Open Enrollment Checklist: 7 Things to Review Before Picking a Health Plan

Open enrollment is your annual window to choose or change your health insurance. Miss it, and you're locked into your current plan (or left uninsured) until the next enrollment period. Here's what to review before you decide.

Before anything else, confirm that your primary care physician, specialists, and preferred hospital are in-network for any plan you're considering. Out-of-network care can cost significantly more — or may not be covered at all.

Each plan has a formulary — a list of covered drugs and their cost tiers. If you take regular medications, look up each one in the plan's formulary to understand what you'll pay. A plan with a lower premium but higher drug costs may end up costing more overall.

The monthly premium is just one piece of the puzzle. Also consider:

• Deductible — what you pay before insurance kicks in
• Copays and coinsurance — your share of costs after the deductible
• Out-of-pocket maximum — the most you'll pay in a year

A high-deductible plan with a low premium may make sense if you're healthy and rarely use care. A lower deductible plan may be worth the higher premium if you have ongoing health needs.

If you choose a High Deductible Health Plan (HDHP), you may be eligible for a Health Savings Account (HSA). HSA contributions are tax-deductible, grow tax-free, and can be withdrawn tax-free for qualified medical expenses. It's one of the best tax advantages available.

Are you planning any major medical events in the next 12 months? Surgery, pregnancy, or ongoing treatment should factor into your plan choice. A plan with a lower out-of-pocket maximum may save you money if you expect significant healthcare use.

Most health plans don't include dental or vision coverage. If you need glasses, contacts, or regular dental work, check whether standalone dental and vision plans are available — they're often affordable and worth adding.

Don't just default to last year's plan. Carriers adjust premiums, networks, and formularies every year. Take 20 minutes to compare your top three options side by side before enrolling.

Not sure where to start? Our licensed health insurance advisors can walk you through your options and help you find a plan that fits your needs and budget — at no cost to you.