Choosing a health insurance plan may seem complicated, but it can be easier once you know the options.

Whether you’re starting a new job or it’s enrollment season at your current job, it’s important to make sure you’re getting everything you can from your health insurance plan. Even if you plan to stay on the same plan, you should still take the time to review a few things before signing up again.

Consider your family’s needs

If you are married and/or have children, think about what your family needs from a healthcare plan. Since coverage can change from year to year, it’s helpful to know which plan is best for your circumstances. For example, if you and your spouse have different healthcare needs, it may be beneficial to have different plans with different levels of coverage or different prices.

Pay attention to open enrollment

This is the eligibility window to enroll in or change an insurance plan. If you are purchasing health insurance through someone, open enrollment typically begins in the fall and can vary by state. If your employer offers health insurance, open enrollment can occur at any time throughout the year.

The open enrollment period is a good reminder to review your situation and make sure you and your family are getting everything you need from your healthcare plan.

Review your coverage options

If you’re considering an individual or family insurance plan other than an employer, think about the coverage you need when choosing a plan.

Individual health insurance plans are often categorized based on how much coverage they provide. For example, in the health insurance marketplace, plans are presented in “metal” categories: platinum, gold, silver and bronze, with “catastrophic” plans also available for some people.

The categories differ only in how you and your plan split costs, not in the quality of care.

Check premiums, co-pays, and deductibles

Insurance plans cover several types of out-of-pocket costs:

• You pay a premium for your coverage, no matter what services you use.
• Co-pays are a fixed fee for certain types of office visits, prescriptions, or other types of care, paid at the time of service.
• Deductibles are costs you pay before your insurance kicks in.
• You may also pay coinsurance on some services — for example, your insurance may cover 80%, leaving you responsible for the remaining 20%.
• Many plans also have out-of-pocket maximums: once you hit this number, your insurance will cover all costs.

Out-of-pocket costs can be complicated and take a toll on your budget. Take time to consider what services you may need next year. Then, see what costs might be associated with those services under any plan you’re considering.

Check the provider network

Write down all the providers you or your family may use next year: physicians, specialists, and even specific hospitals, clinics or pharmacies. During open enrollment, review each plan you’re considering to see if your preferences are covered.2

Keep in mind that medical professionals and insurance companies are constantly updating their contracts. Doctors or other professionals who were in-network last year may be out of network next year.

Consider HSAs and FSAs

Health savings accounts and flexible spending accounts (FSAs) allow you to set aside pre-tax dollars to pay for qualified healthcare expenses, such as co-pays, some prescriptions, and some medical equipment. However, these plans aren’t available to everyone. HSAs require enrollment in a high-deductible health plan (HDHP) or catastrophic plan, and FSAs are only offered through employers (not available at all companies).

If you plan to use an HSA or FSA, check the contribution limits and rollover policy. It’s also a good idea to confirm that these accounts cover the types of medical expenses you expect in the coming year.

Keep in mind the difference between HMOs and PPOs

With health maintenance organizations (HMOs), you’re generally covered only when you visit doctors within the HMO network. PPOs, on the other hand, often offer some coverage for out-of-network services. HMO networks are smaller, and you’ll likely need to name a primary care doctor who will refer you to any necessary specialists.

These plans also have lower premiums and deductibles. PPOs often have wider networks and don’t require referrals, but they tend to be more expensive.

Make sure your medications are covered

Make a list of your medications and note whether you take name-brand prescription drugs or generic ones. Name-brand or patented drugs can be expensive, so it’s important to find a policy that covers them. Generic drugs are generally less expensive, so you may get more benefits or pay more if your prescriptions are primarily generic.4

Call the insurance provider to find out if the plan you’re considering covers the drugs on your list. Don’t forget to ask about copays for filling and refilling prescriptions.