HAMPTON, Va. — Open enrollment for health insurance is officially underway for most private employers and state-based insurance plans, but navigating your options can be confusing — especially if your circumstances have changed over the past year.
As Lois Manzi knows, everyone has different needs when it comes to healthcare coverage.
"Somebody might need the transportation, somebody might need more hospitalization — they might have different medical issues where they need a better pharmacy payout," Manzi said.
To help you figure out the best plan for your situation, I've put together a checklist of what to know, what to ask and when to act.
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Know your enrollment type and deadlines
First, determine whether you're enrolling in your employer's plan or a government-funded plan. If your option is private insurance through your employer, the enrollment dates are set by your company's human resources department. Marketplace plans are open from Nov. 1 through mid-January.
Compare total costs, not just premiums
When evaluating plans, look beyond the monthly premium. Consider deductibles, copays and out-of-pocket maximums as well. Most healthcare costs are increasing across the board.
According to KFF, a health policy organization, "the amount health insurers charge for coverage on the ACA Marketplaces is rising 26%, on average, in 2026. In states that run their own Marketplaces, the average benchmark (second-lowest cost) silver premium, on which the tax credit calculation is based, is rising 17% next year. In states that use Healthcare.gov, these premiums are rising an average of 30%."
Gaylene Kanoyton, president and founder of Celebrate Healthcare, an advocacy group that helps people enroll in healthcare says "don't wait to the last minute."
Kanoyton recommends a three-step approach: "Number one, don't panic. Number two, make sure that you have all the documentation for your household income. Number three is always good to have someone that you trust to walk you through the process."
Verify your provider network
Double-check your provider's network to ensure your doctors, hospitals and medications are covered — or available at the lowest cost possible. Employer plans may offer broader networks, while marketplace options vary by state.
"Your health insurance is so important because all your preventative care is included, you know, your annual physical, your mammogram, your colonoscopy, all of your preventative care is included in your health insurance, and that saves lives," Kanoyton said.
Final takeaways
Look at your plan carefully — don't assume it's the same as last year. Check that your providers and prescriptions are still covered so your doctors and medications remain accessible.
Most importantly, know your deadlines. If you miss the enrollment period, you typically can't enroll until the next open enrollment period.
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
