MDA Insurance Journal Column

How satisfied are you with the plan you now have in place? If you elected a high-deductible health plan to reduce the monthly premium and had a healthy year with few medical costs, you may be pleased with your choice. But if you or a family member had a major health problem or suffered an accident, that high-deductible plan may have put a financial crimp on your cash flow for a while. If a new diagnosis has resulted in the need to take a costly prescription drug, the type of pharmacy benefits a plan offers may be the deciding factor in which health insurance plan to select for next year.

As with most types of insurance, people need to balance their ability to pay a higher deductible and higher co-pay (like 40%/60%) in exchange for a lower monthly premium, with a plan that has less out-of-pocket exposure for unexpected medical expenses and a higher monthly premium. Sometimes, a lower premium, high-deductible health plan that provides 100% coverage once the deductible is met is a better buy than a low-deductible plan that has a higher premium and co-pay. If the previous sentence has you confused, give our health insurance department a call.

No matter what age you are, you need to have a health insurance plan. MDA members who are Medicare-eligible (age 65-plus) will be making choices about their Medicare supplement plan for 2026 this fall during the Annual Enrollment Period. MDA members will need to select a health insurance plan that covers prescription drugs no later than Dec. 15 for an effective date of Jan. 1, 2026. Adult children who were born in 1999 and are currently on a parent’s health plan will need to select their own plans for 2026. MDA members can rely on MDA Insurance to assist them with finding the right plan for their needs, whether it is the MDA Health Plan, an individual health insurance plan, a subsidized plan on the federal Marketplace, a Blue Cross Blue Shield of Michigan group health plan, or a Medicare supplement plan. We have the resources you need to choose wisely.

What is open enrollment? Generally, open enrollment is the one time of year when individuals can change health insurance carriers or plans and add eligible dependents. For employers offering group plans, open enrollment is when they can select a new carrier or change plans made available to employees and adjust employee eligibility and termination rules.

When is open enrollment? Dates vary depending on the type of product you are purchasing.

• Open enrollment for the MDA Health Plan is Oct. 1–Nov. 15. Plan sponsors (practice owners) can change plan offerings and modify eligibility and termination rules. Subscribers can elect different plans and add eligible dependents. If you are interested in offering the MDA Health Plan in your practice, please contact our health insurance department as soon as possible. Call 877-906-9924 and speak to an account executive to discuss your many options.
• Individual health insurance is coverage you purchase for yourself from carriers like Blue Cross Blue Shield of Michigan or Priority Health. Open enrollment for individual plans is Nov. 1–Dec. 15. Subscribers to commercial individual health plans can elect different plans and add eligible dependents. Open enrollment is currently expected to continue until Jan. 15, 2026, for a plan with an effective date of Feb. 1.