Why You Shouldn't Just Auto-Renew
Open enrollment — the annual window when you can change, add, or drop health coverage — comes and goes quickly. Many people simply let their current plan auto-renew without reviewing whether it still meets their needs. This can be a costly mistake. Plans change their premiums, provider networks, formularies, and benefits every year. What worked last year may not be your best option today.
Use this checklist to make a confident, informed decision during open enrollment.
Step 1: Review What Changed in Your Current Plan
Your insurer is required to send you an Annual Notice of Change before open enrollment. Read it carefully. Look for:
- Premium increases or decreases
- Changes to your deductible or out-of-pocket maximum
- Modifications to your plan's formulary (covered drugs list)
- Network changes — have any of your doctors or hospitals been dropped?
- Changes to covered services or benefits
If your current plan has changed significantly, staying put may not make financial sense.
Step 2: Assess Your Healthcare Needs From the Past Year
Look back at how you actually used your health insurance this year:
- How many times did you visit a doctor or specialist?
- Did you have any hospitalizations or procedures?
- Did you meet your deductible? Your out-of-pocket maximum?
- Were all your prescriptions covered on your plan's formulary?
- Did you face any surprise costs or coverage gaps?
This retrospective helps you gauge whether you were over-insured (paying for coverage you didn't use) or under-insured (facing high out-of-pocket bills).
Step 3: Anticipate Next Year's Healthcare Needs
Think ahead to any expected changes in 2025:
- Are you planning any surgeries, procedures, or specialist visits?
- Are you expecting a baby or adding a dependent?
- Do you have new or changing prescription drug needs?
- Are you moving to a new area where your current plan's network may not apply?
- Have your income or household circumstances changed (affecting subsidy eligibility)?
Step 4: Verify Your Providers Are In-Network
Before selecting any plan, confirm that the doctors, specialists, and hospitals you rely on are in-network for that plan. Network directories can change year to year. Don't rely on last year's information — check the current directory on the insurer's website or call the provider's office directly.
Step 5: Check Your Medications
If you take prescription medications regularly, this step is critical. Each plan has a formulary — a list of covered drugs divided into tiers that determine your out-of-pocket cost. Verify that:
- All your medications are on the formulary
- They're on a tier that results in affordable copays
- No prior authorization or step therapy requirements will create hurdles
Step 6: Calculate Your Total Estimated Annual Cost
Don't compare plans by premium alone. Estimate your total annual cost using this formula:
Total Cost = Annual Premium + Expected Out-of-Pocket Costs (copays, coinsurance, deductible)
Run this estimate for both your current plan and any alternatives you're considering. A plan with a lower premium may cost more overall if it has a high deductible you're likely to hit.
Step 7: Don't Forget HSA Eligibility
If you're considering a High-Deductible Health Plan (HDHP), check whether it's HSA-eligible. A Health Savings Account lets you contribute pre-tax dollars to pay for qualified medical expenses — a significant tax advantage that can offset the higher out-of-pocket risk of an HDHP.
Open Enrollment Deadlines: Don't Miss Them
- ACA Marketplace: Typically November 1 – January 15 (dates may vary by state)
- Employer plans: Set by your employer, usually in the fall
- Medicare: Annual Enrollment Period runs October 15 – December 7
Missing open enrollment without a qualifying life event means waiting another full year. Mark your calendar and set reminders. A little time spent reviewing your options now can save you significantly throughout the year.