As you get ready to buy health care coverage, here are a few things to think about before you decide on a plan that works for you and your family.

Do You Qualify for Assistance or Special Enrollment?

Whether you’re buying for the first time or renewing the coverage you have, check to see if you qualify for help paying your monthly premium or your share of the cost for services. The rules may change from time to time.

You may need your tax records from the last year to show your income. If you are enrolling outside open enrollment, you will also need valid proof of the life event that qualifies you for special enrollment.

Do You Have a Doctor You Like?

If you already have providers you like and will still want to see, make sure they’re in the network for the plans you’re interested in. To check, log in to your online account and go to Find Care.

What Affects How Much You Spend?

Your costs for health care coverage include:

• Monthly premium: Generally, the higher the monthly premium, the more the plan pays for covered services. This may be important if you have a chronic condition, plan to have a child, or expect to have higher health care costs.
• Deductible: A deductible is the amount you pay out of pocket before the plan pays. Plans with higher deductibles may have a lower monthly premium. Remember, you must meet the plan’s deductible before the plan starts paying benefits.
• Cost sharing: These include out-of-pocket payments such as copays and coinsurance.

What’s Coming Up? Or Might Be Coming?

We can’t predict the future. Illnesses, injuries and other unexpected events can happen, but you can plan ahead.

• If you have a family history of a chronic condition or conditions, you may want to consider a plan with lower copays for doctor and specialist visits and tests.
• Some sports may raise your risk of getting hurt. You may want to look at plans with a lower deductible if an extended stretch of treatments may come up.
• Consider your mental health as well as your physical health. Therapist visits for stress or mental health conditions may require copays as well.

What Medicines Do You Take?

Prescription drug coverage and copays or coinsurance amounts vary between plans.

All health plans we provide have a list of drugs the plan covers. The list includes payment level tiers. Drugs in a lower tier usually cost less.

If any of your covered drugs moves to a higher tier with a higher out-of-pocket cost, ask your doctor if there are lower tier alternatives or generics available.

Generics typically work like a brand drug at the same dose, strength and use. Generics are also approved by the Food and Drug Administration.

Is a Health Savings Account Right for You?*

Some plans work with an HSA, which is a special savings account you can use to cover a wide range of qualified health care expenses. An HSA can help you take charge of your health and how you spend your health care dollars. Not all plans are HSA compatible, so be sure to review your options.

Please note: Some people with cost-sharing reductions under their benefit plan that reduce the deductible below the federal government’s minimum deductible may not be eligible to contribute to a Health Savings Account. Please consult your tax adviser for more information.

One of our licensed sales agents or your independent, authorized Blue Cross and Blue Shield of Illinois agent can help you understand your options.

*Health Savings Accounts (HSAs) have tax and legal ramifications. Blue Cross and Blue Shield of Illinois does not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax adviser regarding tax consequences of specific health insurance plans or products.

Source: Overview and Basics,   U.S. Food and Drug Administration, 2025