Health Insurance Open Enrollment: What You Need to Know Before Choosing a Plan

Open enrollment is your annual window to sign up for or change your health insurance coverage, and making the right choice typically takes more than a quick glance at your premiums. Whether you are enrolling for the first time or reconsidering if your current plan is working for you, ample preparation can go a long way in verifying that you’re getting suitable coverage at an ideal price point.

Key Dates and Deadlines

Missing your yearly open enrollment period can leave you without coverage options until the next cycle, barring a qualifying life event such as getting married, welcoming a child into your family or starting a new job. Mark your calendar early and gather your documents before the window opens so that you’re ready to give this important task the attention it requires.

What to Compare When Shopping for Plans

Not all health plans are structured the same way. Before you decide on coverage, review these factors:

• Premiums vs. out-of-pocket costs—A lower monthly premium often means higher deductibles and copays, so weigh both against your expected health care use and ability to cover out-of-pocket bills.
• Network coverage—Confirm your preferred doctors and hospitals are in-network, as coverage for out-of-network providers can vary significantly by plan and may involve much higher costs.
• Prescription drug coverage—Check that your medications appear on the plan’s formulary, since covered drugs and cost tiers typically differ across plans.
• Plan type—Different types of health insurance policies, such as health maintenance organizations (HMOs), preferred provider organizations (PPOs) and high-deductible health plans (HDHPs), each carry different rules for referrals, specialist access and flexibility.

Employer Plans vs. Marketplace Plans

If your employer offers coverage, you may want to take time to compare it against marketplace options rather than assuming it is the better deal. Tax credits may be available through the marketplace depending on your household income, though eligibility rules apply, and you should consult a professional regarding your specific situation and options.

Making a Confident Decision

Insurance needs vary by individual, and the right plan depends on your health, budget and preferred providers. Contact MCarrillo Insurance Agency to discuss your situation and options.

This blog is intended for informational and educational use only. It is not exhaustive and should not be construed as legal advice. Please contact your insurance professional for further information.