplements to coordinating visits with your health coach and doctor- care managers are also a go-to resource for questions you may have about how to use insurance at Parsley. They can also help you get invoices that you can then submit to your insurance company for potential reimbursement.
Remember, every insurance program is different so it is best to connect with your insurance provider to clarify your benefits and take advantage of FSA, HSA, and out of network coverage.
Sara is a content creator who has worked with outlets such as Outside Magazine, Well + Good, Healthline, and Men's Journal, and as a journalist at Shape and Self and publications in Washington, D.C., Philadelphia, and Rome. She is also an ACE-certified personal trainer. She has a degree in communication with concentrated studies in journalism from Villanova University.
Outside of office hours, you can usually find her taking a dance class, trying out the latest fitness craze, or teaching and performing synchronized swimming with The Brooklyn Peaches.