Signing Papers

Open Enrollment: How to Get the Most Out of Your Benefits

Your health care plan is about much more than simply going to the doctor and getting medication when you get sick. Medicare and most commercial plans offer a number of benefits that can help you stay healthy and save money.

Not every plan offers all of these benefits, so you should contact the number on the back of your health care ID card or visit your plan’s website before you schedule an appointment.

Preventive services

Little Girl Getting Vaccinated

Did you know there are a number of services that you can get that will keep you and your entire family healthier – and they’re at no cost to you? Under the Affordable Care Act, health care companies cover what are called preventive services. They’re called preventive services because they can help prevent illness and disease.

All in all, there are 15 covered services for children and adults, and they include:

  • Blood pressure screening
  • Cholesterol screening
  • Type 2 diabetes screening (for adults with high blood pressure)
  • Age-appropriate immunizations for hepatitis A & B; HPV; measles, mumps, and rubella; and many others
  • Tobacco use screenings and cessations interventions for tobacco users

You should always check coverage with your plan. You’ll still have to see a doctor that is in your network to get these services, but it’s well worth your time.

No-cost wellness services

Yoga mat

Many plans offer free programs to help members achieve important health goals, such as losing weight, becoming more active, cooking and eating healthier, or reducing stress. For example, your plan might offer you a weight loss program that allows you to log your weight and get easy-to-use tips, recipes, exercise videos, and words of encouragement.

These health and wellness programs are designed to be fun and easy to use, even for those who may be new to healthy habits.

Mental health care

Happy Guy

We all know how important your mental health is, and the affect it has on your body and your family. Many insurance plans, including Medicare Part B, provide coverage for members to see a specialist, such as a psychiatrist or someone who specializes in substance abuse.

And FYI, a depression screening with your primary care doctor is considered a preventive screening. See them first and get recommendations for next steps.

Special screenings for moms-to-be

Mom Playing with Her Baby

You and your health plan both win when you have a happy, healthy baby. That’s why plans are required to cover special preventive services for women who are either currently pregnant or trying to get there. Besides health screenings for conditions like anemia and gestational diabetes, you should be covered for lactation support and breast pumps.

Nurse Line

Nurse With Call Headband

It’s 3 am and your six-year-old just woke you up with a cough and a temperature of 99 degrees. Maybe it’s nothing, but you’d sleep better if you could get some advice. Call the nurse advice line. It’s a great way to avoid an expensive trip to the emergency room, and you can get help right when you need it.

Your health plan’s nurse advice line is available 24/7. Call them anytime to talk to a licensed, registered nurse to find out more about common health issues. You can also call the AltaMed nurse advice line at (866) 266-5092.

If you’re experiencing a true medical emergency, call 9-1-1 or go to your nearest emergency room.

Save on your medication


If you have prescription coverage, you can save even more with generic drugs. In most cases, they are totally identical to the “name brand,” at a fraction of the cost. Be sure to ask your doctor or pharmacist about them.

Many health care plans also offer mail order services. In some cases, you could pay less for your prescriptions. Even if you don’t, you’re still saving several trips to the pharmacy.

Still need some help for Open Enrollment?

AltaMed is here to walk you through your Open Enrollment options for free. Let us help you make smart choices to help you and your family grow healthy.

Get help in English: 833-444-5560
Get help in Spanish: 833-444-5570

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See how AltaMed Health Services can help your family grow healthy.

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For Your Health: 6 Top Questions About Open Enrollment

We’re dedicated to helping everyone get the care they need to grow healthy—and that means empowering you to make the best decisions about you and your family’s health. We’ve answered some of your most important questions about the insurance Open Enrollment period.

Don’t forget, we’re here to help, and we can walk you through your options for free.

Get help in English: 833-444-5560
Get help in Spanish: 833-444-5570

What is Open Enrollment?

Couple on Couch

Open Enrollment is a period of time when you get to make important decisions about your health care and your insurance coverage for the next calendar year. You can stay on the plan you’re on, but you can also choose a new plan that works better for your budget or your health needs.

The plan you pick can have a big impact on you: it will affect how much you pay for a doctor’s visit or prescription, which treatments and services are paid for, and which doctors you can see.

When is Open Enrollment?

Medical Calendar with a Hearth

It depends on what kind of insurance or medical coverage you have. If you get your benefits through Medicare, your Open Enrollment period runs from October 15 to December 7. If you get your care through Covered California, your Open Enrollment period runs from October 15 to January 15.

Why Does It Matter to Me?

Senior Woman Getting a Ticket

Open Enrollment is really important! It is your chance to get the best care for you and your family. Which plan you choose affects:

  • The price of your premiums, or the amount you pay every month for your plan
  • Which doctors and hospitals you can see
  • How much you pay for your care, including office visits, prescriptions, and other services
  • How much you will have to pay out of your own pocket for the entire year
  • If you can get certain kinds of care (for example, dental or optometry visits)

What Happens If I Don’t Choose?

Man Signing Documents

If you already have insurance or Medicare, you will likely continue with the same plan you were already on. If you are on a plan through Covered California or your employer, and your plan goes away, you will automatically get assigned to a plan that offers similar coverage at a similar price.

What Happens If I Don’t Have Coverage and Miss the Deadline?

Patient Happy with His Doctor

If you are at a job and are offered coverage but miss your deadline, you won’t be able to enroll until the following year. But if you have certain life events, like getting married or having a baby, you may qualify for a special enrollment period. You can also get a short-term plan or you may be eligible for Medicaid or Children’s Health Insurance Program (CHIP).

The same is true for Covered California.

If you miss your deadline to sign up for Medicare, you can enroll during the General Enrollment Period that runs from January 1 to March 31 every year. Unfortunately, your coverage won’t start until July 1.

How Can I Learn More?

AltaMed is ready to walk you through your options for free. We’re right here to answer any questions, and to help you grow healthy, every day, at any age. Learn why AltaMed is your best choice and get started today.

Get help in English: 833-444-5560
Get help in Spanish: 833-444-5570

Woman Smiling at 50

Health Screenings After 50

Even if you’ve lived a healthy life, as you enter your 50s, your risk of developing chronic diseases, such as arthritis, heart conditions, cancer, diabetes, and even depression increases. These diseases can take years off your life, as well as affect the quality of your life.

Getting regular screenings can help you:

  • Lower your risk of chronic disease or illness
  • Save money on your medical costs, since chronic diseases require additional medical care
  • Delay or prevent illness or disease by catching them early and treating them

Basically, there’s every reason for you to take charge of your health, especially since most preventive services and screenings are covered by most insurance plans, including Medicaid and Medicare!

Know What Tests You Need

These are a few of the most common screenings you need starting at age 50:

  • Women should get a mammogram every 2 years
  • Colorectal cancer screenings every year
  • Regular diabetes screenings
  • Lipid disorder screenings to monitor blood cholesterol
  • Osteoporosis screenings should start at age 60 to screen for healthy bones

The best way to stay healthy and keep up on your screenings is to get regular health checkups. Depending on your gender and your family health history, your doctor may recommend additional screenings for you.

Call us for more information about the health screenings you need at (888) 499-9303.

Open Enrollment: How to Get the Most Out of Your Benefits