Open enrollment guide · Updated Oct 27, 2026
How to Compare Health Plans During Open Enrollment (2026)
The plan with the lowest premium isn't always the cheapest, and neither is the one with the lowest deductible. The right comparison is total yearly cost: what you pay in premiums plus what you'd pay for care, minus any money your employer puts in an HSA.
Step 1: Annualize your premiums
Multiply your per-paycheck premium by your number of paychecks (26 if paid every two weeks, 24 if twice a month). A $62 premium biweekly is $1,612 a year; a $21 premium is $546.
Step 2: Estimate your care for next year
Use three scenarios: low (a checkup and a few prescriptions, ~$600 in bills), medium (a few specialist visits or an MRI, ~$4,000) and high (surgery, a baby or a hospital stay, $20,000+). Look at last year's Explanation of Benefits statements for a realistic starting point.
Step 3: Run each scenario through the plan
You pay bills up to the deductible, then your coinsurance share (e.g., 20%) until you hit the out-of-pocket maximum. After that, covered care is $0. Example with $4,000 of bills on a plan with a $3,400 deductible and 20% coinsurance: $3,400 + 20% × $600 = $3,520.
Step 4: Subtract employer HSA money and tax savings
If an HDHP comes with an employer HSA deposit (say $750), subtract it. Your own HSA contributions also skip federal income tax and FICA, and most state tax too, which saves roughly 20–35% on what you put in.
Step 5: Compare the worst case
Add the annual premium to the out-of-pocket max. That's the most you could pay in a bad year. If you couldn't cover that from savings, a lower out-of-pocket plan may be worth a higher premium.
Don't forget the network
Check that your doctors, hospital and prescriptions are in-network and covered (the formulary). An out-of-network surprise beats any premium savings.
| Example (single, medium use) | PPO | HDHP + HSA |
|---|---|---|
| Annual premium | $1,612 | $546 |
| Care cost ($4,000 bills) | ~$1,400 | $3,520 |
| Employer HSA | $0 | −$750 |
| Total | ~$3,012 | ~$3,316 |
Illustrative numbers. Copays simplified. At low use the HDHP usually wins; at high use it depends on the out-of-pocket max.
FAQ
When is open enrollment for 2026 coverage?
Employer open enrollment is set by your company, commonly in November. HealthCare.gov open enrollment for 2026 coverage runs Nov 1 to Jan 15 in most states.
Is a high-deductible plan worth it?
Often, if you're generally healthy and use the HSA. Compare total yearly cost at low, medium and high use; the HDHP typically wins at low use.