For those with employer or individual plans, Open Enrollment season only comes once a year. It’s your chance to review, update, or change your health coverage. Many rush through the process or assume their old plan still works, but those mistakes can cost money. They can also limit you to the benefits you’ve counted on.
By understanding some of the most common mistakes people make during open enrollment, you’ll be better prepared to make decisions. Here’s how you can make sure your plan matches both your health needs and your budget.
MISTAKE 1: NOT CHECKING TO SEE IF YOUR PROVIDER IS IN-NETWORK
One of the most common and costly mistakes is assuming your doctor is covered. Networks can change each year, and the plan you select may not include your preferred doctor or hospital. If you don’t verify your doctor is in-network, you would either have to find a new doctor, or you may have to pay out-of-network costs to continue care.
MISTAKE 2: NOT CHECKING TO SEE IF YOUR PRESCRIPTION IS COVERED
Prescription coverage can change every year, even within the same plan. For example, prescription medication that cost $15 last year might move to a higher tier, raising your copay to $40. In some cases, medications drop from the formulary completely.
MISTAKE 3: NOT LOOKING AT WHAT SERVICES AND CARE ARE COVERED
Premiums aren’t the only factor to consider. Many plans vary in coverage of certain visits, procedures, and care. If mental health benefits and therapies like physical or occupational care are important to you, check to see how they’re covered.
Choosing a plan that doesn’t cover services you use regularly can leave you with higher out-of-pocket bills. For example, if you attend therapy sessions twice a month paying a $25 copay, and then switch plans, you may have to pay the full out-of-pocket price instead.
To ensure you have the coverage you want, take the time to review the plan’s Summary of Benefits and Coverage (SBC) and other plan materials. Pay special attention to the care most relevant to you and your family.
MISTAKE 4: NOT CONSIDERING LOW-DEDUCTIBLE VS. HIGH-DEDUCTIBLE PLANS
Picking between low-deductible and high-deductible health plans (HDHP) can feel confusing. Many people choose the lowest premium without realizing how much they may have to pay for most types of care before insurance kicks in. Others go for the lowest deductible without considering if the higher monthly premium makes sense for their situation.
A healthy adult who rarely visits the doctor may spend less with an HDHP paired with a Health Savings Account (HSA). But a parent with a child who needs frequent care could pay thousands more out-of-pocket before meeting a high deductible.
Think about what you’ll spend on healthcare costs for the coming year. If you anticipate frequent visits, procedures, or prescriptions, a low-deductible plan may save money overall. If you’re healthy and most likely only need preventive care, an HDHP may offer long-term savings.
MISTAKE 5: NOT USING SUBSIDIES IF YOU’RE ELIGIBLE
Many people qualify for financial help but never apply. Programs such as the Advanced Premium Tax Credit (APTC) and Cost Sharing Reductions (CSRs) can lower monthly premiums and out-of-pocket costs.
For example, a family of four earning $75,000 may qualify for hundreds of dollars in subsidies each month. Without applying, they could miss out on savings of more than $3,000 a year.
Use the Marketplace calculator or visit Select Health Plans to check your eligibility. Even partial subsidies can make health insurance significantly more affordable.
MISTAKE 6: NOT UPDATING YOUR PLAN DURING OPEN ENROLLMENT
Life changes. Sticking with the same plan without revisiting your circumstances, health needs, and coverage could leave you overpaying or under-covered.
For example, if you develop a condition that requires more doctor visits or medication than you needed prior, you may want to adjust your coverage. On the other hand, if you’re in remission or recovered from a health problem, you may feel good about choosing a different plan.
MISTAKE 7: WAITING UNTIL THE LAST MINUTE
A lot of people hold off on open enrollment until the very end. That can cause mistakes, rushed choices, or even missing the deadline. Once enrollment closes, the only way to make changes is if you qualify for a special enrollment period.
Write down your state’s or employer’s enrollment deadlines and start looking at your options early. Take a look at the key dates for Utah, Colorado, Idaho, and Nevada in our blog about Open Enrollment timelines.
MAKE THE MOST OF OPEN ENROLLMENT
The Open Enrollment season is your once-a-year chance to make sure your health coverage meets your needs. Avoiding these mistakes—from checking your doctor’s network to reviewing your prescriptions and applying for subsidies—can save money, reduce stress, and give you peace of mind all year.
To find a plan that fits your needs, check out the Select Health plans page or call 800-538-5038 to speak with Member Services.
This article is intended for informational purposes only and is not legal or medical advice. Links to other sites are provided as a convenience, but Select Health does not endorse the third-party sites, information, or services.
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