Nov 2, 2026 · 35 min
Open enrollment turns health insurance into a yearly financial calculation
HMO, PPO or High-Deductible Plan? Navigate Open Enrollment as Health Care Costs Rise
Rising premiums and changing coverage can make last year’s plan a poor fit, so comparing total costs and likely care needs matters.
- 1Compare premiums, deductibles, out-of-pocket limits, networks, and referrals rather than judging plans by monthly cost alone.
- 2Estimate next year’s medical spending from past bills and expected changes, then test plans across low- and high-use scenarios.
- 3Review HSA and FSA rules, ACA marketplace changes, and medical bills before deadlines or automatic renewal lock in costly choices.
Don't miss
Kate Ashford’s household spreadsheet approach turns plan selection into a comparison of total costs under different medical-use scenarios.
The brief
Kate Ashford joins Sean Pyles and Elizabeth Ayoola to make the case for reviewing health coverage every year, whether it comes through work, Medicare, or the marketplace.
The central tradeoff is simple but easy to miss: lower premiums often mean higher deductibles, while broader networks and more flexibility can raise the price of coverage.
Instead of guessing, the group recommends comparing premiums, deductibles, and out-of-pocket maximums across realistic scenarios, including major changes such as pregnancy, children’s care, or orthodontics.
Kate describes using a high-deductible plan alongside an HSA, while the discussion explains why tax treatment, portability, contribution rules, and expected spending can change the calculation.
ACA marketplace plans and insurer networks can change, so automatic renewal is not enough; the episode closes with advice to inspect bills and negotiate disputed charges.
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