Check your doctors and prescriptions before you enroll

Two plans can have the same price and the same deductible and still be very different for you. The difference is usually in two lists: the provider directory (which doctors and hospitals are in network) and the formulary (which medicines are covered and at what price). Check both before you enroll. It takes about ten minutes.

Before you start, write down

• Your doctors' full names and the clinic or hospital they work at.
• The hospital you would want to go to.
• Each medicine you take: the name, the strength and how often.

Check the doctors

1. Open the plan's provider directory. On HealthCare.gov it's linked from each plan; carriers also have their own search.
2. Search each doctor by name and location. A doctor can be in network at one office and not at another.
3. Check the hospital the same way.
4. If it matters a lot, call the doctor's office and ask: "Do you take the [plan name] Marketplace plan for next year?" Use the exact plan name. Offices often take one plan from a company but not another.

Networks change every year, so check again at each Open Enrollment, even if you're keeping the same company.

Check the medicines

1. Open the plan's formulary (sometimes called the drug list).
2. Find each medicine and note its tier. Lower tiers cost less. Generic drugs are usually on the lowest tier.
3. Look for letters next to the drug, like PA (prior authorization) or ST (step therapy). They mean extra steps before the plan pays.
4. If a medicine isn't listed, ask your doctor whether a covered one would work.

Then compare the real cost

A plan with a lower monthly price and a higher deductible can cost more over the year if you fill a brand-name prescription every month. Add up premiums plus what you expect to pay for visits and medicine. Our guide to lower-cost coverage walks through that math, and how tax credits work shows what you'll actually pay each month.

A licensed agent can run these checks with you for free while you compare plans.