7 Reasons to Consider Switching Health Insurance Plans

switching health insurance

Did you know that health insurance companies typically auto-enroll you in your same health plan every year if you do not actively cancel your plan?

We get it. Buying health insurance is a pain, and auto-enrollment can seem like a comfortable option. However, since your health, financial, and family situations don’t stay the same from year to year, we don’t think your insurance should either! Spending a little time each Open Enrollment to pick your optimal plan can save you thousands of dollars and get you better care. Here are seven reasons why you might want to consider switching health insurance plans.

1. Your Current Doctor Might Stop Accepting Your Insurance

Doctors are constantly changing which health insurance plans they accept. This means that there’s always a chance your doctors will not accept your health insurance next year. To find out if this is the case, you can call your doctor’s office and ask which plans they will accept.

If your favorite doctor will no longer accept your health plan and you would like to keep visiting him/her, you have two options:

  1. Paying for out-of-network visits. Out-of-network doctor visits are sometimes partially covered by your insurance, but most often are left to you to cover in full. These visits can be very expensive, so it’s important to prepare for your investment ahead of time. Try asking your doctor if they are willing to negotiate cash prices.

  2. Switching health insurance plans. You can ask your doctor which plans they will accept next year. If you find an option that fits your budget and care needs, make the switch! Visit your doctor often? Consider switching health insurance to a plan in a higher metal tier; typically this means that you’ll pay less for your visits, which can actually save you money in the long run.

2. Your Costs Might Go Up

Just because you are enrolled in the same health plan doesn’t mean you’ll pay the same thing year after year. In fact, monthly prices for popular plans are expected to rise by an average of 15 percent from last year, with some states seeing increases by as much as 36 percent! In addition to your monthly health insurance premiums, other costs like your copay, coinsurance, and deductible can change.

The good news: you don’t have to be stuck with a more expensive plan! By switching your health insurance to the cheapest plan in your metal tier, it’s very likely you can pay the same (or less) for a similar option.

3. You Might Not Have the Right Level of Care

Evaluate your care needs and financial investment over the last year. Is your health plan working the way you need it to? If you paid full-price for several doctor visits and prescriptions, try switching to a plan in a higher metal tier that offers better overall coverage. On the other hand, if you paid for an expensive plan, but rarely used it, look into less expensive, higher deductible options.

You should also consider your upcoming care needs. If you or a family member is pregnant or was recently diagnosed with a medical condition, you’ll want to switch to a health plan that gets you access to the right doctors, hospitals, and prescriptions.

4. Your Prescriptions Might No Longer Be Covered

Your health insurance company may decide to no longer cover a prescription; it can even alter how much of the prescription it covers. To avoid getting slammed with unexpected charges at the pharmacy, check with your insurance company to make sure your medications will be covered next year. If something changes, switch to a plan that gets you the coverage you need.

5. Your Plan May No Longer Be Offered in Your Area

Major insurance companies change which geographic areas they cover from year to year; this is particularly common with plans purchased on HealthCare.gov, as insurance companies often decide to change if (or how much) they participate on the federal exchange. If your plan no longer covers your area and you signed up on Healthcare.gov or your state exchange, your insurance company will automatically enroll you in a similar plan… but what your plan covers, how much it costs, and whether your providers are in-network can all change. And what if you enrolled directly with the insurance company and they leave your area? Or you move to a new state? You likely won’t be re-enrolled at all, so it’s especially important to call your insurance company and see if they plan to keep you on board.  

6. You Might Not Be Able to Change Your Mind Later On

There is only one time of year when you can switch to a new health plan (unless you have a qualifying event). If you let your insurance company auto-enroll you, you’ll be stuck with the plan they choose for the whole year! Taking the time to switch to a different option during Open Enrollment is a great way to ensure you have a plan you’ll like and use all year.

7. Your Income Might Change

Health insurance subsidies can make your health plan much more affordable by lowering the cost of your monthly health payment or copay/coinsurance. If you currently have a subsidized plan, but expect to make more money next year, you could end up underpaying for plan and you’ll have to pay the government back at tax time; this could be a significant amount of money, especially if your subsidy increases to match rising plan prices.

On the other hand, if you make less money next year than you did last year–or if you didn’t get a subsidy last year, but could now qualify for one–you’ll lose out on year-round health care savings by not switching. We always suggest accurately re-estimating your annual income in order to get the right subsidy amount and secure more financial stability throughout the year.

Ready to Make the Switch?

Finding a new plan that meets your unique financial and health needs doesn’t have to be a hassle. After you cancel your old plan, Stride makes it easy to compare your options, see if you qualify for subsidized plans, and more!