Fall and winter doesn’t just mean cooler temperatures, fun activities and football playoffs. It’s also open enrollment time for health insurance plans.

Understanding your health insurance policy and comparing your options may seem complicated and daunting, but here are some tips that should make it simpler.

Affordable Care Act

The Affordable Care Act (ACA) aims to get more Americans covered and offers a Health Insurance Marketplace (healthcare.gov) where small businesses and individuals can purchase a policy.

• Open enrollment takes place from Nov. 1 to Jan. 15 for plans that start Jan. 1, 2022.
• Many people qualify for subsidies that reduce out-of-pocket costs.
• The marketplace offers four levels of coverage – bronze, silver, gold and platinum – determined by how costs are shared. To determine which level fits your needs, go to www.Healthcare.gov.
• The ACA requires people to have “qualifying health coverage,” and those who don’t have health coverage face a penalty (a fee) when filing taxes.
• To sign up, you will need Social Security numbers, income details and last year’s tax documents.
• For details or help, visit Healthcare.gov or call 1-800-318-2596.

Check your coverage

For those who already have health coverage, the first step during open enrollment should be to review your current plan so you can compare it with plans offered for the next calendar year. The following items are important factors to take into consideration:

• Deductibles
• Copays
• Monthly premiums
• Covered services

You should also think about how well your plan worked for you and your family in the past year.

• Was your deductible too high?
• How much did you pay for an average doctor visit?
• Were you unable to see a particular doctor or go to a particular facility due to them being out of network?
• Were you satisfied with the prescription drug coverage?
• How often did you use your insurance?
• Did your insurance deny claims?

Comparison shop

Next, check and see if your current plan is changing for next year and compare it to your other options. Some key things to check include:

• Are your doctors in the plan’s network?
• Is your preferred hospital in the network?
• Are your prescription drugs covered?
• Are treatments (physical therapy, mental health visits, etc.) covered?

You can find this information on the insurance company’s website or by calling customer service.

Personalize your search

Always keep your family’s particular needs in mind when choosing health coverage. For example, those planning a knee replacement surgery might need to pay close attention to hospital stay costs and physical therapy coverage.

According to nonprofit advocacy group Consumer Reports, those with expensive medical conditions might look at plans with a higher premium that covers more, while those who are “generally healthy” might want to buy coverage with a lower premium that requires more out-of-pocket costs for care.

Learn more about Spartanburg Regional Healthcare System’s participating insurance plans.