No matter whether you’re shopping for individual health insurance on the marketplace or through open enrollment at your employer, here are a few key things you should keep in mind to help make informed decisions and avoid costly errors.

Example: An HMO typically provides access to only certain providers while PPO plans allow more choices of doctors and can save you money on prescriptions.

1. Know Your Options

If you don’t currently have health insurance, open enrollment is the time to shop around on the marketplace and find something suitable to your budget. Many plans also provide income-based subsidies that can assist with covering monthly premiums and out-of-pocket expenses.

As you compare different options, it’s essential that you understand all of the costs involved. A monthly premium and copayments (flat fees for certain medical services) or coinsurance (a percentage of covered medical bills) should be expected of you. Most plans also feature networks made up of doctors, hospitals and other healthcare providers that have agreed to offer services at set rates; using those within this network usually saves money since your health insurer has likely negotiated discounted prices with them.

Consider what type of health care your or your family requires, for instance if they require referrals to specialists – in such an instance an HMO might be useful; otherwise Preferred Provider Organization or EPO plans offer wider selection of doctors and services without referral requirements, potentially eliminating plans that don’t meet those criteria or are too costly. Finally, narrow your choices down by eliminating plans that don’t offer doctors in your area or are too pricey.

2. Consider Your Needs

When choosing a health insurance plan for yourself and your family, it’s essential that you consider their healthcare needs carefully. Doing this can help ensure you find a plan that suits both your budget and needs – for example if you require certain services like wheelchair coverage. Furthermore, make sure your preferred doctor is included within the network to avoid paying extra out-of-network charges later on.

When considering various plans, it’s also essential to factor in all associated costs. Deductibles, co-pays and premiums all impact how much money will need to be spent annually on healthcare services. When choosing between small or large insurers it may also be worthwhile considering which has more doctors/providers with higher premiums as large companies often boast larger networks but may have higher premiums.

Similarly, to save on healthcare expenses it may be worth exploring options such as Health Spending Accounts (also referred to as HSAs). HSAs allow you to set aside tax-free funds that you can then apply towards medical costs – both out-of-pocket expenses can be reduced and savings for emergencies built up over time.

3. Look at the Costs

As part of your search for health insurance, it’s essential that you consider costs from all angles. This includes your monthly premium (the amount you pay to maintain coverage each month), copayments and coinsurance fees as well as your deductible (which must be met before covered services begin to be covered by your plan). Furthermore, be mindful of an out-of-pocket maximum that applies per year after which point 100% of eligible charges will be covered by your plan.

Keep in mind that the overall cost of your plan may depend on factors outside your control, like market conditions and inflation. But your specific costs will depend on your medical needs and usage as well as which services and prescription drugs your household utilizes regularly.

If you have a favorite physician or pharmacy, check to see if they’re included in your health insurance provider’s network – this can save money since health plans typically negotiate lower rates with these physicians.

An effective way of understanding the true cost of any plan is using an online calculator, which will provide estimates of your total annual costs such as monthly premium, deductible and out-of-pocket maximum costs. Furthermore, reviewing each plan’s summary of benefits provides snapshots of these costs, plus coverage information and its limits.

4. Make Sure You’re Covered

No matter if you’re purchasing health insurance on your own outside of open enrollment or renewing an existing plan through your employer or marketplace, always review each option’s coverage to make sure it suits both you and your family’s medical needs adequately. It’s essential that the plan you select covers your doctor and hospital preferences as well as regular treatments like physical therapy or fertility treatments that you might require – these all can add up quickly over time!

Additionally, choose a plan with an expansive network of doctors that your family can visit within your plan’s network to lower costs – health insurers typically negotiate discounted rates with in-network providers! Furthermore, consider opting out of plans which don’t include your preferred physicians as this could save costs as well.

Remember, most health insurance plans can only deny your application for coverage during open enrollment periods or after life events qualify as qualifying events. If your plan doesn’t cover something recommended by a physician, be sure to talk it over with them first as they might suggest another procedure that fits within its coverage parameters.

For help selecting an ideal healthcare plan, read our handy guide to selecting an effective health plan. Alternatively, contact your state’s insurance commissioner or the National Association of Insurance Commissioners for more guidance.