As open enrolment season approaches, now is the perfect opportunity to review your health insurance options for 2026. Whether you are selecting a plan through Medicare, your employer, or the Affordable Care Act (ACA) Marketplace, taking a little time to prepare can help you make an informed and confident decision—without unnecessary stress.
“Health insurance terminology can be confusing, but understanding the details is essential,” said Cindy George, MPH, Senior Personal Finance Editor at GoodRx. “Taking the time to understand how premiums, deductibles, networks, and medication coverage work can make a significant difference in what you pay and the care you receive.”
Ready to make the most informed choice for your health coverage? Here are Cindy George’s five expert tips to guide you through the process.
- Keep Your Information Up to Date
Whether you use the ACA Marketplace, Medicaid, CHIP, or Medicare’s Extra Help programme, it is vital to update your income and household details each year during open enrolment. Any change in your circumstances—such as income adjustments, new dependants, or relocation—can affect your eligibility for subsidies and other financial assistance.
For those covered under employer-provided plans, ensure your dependants and beneficiaries are listed correctly. Also, promptly report any major life events, such as marriage, the birth of a child, or a change of address. Keeping your information accurate ensures that your coverage remains valid and tailored to your needs.
- Check Your Medication Coverage
Never assume your prescription benefits will remain the same from year to year. Health plans frequently update their lists of covered medications (known as formularies) and adjust the pricing tiers associated with them.
If you are enrolled in a Medicare Advantage or Part D plan, review the list of covered drugs carefully to confirm your prescriptions are still included. Doing so can prevent unexpected expenses in the coming year.
“Make your most important prescriptions a priority when searching for a plan,” George advises. “If a plan stops covering your medication or moves it to a higher tier, compare the GoodRx cash price—often it can be cheaper than your insurance copay.”
- Consider Options Beyond Insurance
Health insurance does not always cover every medication or treatment. According to GoodRx research, some plans exclude certain drugs altogether or impose restrictions such as prior authorisation. In these cases, it can be worthwhile to compare your insurance copay with the cost of paying out-of-pocket.
Services like GoodRx enable consumers to compare cash prices for both branded and generic medications, often offering savings that surpass what insurance plans provide. Although GoodRx is not an insurance product, using it strategically can reduce your overall healthcare costs, particularly for long-term prescriptions.
- Don’t Auto-Renew Without Reviewing Your Plan
Health insurance should never be treated as a “set it and forget it” purchase. Plan costs and coverage levels change annually, so taking the time to compare alternatives is essential. Automatically renewing your current policy without review may result in higher costs or less comprehensive coverage.
“Even if you are satisfied with your existing plan, always compare it before you renew,” George recommends. “Review critical details such as deductibles, out-of-pocket limits, and whether your preferred doctors and medications remain in-network. This helps you avoid unpleasant surprises next year.”
- Use Comparison Tools to Make an Informed Decision
Numerous free resources are available to help streamline the plan selection process. The Medicare Plan Finder allows users to compare Medicare Advantage and Part D options, while HealthCare.gov or state-based marketplaces let you evaluate ACA plans and estimate potential savings.
Additionally, using tools such as GoodRx can help cross-check prescription costs, providing a clearer picture of your total healthcare spending for the year.
By taking advantage of these tools, you can make a well-informed decision that fits both your health needs and your financial situation.
Taking just a little time to review and compare your options during open enrolment could save you significant money while ensuring your plan provides the coverage you require. With these expert strategies, you will be well-equipped to secure the best possible health insurance for 2026.