Plan comparison is not hard, but it is easy to do in the wrong order. Do it in this order and the right answer usually falls out on its own.
First: check what you're eligible for, not what you like
Before comparing anything, find out whether you qualify for Medicaid or a premium tax credit. If either is true, the comparison is largely over — those options win.
This takes ten minutes and saves people thousands. Do it first.
Second: total the real annual cost
Premium times twelve, plus the deductible you would realistically hit, gives a far more honest number than premium alone.
Run it twice: once for a quiet year where you see a doctor twice, once for a bad year where you hit the deductible. A plan that wins both is a good plan.
Third: check the network, by name
Not 'is it a big network' — check your specific doctor, your specific hospital, and any specialist you see regularly.
Narrow local HMO networks are where most unpleasant surprises live. A broad nationwide PPO removes most of that risk, and costs more for exactly that reason.
Fourth: read the exclusions
Prescriptions, maternity, mental health and pre-existing conditions are the four that most often carry limits.
If a plan is unusually cheap, this section is almost always why. Cheap is fine — cheap and surprising is not.
The traps
Three things cost people more than any other:
- Choosing on premium alone and meeting a $9,000 deductible in March.
- Assuming a plan covers a prescription because the last one did.
- Missing an enrollment deadline and going uninsured by accident.
General information only. Not insurance, tax or legal advice about your situation, and not a price offer. Plan availability, pricing and underwriting rules vary by state and carrier.