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Open Enrollment: Compare Health Plans by Total Yearly Cost

By Smart Budget Sheets November 9, 2026
Three numbers per plan, a normal and a bad year, employer HSA money, network checks and the December 15 deadline.

Open enrollment makes health plans look harder to compare than they are. Most of the confusion comes from looking at the premium alone: a cheaper monthly premium can easily mean a more expensive year once you actually use care.

1. Three numbers per plan

Annual premium (your share per paycheck x number of paychecks), deductible, and out-of-pocket maximum.

2. Price a normal year and a bad year

Normal: premium + the care you used this year. Bad: premium + the full out-of-pocket maximum. Compare both totals, not just the premium.

3. Subtract employer HSA money

If a plan is HSA-eligible and your employer deposits into the HSA, subtract that from the plan’s yearly cost. It often flips the result.

4. Check doctors and prescriptions

In-network doctors and your regular drugs on each plan’s formulary. Out-of-network bills are not capped by the out-of-pocket max.

5. Size HSA / FSA contributions

HSA money rolls over; most unused FSA money is lost beyond the carryover or grace period.

6. Deadlines

Employer windows are often only 2-3 weeks. On HealthCare.gov, enroll by December 15 for coverage starting January 1 (open enrollment runs to January 15; state marketplaces can differ).

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General information, not personal financial or insurance advice.

#personalfinance #healthinsurance #budgeting
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