Common Health Insurance Mistakes
Common Health Insurance Mistakes (And How to Avoid Them Before You Enroll)
Choosing a health insurance plan can feel like navigating a maze—especially if you’re doing it during the busy Open Enrollment period. One wrong turn, and you could end up overpaying, under-covered, or stuck with doctors who don’t accept your plan.
Whether you're shopping through the ACA Marketplace or exploring other options, understanding the most common mistakes people make can save you serious money and stress. Here’s a breakdown of the top missteps—and how to steer clear of them.
🚩 Mistake #1: Not Checking the Provider Network
Imagine this: You finally pick a plan, only to find out your child’s pediatrician or your go-to clinic is out-of-network. That means higher costs—or switching doctors altogether.
✅ How to avoid it:
Before enrolling, look up your preferred doctors and hospitals to make sure they’re in-network.
Most ACA plans let you check providers right on the Marketplace website or insurer’s portal.
If your child sees a specialist, double-check that too.
💰 Mistake #2: Skipping the Subsidy Check
Many families assume they don’t qualify for ACA subsidies—but in reality, most people do. Even middle-income households may be eligible for Premium Tax Credits or Cost-Sharing Reductions that make coverage significantly more affordable.
✅ How to avoid it:
Use the official Marketplace subsidy calculator to check your eligibility.
Don’t guess your income—use last year’s tax return as a guide.
Ask a licensed broker to help estimate your savings (it’s free).
🧾 Mistake #3: Only Looking at the Monthly Premium
We all love a low monthly bill, but the cheapest plan isn’t always the smartest choice. A low premium might mean sky-high deductibles and out-of-pocket costs down the road.
✅ How to avoid it:
Balance premium costs with your typical health needs.
If you expect regular doctor visits, prescriptions, or specialist care, a Silver or Gold plan may save you more over time—even if the monthly premium is higher.
🧠 Mistake #4: Not Understanding the Terms
Deductibles, copays, coinsurance, out-of-pocket maximums… it can all sound like alphabet soup. But not understanding these can lead to surprise bills or underestimating your yearly costs.
✅ How to avoid it:
Take a few minutes to learn the basics (our Parent’s Guide to Deductibles & Copays can help).
Look at each plan’s summary of benefits for clear numbers.
Don’t be afraid to ask for help.
🕒 Mistake #5: Waiting Too Long to Enroll
Open Enrollment runs from November 1 to January 15 for most ACA plans. Miss that window, and you’ll need a qualifying life event—like a job change or having a baby—to get covered.
✅ How to avoid it:
Mark your calendar.
Don’t wait until the last day—plans can change, websites can get glitchy.
Set a reminder a week before the deadline to review your options.
🧾 Mistake #6: Forgetting to Cancel Old Coverage
If you’re switching from one health plan to another—say, from employer coverage to the Marketplace—forgetting to cancel your old plan can lead to double billing or gaps in coverage.
✅ How to avoid it:
Confirm cancellation dates with your old provider.
Coordinate start dates carefully so there’s no lapse in coverage.
🩺 Mistake #7: Ignoring Extra Benefits (Like Dental & Vision)
ACA plans often offer pediatric dental and vision, but adult coverage might require a separate add-on. Many folks overlook this and pay out-of-pocket for care they could’ve included.
✅ How to avoid it:
Review optional benefits during enrollment.
Compare dental/vision plans if they’re not included in your medical plan.
If you have kids, check what's covered at no additional cost.
