If you've been putting off choosing your coverage for the upcoming year during this open enrollment season, no one would blame you.
Workers often find themselves choosing an insurance plan from a menu of complicated and pricey options. And for many people, the price tags are going up. On average, U.S. employers expect their health-care costs to rise by 7.7% in 2025, according to a survey from Willis Towers Watson. About a third of companies say they plan to hike employee premiums to help cover the cost.
But by taking a few simple steps, you can make sure you're getting the most cost-effective plan that meets your health-care needs, all while taking full advantage of your benefits.
Think of it like shopping for shoes, says Charlene Rhinehart, a certified public accountant and personal finance editor at GoodRx.
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"The type of shoes you buy depends on what you need them for and how you'll wear them, among other factors, and health insurance works the same way," she says. "You'll want to look at all your needs and pair that with the best type of plan."
If you've been procrastinating during open enrollment, here are three simple steps to just get it done.
1. Do a health audit
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You wouldn't buy shoes without knowing what size you are. So before you try to figure out which insurance policy is best for you, you need to take stock of your health-care needs, says Rhinehart.
"Before you start the process, you want to take a step back and do a personal health audit," she says.
That means taking a look at what you spent on health care in the past year. How often did you go to the doctor? Did you see your primary physician, or did you have to go to specialists? What drugs are you taking and what did you pay for them? Do you have ongoing medical expenses, or did you have some one-offs in the past year?
Make a list of all the providers you regularly use. Are there ones you could absolutely not live without? Or is one dermatologist as good as the next as far as you're concerned?
Answering these questions can help give you an idea of what you might want your health care to look like in the upcoming year, and how best to pay for it.
2. Know your acronyms
Your workplace will likely present you with a list of insurance plans to choose from, which generally fall into one of two categories: high-deductible health plans and co-pay plans.
Here's a quick breakdown.
High-deductible plans
An HDHP requires you to pay out-of-pocket for most medical expenses up to a certain monetary threshold, known as the deductible, before your coverage kicks in. For 2025, these plans carry a minimum deductible of $1,650 for individuals and $3,300 for family coverage, though figures at some plans may be higher.
These plans are often paired with a health savings account, which offers a unique "triple" tax benefit. You can deduct money you contribute to these accounts from your taxable income and should you choose to invest the money rather than spend it, any growth in your investments is tax-free. And as long as you put HSA money toward qualified medical expenses, you won't owe any tax on withdrawals either.
Plus, you are the owner of an HSA. You can take it with you when you switch jobs, and there's no provision that requires you to spend the money within any particular timeframe.
If you have frequent medical bills or expensive prescriptions, these plans might not be ideal for you, since you'll be forced to eat out-of-pocket costs.
"If you're healthy and rarely go the doctor, the health savings account plan is almost always the best option," says Carolyn McClanahan, a physician, certified financial planner and founder of Life Planning Partners. "If you're not so healthy and you have to go to the doctor all the time, the co-pay plan is probably the better option."
Co-pay plans
Unlike high-deductible plans, co-pay plans come with pre-determined costs that you'll pay for things like office visits, prescription drugs and medical procedures. You pay a small portion of the total cost, and your insurance company covers the rest.
The tradeoff: You'll see much more money deducted from your paycheck to cover your premiums. Still, paying the high premiums could be well worth it if it means only paying a fraction of the cost for expensive medical procedures you may need.
Co-pay plans often come with a flexible spending account, which allows you to take a tax deduction for contributing. These are more restrictive than HSAs, however, because you typically have within the calendar year to spend the money you've put in, or you lose it.
These plans come with two common coverage options:
- Health maintenance organizations (HMO) require you to consult with a primary physician to manage your care. To see a specialist, you'll typically need a referral, and you'll only be covered if you use a doctor within your plan's network.
- A preferred provider organization (PPO) lets you see doctors in and out of your network with no referral. Although you'll generally have to meet a separate deductible before coverage kicks in for out-of-network care.
Because they're more restrictive, HMOs are typically cheaper than PPOs. But before choosing an HMO, make sure the doctors you like are within the plan network.
Once you have all your prospective plans lined up, do a little math. Add up your doctors visits and prescription drug costs from the previous year and see if you'd come out ahead with one plan or another.
If you're considering switching plans, examine the new plan's summary of benefits and coverage to see what you might have to pay for certain procedures or treatments. If you take ongoing medications, it may be worth contacting a prospective insurer to see what you might be charged at the pharmacy for your regular scripts.
And if it's unclear whether a provider you like would be in your new network, "the easiest thing to do is pick up the phone and call your doctor's office," says McClanahan.
3. Don't forget the perks
The last thing to take a look at before making your decision is any ancillary benefits your company may provide.
You may be worried, for instance, about the affordability of care under a high-deductible plan. But 62% of firms that offer an HSA offer some form of contribution to employee accounts, according to theย Society for Human Resource Management, which can help defray the costs.
Your firm may also offer telehealth services free of charge, lowering potential out-of-pocket costs even further if you're the sort of person who rarely sees a doctor.
"Under those high-deductible plans all of our virtual care is offered at no cost. And there's a lot that you can do virtually," says Matt Phillips, assistant vice president of benefits at AT&T. "We even have a lot of employees that have their primary care physician relationship virtually."
Even if it won't impact whether you choose one plan or another, open enrollment season is great time to review the benefits offered to employees at your firm to see what you can take advantage of in the upcoming year.
Your company could deposit funds into a tax-advantaged account in return for you completing annual preventative health screenings, for instance.
You may also be able to opt in to supplemental insurance policies through your employer, including pet, life, accident, disability and ID theft coverage. You'll need to examine the premiums and coverage details to determine if such policies are right for you, but in general, you can often expect to pay less than what you'd pay if you bought the same insurance off the shelf, says Phillips.
"Most employers, certainly large employers like AT&T, have leveraged their buying power to negotiate really good deals for you," he says.
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