{"id":47916,"date":"2026-10-12T12:28:46","date_gmt":"2026-10-12T12:28:46","guid":{"rendered":"https:\/\/financialrush.com\/?p=47916"},"modified":"2026-10-12T12:28:46","modified_gmt":"2026-10-12T12:28:46","slug":"what-to-know-before-buying","status":"publish","type":"post","link":"https:\/\/financialrush.com\/?p=47916","title":{"rendered":"What to know before buying"},"content":{"rendered":"

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Momo Productions | Digitalvision | Getty Images<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Open enrollment season is upon us \u2014 and that means millions of Americans will soon need to pick their health insurance plan<\/a> for 2027. <\/p>\n

The choice can have big financial consequences for households, which, with a few exceptions, are generally locked into their insurance plan for a year before being able to switch.<\/p>\n

But choosing a health insurance plan isn’t always a straightforward decision, experts said. <\/p>\n

Consumers who buy insurance through an employer or on the Affordable Care Act marketplace may have a hodgepodge of plans to choose from, with different premiums, cost-sharing provisions, doctor networks and other factors to consider. <\/p>\n

Households are grappling with such choices amid soaring healthcare costs<\/a>, in some cases forcing them to make difficult financial trade-offs during open enrollment, experts said. <\/p>\n

“Employers are passing through the costs more and more in different ways to employees, so it’s important for employees to have their thinking cap on when deciding how to choose their benefits,” said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida.<\/p>\n

She said she recommends consumers use a two-question “algorithm” when determining which plan is right for them. <\/p>\n

Here are some important things to consider during open enrollment this year. <\/p>\n<\/div>\n

What is open enrollment?<\/h2>\n
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Momo Productions | Digitalvision | Getty Images<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Open enrollment is the period during which people can enroll in, renew or change their health plans for the coming year.<\/p>\n

Most Americans under age 65 \u2014 about 166 million people<\/a> \u2014 get health insurance via employer-sponsored health plans.<\/p>\n

Employers have flexibility to set their own open enrollment periods, but typically hold them in the fall and for about a month, said JoAnn Volk, founder and co-director of the Center on Health Insurance Reforms at Georgetown University.<\/p>\n

An additional 19.2 million Americans were enrolled<\/a> in a health insurance plan through the Affordable Care Act marketplace for 2026, according to figures published by the U.S. Department of Health and Human Services in June.<\/p>\n

Participants are typically self-employed, gig workers, early retirees, small business owners and others who don’t get health insurance at work, or through federal programs such as Medicare or Medicaid.<\/p>\n<\/div>\n

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Read more CNBC personal finance coverage<\/h2>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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In states that use the federal ACA marketplace, open enrollment runs from Nov. 1, 2026, to Jan. 15, 2027. <\/p>\n

Consumers must enroll by Dec. 15 in order for coverage to start at the beginning of 2027. Coverage starts Feb. 1 for those who enroll in or change their plans from Dec. 16 through Jan. 15.<\/p>\n

Certain states run their own marketplaces rather than relying on the federally run marketplace. <\/p>\n

Those states’ open enrollment periods may differ: For example, they may allow signups later into December to still\u00a0get coverage that starts Jan. 1, run longer enrollment windows or start earlier than Nov. 1, Volk said.<\/p>\n

Idaho’s open enrollment starts Oct. 15<\/a> and Connecticut’s starts Oct. 23<\/a>, for example.<\/p>\n<\/div>\n

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Consumers can shop for health plans on healthcare.gov<\/a> and navigate to their respective state marketplace<\/a> to enroll.<\/p>\n

Volk said she recommends consumers type the URL to directly navigate to healthcare.gov<\/a> rather than using a search tool such as Google to look for terms like “ACA marketplace” or “Obamacare.” <\/p>\n

A study<\/a> published in August by Georgetown University’s Center on Health Insurance Reforms found that consumers who searched for coverage online via tools such as Google were “frequently routed towards products not regulated by the ACA” with fewer consumer protections. <\/p>\n<\/div>\n

What to consider during open enrollment<\/h2>\n
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Here are the two questions that McClanahan, the founder of Life Planning Partners and a member of CNBC’s Financial Advisor Council<\/a>, said she recommends considering when comparing options during open enrollment:<\/p>\n

1. Is choice or cost more important to you?<\/h3>\n

The answer to this question will help consumers pick from among the alphabet soup of health plan types: HMO, EPO, PPO and POS plans, for example. <\/p>\n

If consumers have a lot of health problems or get sick often, and they want ample leeway to see a broad roster of doctors, a preferred provider organization, or PPO, plan might be best, McClanahan said.<\/p>\n

PPO plans generally have more flexibility than other plan types, allowing for out-of-network and specialist visits without a referral from a primary care doctor. However, the trade-off is they typically carry higher premiums.<\/p>\n<\/div>\n

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By contrast, health maintenance organization, or HMO, plans are “budget-friendly” plans with lower monthly payments, according<\/a> to Aetna, an insurer. However, they’re more rigid: The plans require consumers to pick in-network doctors and get referrals from a primary care physician before seeing a specialist.<\/p>\n

In the middle of cost and flexibility are exclusive provider organization, or EPO, and point of service, POS, plans, experts said. EPO plans require in-network services for insurance coverage, but generally come with more choice than HMOs. POS plans require referrals for a specialist visit but allow for some out-of-network coverage.<\/p>\n

Cost goes beyond comparing premiums, though. <\/p>\n

Consumers should also understand differences between cost-sharing provisions such as deductibles, co-insurance and out-of-pocket maximums, experts said:<\/p>\n