Open enrollment for health insurance begins Nov. 1, and for millions of Americans, the decision of which plan to choose will be made in just minutes — a choice that could affect both their health and their finances for an entire year.
Don’t assume your plan stayed the same
It may be tempting to simply click “same as last year” and move on, but that approach could come with unexpected costs and surprises.
“Insurance companies often change their rates, their network of doctors and covered drugs every year,” Spencer said.
That means a plan that worked well in 2026 may look very different in 2027 — even if the name on the card stays the same.
4 things to check before you re-enroll
Before re-enrolling, Spencer says consumers need to check four specific things:
1. Is your primary care doctor still in-network? If your doctor has left the plan’s network, you could end up paying significantly more for routine visits — or need to find a new physician altogether.
2. Are your specialist doctors still covered? Think urologists, cardiologists and other specialists you see regularly. Network changes can quietly push these providers out of coverage, leaving patients with surprise bills.
3. Is your nearby medical clinic or hospital in-network? Proximity matters in a medical emergency. Confirming that your closest hospital or urgent care clinic remains in-network could save thousands of dollars when it matters most.
4. Are your prescription drugs still on your plan’s drug list? Insurance plans update their formularies — the list of covered drugs — every year. If a medication you rely on gets dropped, your out-of-pocket costs could spike dramatically.
Levi Strauss is an employee health benefits advisor with PBMP in Houston, and he says the most important thing to remember is this.
“We want to make sure when we have a health plan, we can see the providers that we need to see, whether that’s our kids’ primary care doctor, our specialists, and making sure we can get to the hospitals that we need. So always look at your network. Networks are constantly changing. Insurance carriers and hospital systems tend to butt-heads sometimes, and you’ll see that a hospital system is falling out of a network. So make sure that your providers are in network”, Levi says.
Do the math on last year’s care
Beyond those four checks, add up how many times you visited your primary care doctor last year and what you paid out of pocket for that care.
That real-world spending history can help you better gauge what they’re likely to pay in the coming year — and whether your current plan is still the right fit.
Open enrollment starts Nov. 1
With open enrollment just around the corner, now is the time to review your current health insurance plan — before the clock starts ticking.
