Two quotes can look similar and cost very different amounts once you use them. Here's the checklist we use when we compare plans for clients.
1. The monthly premium
Write down the premium after any premium help. Multiply it by 12 to see the yearly cost before you use any care.
2. Deductible and out-of-pocket maximum
The deductible is what you pay before the plan starts sharing costs. The out-of-pocket maximum is the most you'd pay in a year for covered, in-network care. Your worst case for the year is roughly 12 premiums plus the out-of-pocket maximum. See the deductible guide.
3. Your doctors and hospital
Check that each plan's network includes the doctors and hospital you want. A cheaper plan that excludes them isn't cheaper. Use our network checklist.
4. Prescriptions
Look up each medication in the plan's drug list and note the tier and your cost.
5. What's excluded or limited
This matters most on private plans. Ask for a list of exclusions and limits for pre-existing conditions, maternity, mental health, and any other area you might need.
6. Start date and first payment
Confirm the exact date coverage starts and when the first payment is due. Missing the first payment can mean the plan never starts.
A simple comparison grid
| Plan A | Plan B | |
|---|---|---|
| Monthly premium | ||
| Deductible | ||
| Out-of-pocket maximum | ||
| My doctors in network? | ||
| My prescriptions covered? | ||
| Key exclusions | ||
| Start date |
We're happy to fill this in with you. Get the open enrollment checklist for a printable version.
This article is general information, not a guarantee of coverage or pricing. Plan availability, benefits, and eligibility vary by state and individual. Some private plans are medically underwritten and do not include all ACA essential health benefits.