Disclaimer: This Inside South Florida segment is sponsored by Oscar Health. All opinions and views are of the advertiser and does not reflect the same of WSFL-TV.
Open enrollment is here, and choosing a health insurance plan can quickly become overwhelming. Between premiums, deductibles, provider networks, and prescription coverage, there is plenty to consider before making a decision.
Dr. Lia Rodriguez, chief health officer of Oscar Health and president of Oscar Medical Group, shared practical advice designed to help consumers cut through the jargon and choose coverage that fits their needs.
Start With What You Need Now
One of the biggest mistakes consumers can make is assuming the health plan that worked last year will automatically be the best choice this year.
Dr. Rodriguez recommends starting with a simple list. Write down the doctors you've seen, medications you're taking, and any health conditions that need ongoing care. Then consider what could change in the year ahead, including adding a baby or other changes to your household.
The goal is to choose a plan based on your health care needs today and what you reasonably expect those needs to look like over the coming year.
Understand the Costs Beyond the Premium
Knowing a few key insurance terms can make comparing plans easier.
The premium is the amount you pay each month for health insurance. The deductible is the amount you pay before your insurance begins covering applicable expenses. The out-of-pocket maximum is the most you would pay for covered care before the plan covers 100% of applicable expenses thereafter.
Understanding how these costs work together is an important part of evaluating different health plan options.
Check Your Doctors and Prescriptions
Before enrolling, Dr. Rodriguez says consumers should verify that the doctors they trust and the medications they need are covered.
A plan's network identifies the doctors and providers covered by the plan, while its formulary identifies covered medications. Because those lists can differ from one plan to another, checking both before enrolling can help prevent unwelcome surprises later.
Consumers should use their list of current doctors and prescriptions while comparing options to identify plans that provide the coverage they need.
Don't Automatically Choose the Cheapest Plan
A low monthly premium can be appealing, especially when household budgets are tight. But Dr. Rodriguez cautions against making a decision based solely on the monthly price.
Instead, consider the total cost of care, including what you could pay when you actually need medical services, such as doctor's visits or hospitalization. A plan with the lowest monthly cost could ultimately cost more depending on how much care you use.
Looking at the bigger financial picture can help consumers select a plan that makes sense for both their health needs and their family's budget.
For additional information and resources about navigating health insurance, Dr. Rodriguez directed consumers to Oscar Health's website, hioscar.com, which she said offers free, easy-to-understand information for both members and nonmembers.
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