With 2027 Open Enrollment approaching, millions of Americans will soon be reviewing their health coverage for the year ahead. But choosing a health plan based on the monthly premium alone could leave individuals, families, and businesses overlooking some of the factors that matter most once coverage is actually put to use. Beginning with the 2027 plan year, Open Enrollment for Marketplaces using the federal platform is scheduled to run from November 1 through December 15, 2026. State-based Marketplaces may set different enrollment dates within federal requirements.
As people begin comparing their options, OneHealth Plus is encouraging consumers to look at the complete picture, including deductibles, out-of-pocket costs, provider networks, prescription coverage, and how their health care needs may have changed over the past year.
Look Beyond the Monthly Premium
The premium is only one piece of the total cost of health coverage. Consumers should also compare deductibles, copayments, coinsurance, and out-of-pocket maximums. A plan with a lower monthly premium may come with greater costs when care is needed, while a higher-premium option may provide a different balance between monthly expenses and out-of-pocket costs. Before selecting a plan, consumers should consider both what they will pay to maintain coverage and what they could reasonably expect to spend if they need medical care during the year.
“The monthly premium is usually the first number people look at when comparing health coverage, but it shouldn’t be the only number they consider,” said Brian Miller, Principal and co-founder of OneHealth Plus. “The real cost of coverage is also what you’re exposed to when you actually need care. Understanding the deductible, out-of-pocket costs, and what a plan actually covers can give you a much clearer picture of its overall value.”
Miller emphasized that focusing on the lowest premium can obscure deductibles, exclusions, and other costs that become important when someone actually needs care.
Make Sure Your Hospitals and Doctors Are In Network
Provider networks can vary significantly by plan, even when the benefits or premiums appear similar. Before enrolling, consumers should check whether their primary care physician, specialists, preferred hospitals, and other frequently used providers participate in the plan’s network. Families may need to conduct this review for several people, particularly if family members see different specialists or providers. Network type matters as well. Some plans may provide little or no coverage for non-emergency care received outside their network, while others may cover out-of-network benefits at a higher cost.
Review Prescription Drug Coverage
Anyone who regularly takes medication should review the plan’s covered drug list and prescription cost-sharing before enrolling. Consumers should determine whether their medications are covered, what tier they fall under, and whether the plan has a separate prescription deductible or other requirements. A plan that appears less expensive initially may ultimately cost more if a frequently used medication has limited coverage or higher out-of-pocket costs.
Think About What Changed This Year (and What May Change Next Year)
Health coverage needs rarely remain exactly the same from one year to the next. Individuals and families should consider whether they began taking new medications, started seeing a specialist, added a family member, or anticipate a procedure or other significant health care need in 2027. Life changes matter, too. Marriage, divorce, a new baby, a move, a change in employment, or a shift in household income can all affect the type of coverage a household needs or the options available to them.
Don’t Assume Auto-Renewal Is Your Best Option
Even if a current plan remains available for 2027, consumers should still compare it with their other options. Premiums, benefits, provider networks, prescription coverage, and other plan details can change from year to year. Consumers enrolled through the Marketplace should update their application information and review the plans available in their area before allowing existing coverage to automatically renew. Taking time to compare can help consumers understand whether their current coverage still aligns with their health needs and budget.
“Too often, people wait until Open Enrollment is underway to start asking whether their current coverage still works for them,” said Sean Colrick, CEO and co-founder of OneHealth Plus. “Reviewing your options early gives you time to ask questions, understand your options, and determine whether your coverage still fits your health needs and budget before you’re making a decision under pressure.”
Colrick encouraged brokers and their clients to begin these conversations before Open Enrollment, noting that reviewing coverage early provides more time to make informed decisions.
Small Businesses Should Review Coverage Through Both a Business and Employee Lens
Open Enrollment season is also a valuable reminder for small employers to review the health benefits they provide. Business owners should consider not only what coverage costs the company, but also what employees are expected to pay and how effectively the benefits meet their workforce’s needs. Questions to consider include: Has the employer contribution changed? Are employees facing higher deductibles or other out-of-pocket costs? Does the provider network work for employees in the areas where they live? Are the benefits competitive enough to help attract and retain employees?
Small employers should also evaluate their options early rather than waiting until a renewal deadline forces a decision. Unlike the annual Individual Marketplace Open Enrollment Period, certain small-business coverage options may be available throughout the year, giving employers additional flexibility to evaluate what works for their business and employees.
Start Asking Questions Before You Have to Make a Decision
For consumers and employers alike, understanding health coverage before enrolling can help prevent surprises later. That means asking questions about what a plan covers, where care can be received, what costs apply when coverage is used, and how the plan fits into an individual, family, or business budget.
“Health coverage is personal, and there isn’t a one-size-fits-all solution,” Miller said. “The right choice depends on the individual, which is why understanding what’s available, asking the right questions, and knowing exactly what is and isn’t covered is so important before enrolling.”
OneHealth Plus offers a private, level-funded health plan for individuals, families, sole proprietors, 1099 workers, and small businesses, with nationwide access through the Cigna PPO Network and year-round enrollment for eligible applicants.
As consumers and businesses prepare for 2027, OneHealth Plus encourages them to compare their options, understand the details, and choose coverage based on their individual circumstances rather than any single price or feature.
