How to Choose Health Insurance: Step-by-Step

1. Review Your Coverage Options
   Check employer plans, the Marketplace, Medicaid, or Medicare—see what you qualify for based on age, income, or job status.
2. Estimate Your Yearly Health Needs
   Consider doctor visits, prescriptions, planned surgeries, or ongoing care for yourself and any dependents.
3. Compare Monthly Premiums and Out-of-Pocket Costs
   Look beyond the monthly price—factor in deductibles, copays, coinsurance, and out-of-pocket maximums.
4. Check Plan Networks and Covered Providers
   Make sure your preferred doctors, clinics, and hospitals are in-network for any plan you’re considering.
5. Look for Prescription Drug Coverage
   Review the plan’s formulary to ensure your medications are covered and affordable.
6. Compare Extra Benefits
   Some plans include dental, vision, telehealth, or wellness incentives—factor those into your choice.
7. Apply Before the Deadline
   Sign up during open enrollment or a qualifying event to avoid gaps in coverage and possible tax penalties.

What to Expect When Choosing Health Insurance

• There’s no “one size fits all” plan: The best choice depends on your health, family, and budget.
• You may feel overwhelmed by the choices: Comparing premiums, deductibles, and coverage takes patience—but it pays off.
• You’ll need to gather personal info: Have income details, Social Security numbers, and provider lists handy for applications.
• Out-of-network costs can be high: Sticking to in-network doctors usually saves you money.
• Coverage doesn’t start instantly: Most plans begin the month after you enroll—watch your start date to avoid gaps.

Pro Tips & Common Mistakes to Avoid

• Don’t choose a plan by premium alone: A low monthly price may mean high out-of-pocket costs later.
• Check the network before enrolling: Using out-of-network doctors can mean surprise bills.
• Read the Summary of Benefits: Every plan provides a plain-language overview—use it for quick comparisons.
• Look for free preventive care: Annual checkups and screenings are usually covered at no extra cost.
• Don’t wait until the last minute: Open enrollment and special enrollment periods have strict deadlines—mark your calendar.

How Maria Chose the Right Health Insurance for Her Family

Maria, a 42-year-old teacher and mom of two, needed to pick new health insurance after her husband started a small business. She was overwhelmed by Marketplace options—some with low premiums but high deductibles, others with better coverage for higher monthly cost.

She listed her family’s regular needs: allergy prescriptions for her son, annual physicals, and her own asthma specialist. Maria used the plan finder tool to filter options with those providers in-network and checked drug lists for her son’s medicine.

Instead of picking the cheapest plan, Maria chose one with a higher premium but lower deductible and out-of-pocket limit. She calculated that the savings on prescriptions and office visits would more than offset the extra monthly cost.

The result? Maria’s family avoided surprise bills, had easy access to care, and felt secure knowing they were covered for the year ahead.

Frequently Asked Questions

Need Help Choosing the Right Health Plan?

Not sure which health insurance fits your needs? Our nonprofit counselors can help you compare plans, understand costs, and enroll with confidence.