As open enrolment season arrives, it’s the perfect time to review your health insurance options for 2026. Whether you’re choosing a plan through Medicare, your employer, or the Affordable Care Act (ACA) Marketplace, taking a little time to prepare can ensure you make an informed choice without the 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 for you can help you save money and find a plan that suits your needs.”
Ready to make the best decision for your health coverage? Here are George’s five expert tips to guide you:
1. Keep Your Information Up to Date
Whether you use the ACA Marketplace, Medicaid, CHIP, or Medicare’s Extra Help programme, it’s crucial to update your income and household information every year during open enrolment. Changes in your personal circumstances can affect your eligibility for certain programmes and the amount of financial assistance you receive.
If you’re enrolled in an employer health plan, make sure your dependents and beneficiaries are correctly listed, and report any life changes like a marriage, the birth of a child, or a change of address. This ensures your coverage remains relevant and accurate.
2. Check Your Medication Coverage
Don’t assume that your prescription coverage will remain the same as last year. Health plans often update the list of medications they cover and change the costs associated with them. If you’re enrolled in Medicare Advantage or a Part D plan, double-check that your prescriptions are still included. A quick review now can save you from costly surprises later on.
“Make your most important prescriptions a priority when searching for a plan,” advises George. “If a plan no longer covers your medication or moves it to a higher price tier, you can check the GoodRx cash price. In many cases, this may be much lower than your insurance copay.”
3. Consider Options Beyond Insurance
It’s important to remember that insurance alone may not cover all of your medication costs. Research from GoodRx shows that some plans may exclude certain medications or impose restrictions, such as prior authorisation. In these cases, it’s worth comparing your insurance copay with the cost of medication without insurance.
For example, services like GoodRx allow you to compare cash prices for both branded and generic medications, potentially offering substantial savings that may beat your copay. While GoodRx isn’t insurance, it can often provide a more affordable option, so factoring it into your decision-making process could benefit your overall budget.
4. Don’t Auto-Renew Without Reviewing Your Plan
Health insurance isn’t a “set it and forget it” type of purchase. Since costs and coverage can change annually, it’s always worth taking the time to shop around. Automatically renewing your plan without a review could mean missing out on a more cost-effective or comprehensive option.
“Even if you’re happy with your current plan, make sure you compare it before you renew,” George recommends. “Check key factors like the deductible, out-of-pocket maximums, and whether your preferred doctors and medications are covered. This will help you avoid any unexpected surprises next year.”
5. Use Comparison Tools to Make an Informed Decision
There are several free tools available to make plan shopping faster and easier during open enrolment. The Medicare Plan Finder allows you to compare Medicare Advantage and Part D options. HealthCare.gov or your state marketplace helps you review ACA plans and estimate potential savings. In addition, you can use GoodRx to cross-check prescription prices, giving you a clearer picture of your total yearly healthcare costs.
By using these resources, you’ll be able to make a more informed choice about your health coverage and avoid overspending on medications and premiums.
Taking a little time to review and compare your options could save you money and ensure that your health plan suits your needs for the year ahead. With these expert tips, you’ll be well on your way to securing the best coverage for 2026.