Pick the Right Health Plan in 5 Simple Steps

1. Check the Network

Confirm your doctors, hospitals, specialists, and preferred pharmacy are in-network before you enroll.

2. Check Your Prescriptions

Confirm each medication is covered and review its tier, copay, and any restrictions like prior authorization.

3. Compare Total Cost

Look at Premium + Deductible + Copays/Coinsurance together. The out-of-pocket maximum is the yearly ceiling for covered in-network care — it does not include your premiums.

4. Match the Plan to Expected Use

• • Low use: a lower premium may matter more.
• • Regular visits/prescriptions: balance premium with copays and deductible.
• • High or predictable use: a higher premium with lower cost-sharing may cost less overall.

5. Check the Plan Type

• • HMO: usually requires in-network care and may require referrals.
• • PPO: usually offers more flexibility at a higher price.
• • EPO: generally covers in-network care only but often does not require referrals.

Exact rules vary by plan.