Open Enrollment Guide: How to Pick the Best Health Insurance Plan

When Is Open Enrollment?

ACA Marketplace (Healthcare.gov): November 1 through January 15. Employer-sponsored plans: varies by employer, typically October-November. Medicare: October 15 through December 7 (Annual Enrollment Period). Missing these deadlines means waiting until next year unless you have a qualifying life event.

Step 1: Estimate Your Healthcare Usage

Review last year's medical expenses. How many doctor visits, prescriptions, and procedures did you have? Are any surgeries or major procedures planned? If you're generally healthy with few prescriptions, a high-deductible plan may save money. If you have chronic conditions or planned procedures, a richer plan with higher premiums but lower out-of-pocket costs is often cheaper overall.

Step 2: Calculate Total Annual Cost

Don't just compare premiums. Calculate: (monthly premium x 12) + expected deductible spending + expected copays/coinsurance. A $400/month plan with $1,000 in expected copays costs $5,800/year. A $300/month plan with $3,000 in expected deductible costs $6,600/year. The cheaper premium isn't always the cheaper plan.

Step 3: Verify Your Providers Are In-Network

Call your preferred doctors and hospitals directly to verify network participation. Online directories are often inaccurate. If your doctor is out of network, the plan may save on premiums but cost much more when you actually need care.

Step 4: Check the Formulary

Review the plan's drug formulary (covered medication list) to ensure your prescriptions are covered and on a reasonable tier. A plan that doesn't cover your $500/month medication will cost far more than one with higher premiums that does.