Choosing a Health Insurance Plan

You'll likely be considering which plan is right for you during open enrollment, when you can shop for a plan on the government’s Health Insurance MarketplaceA resource where individuals and families can: learn about their health coverage options; compare health insurance plans based on costs, benefits, and other important features; choose a plan; and enroll in coverage. .

When you’re choosing a health insurance plan, you’ll want to look at more than the premiums and deductibles to evaluate plan options. Take a look at the co-insurance amount, too, and then decide which deductible, premium and co-insurance mix is the best option for you.

Choose the plan that is right for you

There are many factors to consider when choosing a health plan. Think about both your medical and financial needs – from coverage options to monthly premiumsThe amount that must be paid for your health insurance or plan. , to co-paymentsA fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. and deductiblesThe amount you owe for eligible health care services before your health insurance or plan begins to pay. . Consider your family situation, your family’s anticipated health care needs and available plan options.

It's a good idea to assess your needs and identify your priorities so you know what to look for in a plan. Consider costs, coverage, benefits, doctor flexibility and plan limitations to help you decide which plan is right for you.

Once you know what plan options are available, you can evaluate plan options to determine which one is right for your situation. Review your plan materials – such as brochures, benefit summaries and websites – to find the details that will help you decide. Things to consider include:

• Affordability (total cost)
• Coverage and benefits
• Access to doctors and hospitals
• Exclusions and limitations
• Health and wellness resources

More control over health care spending

You may be able to pair your health plan with a Health Savings Account (HSA) that you can use to pay for qualified medical expenses. An HSA must be paired with a qualified high-deductible health plan. It allows you to put away a limited amount of pre-tax dollars to pay for eligible medical expenses. An HSA is yours to keep even if you change employers or benefits.

There’s a plan for everyone – but if you’re still not sure, consider which of these statements best describes you and your family.

• “I hardly ever go to the doctor. My main priority is keeping my monthly payments as low as possible.” A Bronze Plan might be right for you.
• “We’re trying to balance budgeted monthly payments with out-of-pocket costs for health services throughout the year.” A Silver Plan might be right for you.
• “I want to reduce my out-of-pocket expenses through the year. I think we'll be using more medical services so I don’t mind paying a bit more each month.” A Gold Plan might be right for you.
• “Considering our current health situation, we're probably going to use a lot of health services this year. I’m willing to pay a higher monthly premium to keep my medical expenses as low as possible throughout the year.” A Platinum Plan might be right for you.

Resources

• Health Insurance Basics