How to Choose a Health Insurance Plan

Picking a health insurance plan can be complicated, but we're here to help make it easier.

Several factors go into selecting your health insurance. Many of them will be specific to your own situation and require careful consideration. But before you get into the details, it can be helpful to narrow your choices based on some big-picture issues.

Your budget, how often you go to the doctor, and whether you use prescription drugs are some of the points you may need to consider. You also may need to brush up on the language of health insurance. Our enrollment guide includes a term glossary for easy reference.

Consider Your Health Insurance Budget

Cost is one of the most important considerations most people have. How much do you have available to spend each month on your health care plan premium? How many prescriptions do you take? How often do you visit the doctor? What’s the most you could afford to pay out of pocket for the whole year?

All these factors can help you determine which plan is the most affordable and provide you and your family the best value. You’ll want to think about:

• Frequency of doctor visits: Do you rarely visit the doctor? A low premium plan with a higher deductible may be right for you. Do you have regular appointments with your primary care doctor and one or more specialists? You might want to choose a plan that offers a number of doctor visits each year at no cost to you.
• Upcoming surgeries or procedures: You may already know that you need surgery or multiple medical procedures in the new year. Factor them into your decision by comparing how different plans cover what you need.
• Prescriptions: Most plans cover prescription drugs by requiring a co-payment or co-insurance, based on the type of drug. If you use certain highly specialized drugs, you should consider how much those copays will cost you out of pocket. Some plans offer our Wellness Drug benefit, providing certain types of medications to our members with a co-payment or co-insurance without meeting a deductible first. 

Review Your Plan Options

We offer three health insurance plan types: Vermont Preferred, Vermont Select, and Standard. Within these plan types there can be up to four levels (Platinum, Gold, Silver, and Bronze) with varying coverage options.

For example, our Preferred plans offer combined primary care and mental health visits at no cost, while Select plans are high-deductible health plans for Health Savings Account (HSA) options. In our Standard plans you may pay a co-payment for office visit-based services before meeting a deductible.

When choosing a plan, it may help to evaluate premiums first (Bronze has the lowest and Platinum the highest). First, select a level that fits your monthly budget. Then compare plan details within your chosen level to look for the features most important to you.

Our Individual & Family Plans & Premiums Chart and online tools can help you easily compare all our available plans. Try our Find-A-Plan tool, which guides you through the selection process by asking questions specific to your health care needs. Our plan comparison chart allows you to see all of our plans — with their costs and benefits — side by side.

Think High Versus Low: Deductibles, Premiums, and Cost-Sharing

This is where you start digging into the details.

Generally speaking, plans that have a high deductible have lower monthly premiums. These might be the best option for people who rarely visit the doctor or don’t use prescription medications.

Higher-premium plans cost more each month but generally come with a lower deductible. This might make it easier for people with frequent, regular medical needs to budget for their care throughout the year.

All plans — whether high deductible/low premium, vice versa, or somewhere in between — also have some cost-sharing structure. It’s important to consider the amount you pay out of pocket each time you use your health insurance. 

Save Money on Health Care

You may have additional options to help you save money on your health insurance plan costs.

Health Savings Accounts (HSA)

Some health insurance plans allow you to set up a Health Savings Account. An HSA is a financial account that can help you save for future medical costs and pay for qualified medical expenses pre-tax. Our Consumer-Directed Health Plans (CDHP) would allow you to contribute to an HSA. 

Health insurance subsidies

You may qualify for a federal or state subsidy to help you afford your health insurance premium. These subsidies may be available for households based on their income. Our plan comparison tool can help you determine if you’re eligible.

Get Help Choosing Your Plan

You may want more personalized assistance in choosing your health plan. If you do, we’re here to help.

“We understand the value in your health and help determine what plan is the best for you,” said Blue Cross Sales & Service Manager Jordan Benson. “We try to understand your needs from premium cost to medical services and pharmacy use — and find a plan that is most supportive of those needs.”

There are two ways consumers can purchase Blue Cross coverage:

• Vermont Health Connect, where you can enroll if you are eligible to receive federal or state subsidies.
• Blue Cross VT, where you can enroll directly with us if you don’t qualify for subsidies.

Our local support team is here to answer your questions throughout Open Enrollment at (800) 255-4550.

Open Enrollment Details

Open Enrollment started November 1 and continues through January 15, 2023. You need to enroll by December 15 for a January 1, 2023, effective date. Otherwise, your plan will go into effect in February. If you’re uninsured or want to change your plan, you need to enroll by January 15, 2023.

We’re also available to help if you have a qualifying event during the rest of the year, such as a birth, marriage, divorce, or loss of coverage. We'll guide you through the process and help you choose the best plan to meet your specific needs.