7 Reasons to Consider Switching Health Insurance Plans
Did you know that health insurance companies typically auto-enroll you in your same health insurance plan every year if you don’t actively cancel the plan?
We get it. Re-shopping health insurance sounds like a pain, so auto-enrollment can seem like a comfortable option.
However, because your health, financial, and family situations don’t stay the same from year to year, your insurance probably shouldn’t either. Spending a little time each Open Enrollment to pick the right plan can save you thousands of dollars and get you better care. With that in mind, here are seven reasons why you might want to consider switching health insurance plans.
1. Your plan may no longer be offered in your area.
Major insurance companies change which geographic areas they cover from year to year. 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 this plan covers, how much it costs, and whether your preferred doctors are in-network can all change.
Insider tip
If your health insurance plan is no longer offered next year, you will automatically be enrolled in the most similar plan, sometimes from a different health insurance company. We recommend shopping for a new plan to make sure your doctors and prescriptions remain covered!
2. 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 current 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 in the coming year.
If your favorite doctor will no longer accept your health plan and you would like to keep visiting them, you have two options:
Pay 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 to pay ahead of time. Try asking your doctor if they are willing to negotiate cash prices.
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 health care needs, make the switch. If you visit your doctor often, consider switching 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.
3. Your costs might go up or down.
Just because you are enrolled in the same health plan doesn’t mean you’ll pay the same amount for care year after year. As the cost of care increases, your insurance company may raise your costs to keep up. In fact, the monthly premiums for some plans could rise as much as 51 percent in the coming year!
The good news: You don’t have to be stuck with a more expensive plan. By re-shopping for coverage, it’s possible you could pay the same (or less) for a similar option.
On the other hand, it’s possible that your insurance company may lower the cost of your plan as much as 14 percent in the coming year. But if you don’t check, you won’t know whether your current coverage is still the ideal price. The moral of the story? Always re-shop to make sure you’re maximizing your savings from year to year.
The cost of your health insurance could rise by as much as 51 percent or decrease by as much as 14 percent next year. Always re-shop your current coverage to make sure you're maximizing your savings from year to year.
- Peterson-KFF Health Systems Tracker
4. 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, it’s worthwhile to 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.
5. 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.
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 — plus, it may or may not suit your needs.
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 premium, copay, or coinsurance.
If you currently have a subsidized plan but expect to make more money next year, you could end up underpaying for the plan. If that happens, you’ll have to pay the government back at tax time. That could cost a lot 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 could lose out on year-round health care savings by not switching. We always suggest 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 enroll you in the right plan for your needs.
Enter your ZIP code below to get personalized plan recommendations for 2025 in less than five minutes.
