Open enrollment season is here. Whether you’re exploring options through your employer or looking for coverage through kynect, Kentucky’s Marketplace, choosing the right health care coverage plan can feel challenging. Here’s a quick guide to help you compare plans. We have even created a spreadsheet you can download for free to help you visually compare your plan options.

Evaluate Your Needs: Start by considering your household’s health care needs. Think about who needs coverage, ongoing health conditions, and any upcoming medical needs like surgery or regular medications. If you travel frequently, or for prolonged periods, or have specific provider preferences, these factors can also influence your decision.

Understand Plan Types: Know the difference between Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs). HMOs typically have lower premiums and more limited provider networks, while PPOs offer greater flexibility. Also, check to see if your employer offers a Flexible Spending Account (FSA) or Health Reimbursement Account (HRA) for a tax-free way to pay your medical expenses, or if the employer or Marketplace plans available to you have Health Savings Accounts (HSAs) attached.

Analyze Costs: Carefully compare premiums, deductibles, co-pays, and co-insurance. A plan with a lower premium might come with a higher deductible, which could work well if you don’t anticipate many medical expenses. Take note of each plan’s out-of-pocket maximum, which is the most you’ll have to pay, other than premium costs, in a year for covered services. For medications, look at how they’re tiered within the plan, as generics often cost less than brand-name drugs.



Check Network Coverage: Look up your preferred doctors, pharmacies, and hospitals to determine whether or not they are in the network for each plan you are considering. Out-of-network services typically cost more, so it’s best to know what your benefits are in advance.

Organize and Compare: Sorting through plan details can get overwhelming, but our free downloadable spreadsheet can help. It lets you easily see how your potential total yearly costs compare with different plans.

If you’re shopping on the Marketplace, remember to see if you qualify for premium subsidies or cost-sharing reductions (CSRs), which can make a significant difference in affordability. Remember that for qualified insureds, the subsidies can be applied to any tier plan (Bronze, Silver, Gold, Platinum), while CSRs only work with Silver plans.

Watch the video below for a full walkthrough on how to use the spreadsheet and choose the best plan for you and your family.

Open enrollment for kynect coverage continues through January 15th. You must sign up for a plan by December 15th for coverage to start January 1st. If you sign up after December 15th, coverage will begin on February 1st. 

TAI provides free resources to help you compare plans, navigate insurance terminology, and understand and effectively use your coverage.

Get ahead of the process by visiting AsclepiusInitiative.org/toolkit to access these free resources. With the right information, you can confidently navigate your open or annual enrollment and choose the best coverage for your medical and financial needs.

Open enrollment for Medicare runs through December 7th. One of the most important decisions to make is between Traditional Medicare and Medicare Advantage, each of which has its own pros and cons.

In 2025, several changes will make Traditional Medicare coverage more affordable, including a new $2,000 per year cap on out-of-pocket prescription drug costs under Medicare Part D. This provides relief for many seniors. Financial assistance for low-income beneficiaries is also expanding, and price negotiations for certain high-cost drugs could lower costs.

Despite these changes, the decision between Traditional Medicare and Medicare Advantage remains complex. Traditional Medicare offers flexibility, allowing you to see any doctor nationwide who accepts Medicare. However, it has no cap on out-of-pocket expenses. Medicare Advantage, offered by private insurers, bundles different types of services into one plan and may offer extra benefits like dental and vision care. On the other hand, Medicare Advantage plans typically limit your network of providers and often require pre-authorization for various health care services.

Visit AsclepiusInitiative.org/Medicare to learn more about your Medicare coverage options.

The Asclepius Initiative is part of Kroger’s Community Rewards program. Select TAI as the charity of choice and a portion of the receipt will be donated to TAI each time the Kroger Plus Card is used. Signing up is quick and only has to be done once.

1. Go to KrogerCommunityRewards.com

2. Sign into using current login information or the number on the back of the card

3. Select TAI as the organization: search for us by name or by using our code, DG163

Help us continue to provide you with relevant and up-to-date health care coverage information.