By Stephanie Vojicic, President, Anthem Blue Cross and Blue Shield in Missouri

Think about the last major purchase you made. You likely didn't settle on the first option you found. You compared prices, weighed what you would get for your money and considered which choice best fit your needs.

Choosing health coverage calls for that same thoughtful approach.

Healthcare costs are a concern for many families. According to KFF, 36% of U.S. adults say they have skipped or postponed needed healthcare in the past year because of cost.

Missourians face similar pressures. A 2025 West Health-Gallup healthcare scorecard found that 31% of Missouri adults had avoided a doctor-recommended procedure, lab test or evaluation in the previous year because they could not afford it, while 24% said healthcare costs were a major financial burden for their household.

That's why Open Enrollment involves more than comparing monthly premiums. It's a chance to consider the full picture: what you'll pay for coverage, what you may pay when you need care, which doctors and hospitals are in-network, how your prescriptions are covered and what resources can help you make informed decisions throughout the year.

As you compare your options, here are five things to keep in mind.

1. Know the terms that affect what you pay

The monthly premium may be the most visible number when comparing health plans, but it doesn't tell the whole story.

A plan with a lower premium can look attractive at first glance, but what matters is what you could spend over the course of the year. Deductibles, copays, coinsurance and the out-of-pocket maximum can all affect your costs when you actually use your benefits.

Instead of asking only, "What will this cost me each month?" consider asking, "What could my healthcare cost me over the course of the year?"

Think about the care you and your family typically use. Do you regularly see specialists? Take prescription medications? Expect a procedure or ongoing therapy? A plan with a higher monthly premium may sometimes offer lower costs when you receive care.

And remember: where you receive care matters, too. Using in-network providers and choosing an appropriate care setting can make a meaningful difference in what you pay.

2. Check the network before you enroll

Most of us wouldn't sign up for a streaming service without first checking whether it includes the shows we want. The same principle applies to healthcare.

Before selecting a plan, check whether the doctors, specialists, hospitals and health systems you prefer are in the plan's network.

That's important if you already have established relationships with healthcare providers or anticipate needing specialty care in the coming year.

Don't assume a provider who participated in your current plan will automatically participate in a new one. Provider networks can differ by plan, even when plans are offered by the same insurer. Taking a few minutes to check before enrolling can help prevent an unwelcome surprise when you need care.

3. Put your prescriptions on the shopping list

If you regularly take medication, prescription coverage can have a significant impact on your healthcare spending.

Before enrolling, make a list of the medications you currently take and check how each plan covers them. Look at the plan's drug list, or formulary, as well as its pharmacy network and applicable copays or coinsurance.

You may also want to check whether the plan offers options that could help lower costs, such as home delivery or lower-cost alternatives when clinically appropriate.

Even if you don't take regular medications today, understanding the prescription benefit can help you know what to expect if that changes during the year.

4. Shop for the healthcare you actually use

There isn't one health plan that's right for everyone. The better question is: Which plan fits the way you and your family use healthcare?

Someone who rarely visits the doctor may have very different priorities from a parent with young children, someone managing a chronic condition or a person expecting surgery in the coming year.

Look back at the healthcare you've used recently and think ahead to what you might need next year. Consider primary care visits, specialists, behavioral healthcare, ongoing therapies, prescriptions and any planned procedures.

Then consider something consumers don't always think about during enrollment: where you receive that care.

For some routine or non-emergency needs, you may have several appropriate options, such as virtual care, a primary care office, an urgent care center or another outpatient setting. Costs can vary depending on where services are provided.

Knowing those choices — and using available tools to compare them before receiving care — can help you get more value from your benefits and potentially reduce healthcare costs without sacrificing quality.

5. Don't stop shopping after Open Enrollment ends

Choosing coverage is only the beginning.

We compare prices throughout the year for flights, hotels, groceries and countless other purchases. Healthcare shouldn't be the exception.

Many health plans now offer digital tools and support that can help members find in-network providers, understand their benefits, compare care options and estimate costs before an appointment or procedure.

For example, Anthem Blue Cross and Blue Shield offers tools and resources designed to help members navigate their healthcare and make more informed decisions. Through the Sydney Health app, Anthem members can use the Find Care feature to search for in-network providers and compare estimated costs for certain services.

Consumers who used the Find Care digital feature saved an average of $185 and experienced a 32.7% reduction in out-of-network use.

That's important because lowering the cost of care isn't only about what happens when you choose a health plan. It's also about having useful information when you're making healthcare decisions throughout the year.

A quick Open Enrollment shopping list

Before you choose a plan, see whether you can answer these questions:

• What could I spend over the entire year, not just on monthly premiums?
• Are the doctors, specialists and hospitals I want to use in-network?
• How are my current prescriptions covered?
• What healthcare needs do I or my family expect in the coming year?
• What resources can help me understand and use my benefits?
• Can I compare estimated costs and care options before scheduling certain services?
• If I need routine or non-emergency care, do I understand the different care settings available to me?

Open Enrollment is your opportunity to select coverage. Making the most of that coverage, however, is an opportunity you have all year.

When you understand your benefits, stay in-network and use available tools to compare options before receiving care, you can make better-informed healthcare decisions and take a more active role in managing your spending.

Anthem members have access to tools and resources designed to make healthcare simpler to navigate and help them find the right care, at the right place and at the right time.

To learn more about Anthem coverage and resources available in Missouri, visit anthem.com/healthcareinmissouri.