Navigating health insurance during open enrollment can feel overwhelming, but it doesn’t have to be. With so many plans, terms, and deadlines to consider, it’s easy to feel unsure about making the right decision. The truth is, choosing a health insurance plan doesn’t just impact your finances—it affects your ability to access the care you need throughout the year.

That’s why making informed choices during open enrollment is so important. The wrong decision could leave you paying too much for coverage you barely use or, worse, stuck with a plan that doesn’t meet your needs. On the other hand, the right plan can help you save money, stay healthy, and avoid unexpected surprises when you need medical care the most. In this guide, we’ll share 10 must-know tips to help you select the perfect health insurance plan. From understanding the fine print to balancing costs with benefits, these tips will empower you to navigate open enrollment like a pro. By the end, you’ll feel confident in choosing a plan that works best for you and your family.

Tip 1: Assess Your Past Healthcare Usage

Before choosing a new plan, take a moment to review your past year’s healthcare needs. Start by looking at how often you visited the doctor, what kind of treatments or procedures you had, and any medications you regularly take. By understanding your typical healthcare usage, you can better estimate what type of coverage you need, helping you avoid plans that either under- or over-insure you. If last year was filled with frequent visits or recurring prescriptions, you might want a plan with lower out-of-pocket costs. But if you rarely used medical services, a higher deductible plan with lower premiums might save you money.

Tip 2: Anticipate Upcoming Needs

Planning for the year ahead is just as important. Think about any major life changes or health events you anticipate, such as surgeries, pregnancy, or changes in prescription needs. Even if you’re generally healthy, it’s wise to account for preventive check-ups and screenings, which are usually covered by most plans but may still involve out-of-pocket costs. Considering these factors upfront will help you choose a plan that provides the right coverage without costing you more than necessary.

Tip 3: Learn the Differences Between HMOs, PPOs, and EPOs

Health insurance plans often fall into one of three types: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs).

• HMOs generally have lower premiums and require you to use a network of doctors, with referrals needed for specialists.
• PPOs allow for more flexibility, giving you access to a broader network and the option to see out-of-network providers, though they often come with higher costs.

EPOs are a middle ground, offering slightly more flexibility than HMOs but still limiting coverage to in-network providers.
Understanding these distinctions can help you determine which plan aligns with your healthcare habits and preferences.

Tip 4: Balance Premiums and Out-of-Pocket Costs

When comparing plans, don’t just focus on the monthly premium. Consider the deductible, copayments, and coinsurance as well. Plans with lower monthly premiums often come with higher out-of-pocket costs, while higher premium plans typically have lower costs when you receive care. Think about whether you’d prefer to pay more upfront in exchange for reduced costs when you visit the doctor or if a lower premium with higher per-visit expenses better suits your budget.

Tip 5: Understand Deductibles, Copays, and Coinsurance

Understanding the terms that impact your healthcare costs can prevent surprises down the line. The deductible is the amount you pay out of pocket before your insurance kicks in, copays are fixed fees for services (like doctor visits), and coinsurance is the percentage of costs you pay after meeting the deductible. Each of these factors impacts the total amount you’ll spend on healthcare, so knowing what they mean helps you choose a plan that’s financially realistic.