What Are the Mistakes to Avoid When Choosing a Health Insurance Plan?

Choosing the best health insurance plan is one of the most important financial and health-related decisions you’ll make for yourself and your family. With so many options, terms, and fine print, it’s easy to make costly mistakes that could leave you underinsured or paying more than necessary. At California Affordable, we’re dedicated to helping Californians find the right coverage without the pitfalls.

Continue reading to learn common mistakes to avoid when choosing health insurance.

1. Focusing Only on the Monthly Premium
   It’s tempting to choose the plan with the lowest monthly premium, but that can be a big mistake. Low premiums often mean higher deductibles, copayments, and out-of-pocket maximums. If you need frequent medical care or prescriptions, a low-premium plan could end up costing you more in the long run.

   Tip: Always calculate the total cost of a plan, including premiums, deductibles, copays, coinsurance, and out-of-pocket maximums.

2. Ignoring the Provider Network
   Not all health insurance plans cover every doctor or hospital. If you have preferred healthcare providers, check that they are in-network for the plan you’re considering. Out-of-network care can be much more expensive or not covered at all.

   Tip: Use the insurer’s provider directory or ask your doctor if they accept the plan you’re considering.

3. Overlooking Prescription Drug Coverage
   Prescription coverage varies widely between plans. Some plans may not cover your medications, or may have higher copays for the drugs you need.

   Tip: Review each plan’s drug formulary (list of covered medications) to ensure your prescriptions are included and affordable.

4. Not Considering Your Healthcare Needs
   A young, healthy person may not need the same coverage as someone with a chronic condition or a growing family. Choosing a plan without considering your medical history, anticipated doctor visits, or upcoming procedures can leave you underinsured.

   Tip: List your expected medical needs for the year and choose a plan that matches your usage.

5. Missing Enrollment Deadlines
   Health insurance enrollment is limited to specific periods. Missing the Open Enrollment window or not qualifying for a Special Enrollment Period can leave you uninsured for the year.

   Tip: Mark your calendar for Open Enrollment dates and act promptly. Covered California is the official marketplace for health plans and provides key deadlines.

6. Not Checking for Subsidy Eligibility
   Many Californians qualify for premium subsidies or cost-sharing reductions through Covered California, but some miss out by buying plans directly from insurers.

   Tip: Use the Covered California Shop and Compare Tool to check if you’re eligible for financial assistance.

7. Skipping the Fine Print
   Every plan has details about what’s covered, what’s not, and what you’ll pay. Skipping these details can lead to surprise bills.

   Tip: Read the Summary of Benefits and Coverage (SBC) for each plan. If you have questions, ask a licensed agent or call California Affordable for help.

8. Assuming All Plans Cover Essential Benefits Equally
   While all ACA-compliant plans cover essential health benefits, the specifics can vary. Some may offer better mental health, maternity, or preventive care coverage.

   Tip: Compare benefits side-by-side, especially if you have specific health needs.

Make Informed Choices for Your Health and Finances

Finding the best health insurance plan requires careful consideration of your needs, budget, and the fine print. Avoid these common mistakes, use trusted resources, and don’t hesitate to seek expert help. At California Affordable, we’re here to guide you every step of the way—so you can protect your health and your wallet with confidence.

Ready to find the best health insurance plan for you? Contact California Affordable today and get personalized assistance. You can also call us directly at (800) 903-0326.

Frequently Asked Questions (FAQs)

Q1: Can I switch my health insurance plan outside of Open Enrollment?

You can only switch plans outside of Open Enrollment if you qualify for a Special Enrollment Period, such as losing other coverage, moving, getting married, or having a baby.

Q2: What happens if I make a mistake during enrollment?

If you realize you made an error (such as entering incorrect income or household information), contact Covered California or your plan provider immediately to correct it. Some mistakes can be fixed if caught early.

Q3: Are dental and vision plans included in health insurance?

Pediatric dental is included in all ACA health plans, but adult dental and vision coverage are usually separate and must be purchased as add-ons.

Q4: How do I know if my medications are covered by a plan?

Each plan has a formulary (list of covered drugs). Check this list on the insurer’s website or ask your pharmacist or doctor before enrolling.