Finding the right health insurance plan for you
How to compare health plans
Whether you're buying insurance on the Health Insurance Marketplace® (Marketplace) or comparing plans available through your employer, picking a health plan is a big choice.
Looking at health insurance plans means thinking about your budget and your health care needs. Let's break down the most important details together so you can find the best value for your life.
Step 1: Review all costs, not just the premium
When you compare health plans, the monthly bill is usually the first number you see. This is called your premium. It is the amount you pay every month just to keep your coverage active.
The lowest premium isn’t always the best deal, though. There are a few other parts of a health plan that affect your total cost. Understanding all the costs and having a sense of the care you might need during the year can help you choose what fits your budget.
Step 2: Check if your doctors and medications are covered
It’s important to look at which doctors are in-network for each plan as you compare options.
Health plans work with specific doctors and hospitals. This is called a provider network. Using in‑network care usually costs less. Going out-of-network can mean higher costs for you or no coverage at all. As you compare plans, check if your regular doctors and nearby hospitals are in a plan's network.
If you regularly take medicine, look at plans’ drug lists. This list is a formulary. Every health plan has its own formulary, and it shows which drugs the plan helps pay for. Check if your medications are on the list and what your copay will be at the pharmacy.
Step 3: Compare metal tier plans on the Marketplace
When shopping for plans on your own, you might see plans grouped into metal tiers. The Affordable Care Act created these levels to make it easier to compare plans.
Bronze plans usually have the lowest monthly premiums and the highest deductibles. They might be a good fit if you don’t expect much care and want basic protection. Silver plans offer a middle ground. Gold and Platinum plans cost more each month, but your plan pays for a larger amount of your care, which can be helpful if you need regular treatment.
You can also check if you qualify for financial help. Subsidies[D] can lower monthly premiums and make the Silver, Gold, and Platinum plans more affordable.
How to enroll in a plan
If you buy insurance yourself through the Marketplace or directly from an insurance company, you can sign up during Open Enrollment in the fall. Certain life events, like losing coverage, getting married, or having a baby, may let you sign up sooner through a special enrollment period (SEP).[D]
If you get insurance through your job, check with your human resources team for enrollment dates.
