15 Costly Health Insurance Mistakes to Avoid When Choosing Your Plan

INSURANCE
Open enrollment time is here, so pick the plan that best suits your medical needs.
Updated May 8, 2024
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Open enrollment is here, and that means it may be time to pick a new healthcare plan to fit your expected needs for the coming year.

Your employer may offer options and you may be unsure which one to choose or what makes one plan better than another. Perhaps, you want to keep more money in your bank account so the lowest-priced plan is more attractive.

To help you choose, consider the following common mistakes people make when selecting a healthcare plan during open enrollment that may cost them in the next year.

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Sticking with the same plan

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If you don’t take the time to compare all of the health insurance plans and just rush through the process, you could leave chances to build up your savings on the table. 

Or, even worse, you may find yourself with a plan that no longer covers certain medications or your favorite doctor.

Compare policies and make sure you look at all of the details of each before you simply select one. Specifically, focus on any exclusions, in-network care, and medication coverage as a starting point.

Choosing a plan because it’s the least expensive

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Low premiums mean everything to many people, but saving money on health care at the cost of good insurance is actually damaging to your budget.

Low-premium health insurance plans may offer very limited coverage and may have high copays, coinsurance, and deductibles. You may end up paying for most of your care needs anyway.

Don’t assume higher premiums are a solution either, since coverage may vary significantly between insurers and their plans. The bottom line is you need to research what you’re paying for to ensure it’s worth the investment.

Not comparing provider networks and prescription medication coverage

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This is a costly mistake for many, even those who are healthy and don’t need more than preventive care right now.

Check to see if your current medications are covered and your doctors are in-network when you evaluate health care plans. Look at the provider network and drug formulary to do so. Then, consider your care options for new providers should you need them.

You may also want to check the hospitals that are in the network of a plan to be sure your preferred one is included.

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Not providing all of your medical history

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If you do not provide accurate information about your health, especially about pre-existing conditions, the insurance company may not cover you at all. 

Typically, the health care company will find out about your medical diagnosis when you receive care, and that could limit your coverage.

If you’ve been diagnosed with any type of medical condition, from high blood pressure to diabetes, share that information on the application. Not doing so could void your policy or coverage, creating a very expensive outcome.

Skipping health insurance

You’re young, healthy, and haven’t had to go to the doctor in the last year. That may make you think you can skip paying for health insurance, but doing so could be a costly mistake.

You could end up paying hundreds of dollars for a doctor’s appointment for a checkup or 10 times that amount if you need to go to an emergency room.

You never know when something such as an illness or injury will happen. Having a policy in place minimizes the financial impact.

Not considering the worst-case scenario

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How much is this policy going to cost when you reach out for care? There are times when you may need more medical care or to visit a doctor that’s not in your network.

Now, consider what happens in the worst case, especially if you end up having to pay out-of-network costs or a serious accident occurs.

Consider what the out-of-pocket maximums are for the policy, and compare each level of coverage provided by the insurer to determine which fits your needs best.

Skipping the add-on coverage options outright

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Many health care plans provide additional types of coverage for an extra cost. The problem is that many people see these add-ons as just an additional cost. 

When you want to save money on health care, you may decide not to even look at them. But add-ons can often help provide ample financial protection for people who need them. 

The additional coverage may include costs for critical illness insurance, providing maternity care, home care treatment, or broader network coverage.

Not realizing what your costs are for a routine appointment

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The policy may say that preventive care is included, but that may not include various types of diagnostic testing. You may not know that you still have to pay a copay to continue to see your current doctors even if you didn’t in the past.

Take the time to learn what it will cost you out-of-pocket to see your preferred providers. Consider copayments, coinsurance, and deductible costs.

Remember, these will change from year to year, and some are due at the time of receiving care.

Lacking a focus on potential future costs

9dreamstudio/Adobe medical treatmant billing statement

It’s a mistake not to consider what could happen to your family during the year to come that could require additional doctor’s care.

If your child is enrolling in a sport, that’s going to increase the risk of doctor visits. If you are entering a higher risk period for developing a medical issue, even drastic conditions like cancer or diabetes, the need for medical care, including screenings, increases.

Consider what medical care your family received during this past year. Then, consider what could happen in the next year. Could you have another baby? Is there a need to consider vision insurance now that wasn’t there last year?

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Not knowing if a plan requires a referral

LIGHTFIELD STUDIOS/Adobe patient giving id card to doctor

When you need medical care, you may just want to call a doctor, get an appointment, and show up. Some insurance plans require you to get a referral from your physician first, and that slows down access to care.

If this isn’t something you want to deal with, consider a policy that doesn’t require referrals. That’s especially true when there’s a high risk of needing specialist care or a procedure.

Not investing in a flexible spending account

Drazen/Adobe financial consultant and her client using laptop during meeting

A flexible spending account (FSA) could be a valuable tool for those who want to put tax-free money aside to cover their medical needs. Yet many people don’t consider them.

Setting aside money tax-free may lower your income tax obligations and help pay for out-of-pocket medical costs. 

For instance, your FSA money can cover copayments, deductibles, and qualified prescription drugs. But it also covers items like contact lens solution, blood pressure monitors, and prescription sunglasses.

Choosing a plan with a limited network of providers

DC Studio/Adobe female nurse holding clipboard wearing scrubs talking to senior pateint sitting in waiting area

You may choose a health care plan that offers coverage for the doctor you need now, but what happens if you need more care or don’t like your doctor? If the plan has a limited network near you, that could mean you are stuck.

Be sure to consider how large the network of care providers are and the alternatives available to you if you need to switch doctors or see a specialist.

Not getting enough coverage

Antonioguillem/Adobe sad disabled woman claiming on phone

This is a huge mistake, and it often comes down to people not realizing how much medical care costs.

If you choose a policy with a lower premium, it may have limited coverage, meaning your out-of-pocket costs are much higher, and that could limit your care.

Always ensure your coverage meets or exceeds the value of care you received in the last few years. If you’re unsure, look at the average cost of health care in your area to determine which policy is a good fit.

Limiting coverage if you travel

EdNurg/Adobe catalonia ambulance riding at barcelona street

Do you have medical coverage if you travel abroad?

Most health insurance plans do not cover these costs, and for those who travel often, that could be an expensive mistake.

Look at your options for travel insurance, both through your health care plan and through a specialized travel insurance company. It could save you dearly in the long term if an emergency happens.

Not asking questions

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As you compare health care plans, remember that this is a big financial decision that can impact your ability to get the medical and mental health care you need. If you are unsure about a policy, don’t assume you know the answer.

Contact the provider and ask questions. Get details about how a plan could work for you. Ask the representative to help you compare tiered plans carefully.

Bottom line

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Choosing a good health plan that covers preventive care can help lower your financial stress, especially if you develop a medical problem with treatment costs that keep adding on. 

Now is the time to act. Open enrollment doesn’t mean you should wait until the middle of December to choose the health care policy for your needs. 

Start comparing coverage options now so that you can make a confident decision about which plan is best suited for your needs.

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Author Details

Sandy Baker Sandy Baker is a has over 17 years of experience in the financial sector. Her experience includes website content, blogs, and social media. She’s worked with companies such as Realtor.com, Bankrate, TransUnion, Equifax, and Consumer Affairs.

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