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Your Guide to Choosing a Health Insurance Plan

Even though there are so many options available and a limited window for enrollment, choosing a health insurance plan doesn’t have to be hard. We’ve put together this handy guide to help you feel empowered to choose the best plan for you and your family without feeling rushed or overwhelmed.
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Decide where to get your health plan

Employer

Many people get their health insurance through their employer since employers often pay part of the premium. If you have this option, talk to your employer about what’s available to you.

Marketplace

If you don’t get health insurance through your employer or would rather have a personal plan, you can shop for health insurance through the state or federal Marketplace.

Direct Purchase

If the Marketplace isn’t for you, you can also buy health insurance directly from a health insurance company. Many health insurance companies allow you to explore the plan options available to you online or over the phone with a licensed insurance agent.

Factors to compare between plans

When comparing plans, there are a few factors you’ll want to take into consideration: network, cost and benefits.

Network

Look at each plan’s network and determine if your preferred providers are in-network. If your doctor is not in-network with a plan you are considering but you want to continue to see them, you may want to consider a different plan. You can always ask your doctor directly if they take the health plan you’re considering. If you don’t have any preferred providers, look for plans with large networks and doctors near you.

Cost

Examine the out-of-pocket cost differences between plans, including the deductible, copayments, and coinsurance of each plan. While a low premium can be appealing, it may lead to higher out-of-pocket costs, especially if you have a chronic condition or frequently need emergency care or extra visits with a doctor. However, if you know you’re in good health and don’t often need medical care, paying a higher premium may not be the right fit for you. Balance cost and coverage according to your financial and medical needs.

Benefits

While benefits are not often as important as a factor as network and cost are, it can be helpful in narrowing down your options. Compare the summary of benefits for each plan option you’re considering. See if any of your plans offers a wider range of services, like coverage for mental health care, fertility treatments or emergency coverage. If so, you’ll want to choose the plan with the benefits that help you and your family the most.

Questions to Ask

If you think you’ve found the right plan for you, make sure you run through the following questions to help confirm it’s a good fit for your needs. It can even help to contact the plan’s customer service line or a licensed agent to ensure you’re able to answer these questions fully.

  • Does this plan include my preferred doctor, hospital and/or clinic?
  • Are my medications or prescription drugs covered under this plan?
  • Is my pharmacy in-network with this plan?
  • Does this plan cover my ongoing health care needs or any planned needs, like upcoming surgeries or maternity services?
  • What coverage do I have with this plan while I’m traveling?
  • Does this plan offer any additional benefits, tools or support to help me maintain a healthy lifestyle?

Learn More About Health Insurance

  • When and How to Enroll >

    Find out more about the enrollment process, including when you're able to enroll and how to get a health insurance plan.

  • Affordable Care Act >

    Learn more about the Affordable Care Act, or Obamacare, and how it could help you get more affordable health insurance coverage.

Policies have limitations and exclusions. The amount of benefits provided depends on the plan selected and the premium may vary with the amount of benefits selected.

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