Look, I’ll be honest with you. Choosing a health care plan ranks right up there with doing my taxes and going to the dentist on my list of “things I’d rather not deal with.” It’s stressful, it’s confusing, and somehow every year it feels like the rules have changed just enough to make your head spin.
But here’s the thing. We can’t just ignore it and hope for the best. That’s like trying to tour in a van with no insurance. Sure, it might work out fine until it doesn’t, and then you’re totally screwed.
So I sat down with Mike Anderson, owner of Anderson Benefit Partners and an actual expert in health insurance. And I gotta say, Mike made this whole mess a lot easier to understand. If you’re anything like me and find yourself dreading open enrollment every year, stick around. This might actually help.
The UCare Bombshell: When Your Insurance Company Pulls the Plug
Right before we recorded this episode, some pretty wild news dropped here in Minnesota. UCare, which services around 300,000 people in Minnesota and Wisconsin, announced they’re shutting their doors. If you’re sitting there thinking “wait, what happens to all those people?”… yeah, that was my reaction too.
Here’s where it gets even more complicated. Back in late September, UCare had already announced they were closing their Medicare Advantage plan. That affected around 158,000 Medicare beneficiaries who suddenly lost access to their plan. At the time, UCare was saying “don’t worry, our individual family plans are still good, we’re staying open for that.”
Then boom. Plot twist. They announced that Medica is acquiring those individual family plans. So if you’re a UCare member, you’ll become a Medica member, but it looks like you’ll still use your UCare card through 2026. The acquisition is supposed to happen in early 2026.
Now, if you’re freaking out about this, I get it. Your plan isn’t just going to magically become the exact same plan with a different logo. Plans aren’t apples to apples. Networks are different. Benefits are different. It’s a whole thing.
Mike explained that insurance companies typically do what’s called a “crosswalk” where they try to match you to their most similar plan. But here’s my take: don’t just accept whatever they give you. This is your health and your money we’re talking about. Take the time to actually compare what you’re being moved into against what else is available.
Why You Should Absolutely Work With a Broker (And No, It Doesn’t Cost More)
Okay, real talk. I didn’t understand this for the longest time, and it’s one of those things that feels too good to be true but actually isn’t.
When insurance companies file their rates with the state, they include a broker service fee in those rates. If you don’t use a broker, the insurance company just keeps that fee. If you do use a broker, that fee goes to them for helping you navigate this mess. Either way, you pay the same price for the plan.
Let me say that again because it’s important. You pay the exact same amount whether you use a broker or figure it all out yourself.
So why would you not use a broker? It’s like having a guide who knows the terrain versus wandering around in the dark with a flashlight. The broker’s job is to help you cut through all the noise and pick the right plan for you and your family. They don’t work for the insurance company. They work with you to find what actually fits your needs.
How to Actually Compare Health Insurance Plans
When you’re staring at a bunch of different health plans, it’s easy to get overwhelmed. There are like seventeen different numbers to look at, a bunch of terminology that sounds like it was designed to confuse you, and somehow you’re supposed to make an informed decision.
Mike broke down how he walks families through this, and it actually made sense.
Start With Your Doctors
This is huge, especially with individual family plans. The provider networks are vastly different from employer coverage. Just because you have Blue Cross through your employer doesn’t mean individual Blue Cross plans have the same network.
If you have a relationship with a provider you like, you probably don’t want to change. And if you have a family where different people go to different healthcare systems (like one person goes to Fairview, another to Allina, someone else to Health Partners, and maybe Mayo for something specific), finding a plan that covers everyone can get pretty complicated.
So step one: figure out where you and your family actually go for care. Then make sure whatever plan you’re considering actually includes those providers in network.
Factor in Your Household Income
This matters more than you might think. Your household income can affect whether you qualify for a tax credit, which can make a massive difference in what you’re actually paying out of pocket for your premiums.
Think About How You Actually Use Healthcare
Do you go to the doctor all the time or just for emergencies? Do you or someone in your family see a counselor or therapist regularly? Are you on prescription medications?
All of this plays into whether you want a plan with a lower deductible and higher premium, or vice versa. If you’re healthy and rarely go to the doctor, you might be fine with a high deductible plan that has lower monthly premiums. But if you know you’re going to hit your out-of-pocket maximum every year anyway, you want to look at that number carefully.
Don’t Forget About Prescriptions
Prescription drug coverage varies wildly between plans. If you or someone in your family is on regular medications, you need to check what those meds cost under different plans. Some plans might look great until you realize your $500/month medication isn’t covered or requires a huge copay.
The Hidden Costs Everyone Forgets About
Health insurance isn’t just about your monthly premium. In fact, the premium might be the smallest part of what you actually spend on healthcare in a year.
You’ve got:
- Deductibles (what you pay before insurance kicks in)
- Copays (fixed amounts you pay for specific services)
- Coinsurance (percentage you pay after hitting your deductible)
- Out-of-pocket maximum (the most you’ll pay in a year)
That out-of-pocket maximum is critical. Because if something catastrophic happens (cancer diagnosis, heart attack, major accident, baby in the NICU), you need to know what your worst-case scenario looks like financially.
Mike mentioned families with babies in the NICU, and man, that hit home. A baby in the NICU can cost $3,000 a day. If your kid is in there for 80 or 110 days, you’re looking at potentially over a million dollars. Without insurance, what would you even do? Seriously, what’s the plan there? There isn’t one.
The Cash Pay Debate: Can You Just Skip Insurance?
We touched on something interesting during the conversation. Sometimes if you pay cash for a doctor’s visit, it can actually be less expensive than using your insurance because of how the billing works.
But here’s the catch. If you’re thinking “well, I’ll just pay cash for everything and skip insurance,” you’re playing a dangerous game. Sure, you might save some money on routine visits. But what happens when you need a specialist? What happens when you have that major health event?
Insurance isn’t just about paying for care. It’s also what secures your appointment with specialists and providers. Without insurance, getting in to see a cardiologist or oncologist or getting scheduled for necessary procedures becomes a lot harder. Providers know insurance is their guaranteed payment.
So yeah, I’m not saying you should never ask about cash prices. Sometimes it makes sense for specific things. But going completely without insurance? That’s a risk I wouldn’t take.
Healthcare Costs Are Out of Control
Look, we all know healthcare in this country is expensive. Like, ridiculously expensive. And it’s not just about insurance companies being greedy (though let’s be real, there’s plenty of that).
Mike pointed out something important. We’re a capitalist society, so there’s a profit center in every piece of the healthcare system. The care delivery side. The insurance side. The pharmaceutical side. Every single piece has someone trying to make money off it.
And yeah, there’s a lot of bloat, fraud, waste, and abuse in the system that’s inflating costs for everyone. We’re probably spending money on things as a society that we really shouldn’t be.
This is a much bigger conversation than just “how do I pick the right health plan.” But it’s worth acknowledging that the system is kind of broken, and we’re all just trying to navigate it the best we can.
Key Takeaways for Open Enrollment
Mike gave some solid advice for anyone going through open enrollment right now:
Take a few minutes every year to review your plan. Yeah, I know it’s not fun. But circumstances change. Your health changes. Available plans change. What worked last year might not be the best option this year.
Don’t just let your plan auto-renew without looking at it. Most of the time, plans will automatically renew. But not always. And even if it does renew, are you sure it’s still the best option? Especially if you’re on the exchange (MNsure or healthcare.gov), weird stuff can happen. Plans change. Networks change. You might get pushed to a county or state program if your eligibility changes.
Leverage the advice of a professional. Seriously, why wouldn’t you? It doesn’t cost you anything extra, and you get someone who does this for a living helping you make sure you’re not missing something important.
If you need to find a broker and you’re in Minnesota, Mike’s your guy at Anderson Benefit Partners. If you’re outside Minnesota, he recommends going to nabip.org (that’s the National Association of Benefit and Insurance Professionals). They have an agent finder tool, and those are the people who are highly engaged in their profession.
Don’t Just Accept Whatever They Give You
Here’s the bottom line. Health insurance is complicated, yes. But it’s also too important to just blow off or accept whatever gets handed to you.
Your health and your money are on the line here. Whether you’re dealing with a plan change because your insurance company is shutting down, or you’re just going through regular open enrollment, take the time to actually look at your options.
Work with a broker if you can. They can help you navigate all the doctors, meds, networks, and costs without you having to become an insurance expert yourself.
And remember: the cheapest plan isn’t always the best plan. The plan your employer offers isn’t automatically the right choice if you can get better coverage elsewhere. And the plan you had last year might not be the right plan for you this year.
This stuff matters. Your future self will thank you for taking the time to get it right.
Now go forth and conquer open enrollment. You’ve got this.
About Anderson Benefit Partners: Mike Anderson and his team work in three main areas. Employer benefits, individual family plans for people under 65, and Medicare for seniors. You can find more information at andersonbenefitpartners.com.
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