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Picking a good health insurance plan can be confusing. Here's what to keep in mind

An illustration of three candy jars. The first jar on the left is locked shut and reads "HMO," the jar in the middle has the lid cracked and reads "PPO," and the last jar is a candy machine that requires a coin to be inserted to release a piece of candy.
Subin Yang for NPR

HMO, PPO, FSA – OMG!

Open enrollment season is upon us, and it's time to sign up for a health insurance plan for the next calendar year. But between the alphabet soup of acronyms and all those daunting data tables, it can be hard to figure out which plan to choose.

While we know this task isn't as exciting as spooky szn or pumpkin-spiced everything, it's important for your health (and will serve you a lot longer than that polyester Halloween costume).

The good news: Life Kit has expert advice to help take the scary out of this process. Here's a cheat sheet of what to keep in mind as you make a decision.

Read your plan's summary of benefits

The first step is to know what's in your health insurance plan, says Tasha Carter, the insurance consumer advocate for the state of Florida. "Many consumers fail to take advantage of the benefits that are offered by their health insurance policy simply because they don't know they exist – or even worse, they end up paying out of pocket for expenses that may have been covered."

So, even though you've had the same plan for years, take a few moments to look over your plan's latest summary of benefits. Health insurance companies are required to provide a summary of benefits and coverage written in simple language. If you don't get it in the mail at the beginning of the year, log on to your health insurance website or call the number on the back of your insurance card and ask for it.

"Oftentimes, insurance companies make changes to benefits, so you want to make sure you understand what those changes are and how they may impact you" and your health, Carter says. Listen to our episode on how to maximize your health insurance coverage here.

Get a sense of your medical needs from a doctor you trust

That can dictate what kind of health insurance you might need in the coming year. "Having someone who's been following you, ideally for years, is extremely valuable in helping you to make decisions" about your health care — and therefore your coverage plan, says pediatrician Dr. Nicole Rochester.

And make sure your preferred primary care doctor and prescription medications are still covered by your insurance, says Aaron DeLaO, formerly the director of health initiatives at the nonprofit group Foundation Communities. Otherwise, he says, you should it "eliminate it" and "find a plan that's going to cover those."

Demystify health insurance jargon

Learn what common health insurance terms like "CHIP," "cost-sharing" and "deductible" mean. It can empower you to better understand what signing on to a plan might mean for your budget and your health. Read our handy glossary of terms here.

Take advantage of freebies ...

Even if you have a bare-bones plan with high deductibles, screenings and other preventive care should be included in your coverage, says Carter, the insurance consumer advocate. That includes screenings for diabetes, cholesterol and blood pressure. To get a handle on what you might need in the coming months, check out this list of recommended screenings by age compiled by the American Academy of Family Physicians.

... and perks

Another advantage of reading your insurance coverage plan super carefully? You might discover useful benefits. Your insurer, for example, might offer discounts to your local gym membership or services that improve your quality of life, like LASIK surgery or massages.

The digital story was edited by Malaka Gharib. We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at LifeKit@npr.org.

Copyright 2022 NPR. To see more, visit https://www.npr.org.

Andee Tagle
Andee Tagle (she/her) is an associate producer and now-and-then host for NPR's Life Kit podcast.