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How to navigate open enrollment

October 17, 2019 | UCI Health
uci health physician d sajee lekawa
UCI Health internal medicine physician Dr. D. Sajee Lekawa answers your questions about open enrollment.

When it comes to choosing a healthcare plan, we each have different needs and priorities. Many employers and insurance companies offer an enrollment period each fall to renew or revise your health plan for the coming year.

UCI Health primary care physician Dr. D. Sajee Lekawa says open enrollment affords you the opportunity to consider whether you’re satisfied with your current plan and what you want from a health provider.

Lekawa, medical director at UCI Health — Tustin, answered the following questions about open enrollment:

Should people reconsider their health insurance and provider each year?

Yes, you want to make sure that you’ve been happy with the care you’ve received in the previous year. Be proactive about changing if you haven’t been satisfied. You have choices and you want to do everything possible to pick the provider who is right for you and your family.

What should I consider when choosing a health plan?

Prioritize what you want in a primary care physician and in a healthcare network.

Do you want your provider to be close to your work or home? Will you want an array of specialists to choose from?

The most important thing is to choose a primary care doctor who understands you and makes you feel at ease, because this will be the physician you’ll see first and most often.

What should I consider if I’m a first-time Medicare beneficiary?

More than just selecting a primary care network, you will want to look at your specialty care network and the hospital these physicians are affiliated with.

You should feel comfortable going to the facilities and doctors who will provide you the best care. If you already see specialists and you’re happy with them, make sure they’re in your network.

Why do I need to choose a primary care provider during open enrollment?

Your primary care provider is your go-to person. You need to make sure you have good and timely access to the physician you’ll see for acute problems and the one who’ll coordinate all your care.

If you were feeling sick and found that you couldn’t see your doctor for a few weeks, it may be time to consider switching to a different primary care provider. Remember, though, you can change your doctor within a network before the 15th of the month at any time during the year.

You can only change your health insurance plan during open enrollment.

What qualities should patients look for in a primary care provider?

The No. 1 thing to consider is that they connect with you and make you feel confident they’re caring for you in the way you want.

What are the benefits of choosing a primary care provider who is part of UCI Health?

We provide access not only to primary care services but also to UCI Health specialty care providers. With our referral process, you don’t have to call individual specialists. Instead, the patient is contacted to schedule an appointment.

Some of our UCI locations provide:

What does it mean to receive care at an academic medical center?

UCI Medical Center is Orange County’s only academic center, and home to its only Level 1 trauma center and only National Cancer Institute-designated comprehensive cancer center. It is where other hospitals send their most difficult cases. It is where community physicians send patients who need more complex, specialized care.

Through UCI Health’s network of specialists, you also have access to this higher level of care. It is where the future doctors of Orange County are trained.

What else separates UCI Health from other networks?

Because we are part of an academic medical center, I have patients who are enrolled in clinical research trials, studies of new therapies that are not offered at other nearby hospitals and medical centers.

What’s the best way to learn more about UCI Health?

Our website offers news and feature stories highlighting our new treatments, research, awards, honors and where you can find us. We are expanding to serve more people throughout Orange County.

Important open enrollment deadlines

Open enrollment periods for 2020 health plan coverage are: 

  • Medicare: Oct. 15–Dec. 7, 2019 (First-time beneficiaries have a seven-month initial enrollment period to sign up for Part A and/or Part B).
  • Insurance through your employer: Check with your employer because open enrollment dates vary.
  • Covered California: Oct. 15, 2019–Jan. 15, 2020.

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