Why Open Enrollment Mistakes Are Common
Open enrollment requires making important decisions within a limited timeframe. Because health insurance can be complex, many people make avoidable mistakes that affect costs, coverage, or access to care for the entire year.
Understanding common open enrollment mistakes helps individuals make better decisions and avoid problems that are difficult to fix once enrollment closes.
Focusing Only on Monthly Premiums
One of the most common mistakes is choosing a plan based solely on the lowest monthly premium. While premiums matter, they are only one part of total healthcare costs.
Low-premium plans often have higher deductibles, copayments, and coinsurance. Failing to consider out-of-pocket costs can result in higher overall spending when care is needed.
Ignoring Changes to Existing Plans
Many people assume their current plan will stay the same and rely on automatic renewal. However, plans often change premiums, provider networks, drug formularies, or cost-sharing each year.
Not reviewing plan updates during open enrollment can lead to unexpected costs or loss of access to preferred providers.
Overlooking Provider Network Changes
Provider networks frequently change from year to year. A plan that included preferred doctors or hospitals previously may no longer do so.
Failing to check network participation during open enrollment can result in higher out-of-network costs or the need to switch providers mid-year.
Not Reviewing Prescription Drug Coverage
Prescription drug coverage is another area often overlooked. Formularies, drug tiers, and pharmacy networks can change annually.
A plan that covered medications affordably one year may increase costs the next. Reviewing prescription coverage during open enrollment helps avoid unexpected medication expenses.
Misestimating Income for Marketplace Coverage
For Marketplace plans, inaccurate income estimates are a common mistake. Overestimating or underestimating income can affect premium tax credits and lead to repayment obligations or missed savings.
Open enrollment is the best time to update income estimates carefully to ensure subsidies are applied correctly.
Failing to Consider Expected Healthcare Needs
Some individuals choose plans without considering upcoming healthcare needs. Anticipated surgeries, ongoing treatments, or regular specialist visits should influence plan selection.
Choosing coverage that does not align with expected usage can lead to higher out-of-pocket costs and financial stress.
Missing Enrollment Deadlines
Missing open enrollment deadlines is a serious mistake that can limit coverage options for an entire year. Employer and Marketplace enrollment windows are often short.
Failing to act on time may result in being uninsured or locked into coverage that no longer fits needs.
Not Reviewing Dependent Coverage
Changes in household circumstances, such as aging dependents or changes in eligibility, should be reviewed during open enrollment.
Failing to add or remove dependents correctly can result in coverage gaps or unnecessary premium expenses.
Skipping Plan Comparison Tools and Resources
Many employers and Marketplaces offer tools to compare plans side by side. Not using these resources can lead to uninformed decisions.
Comparison tools help estimate total costs and highlight differences that are not obvious from premiums alone.
Assuming Special Enrollment Will Be Available Later
Some individuals assume they can change coverage later through a special enrollment period. Special enrollment requires a qualifying life event and has strict time limits.
Relying on future eligibility is risky and may leave individuals stuck with unsuitable coverage.
Why Avoiding These Mistakes Matters
Open enrollment decisions usually remain in effect for the entire plan year. Mistakes can result in higher costs, reduced access to care, or coverage gaps that are difficult to correct.
By understanding common mistakes and taking a deliberate approach, individuals can use open enrollment effectively and choose coverage that supports both health and financial goals.
Related Guides