How do I actually choose a health plan during open enrollment?

Don't anchor on the premium alone — compare the total expected cost. Look at four numbers for each plan: the monthly premium, the deductible, the out-of-pocket maximum, and how your specific doctors and prescriptions are covered. Estimate a realistic year of care (routine visits, a surprise ER trip, your regular meds) and run it through each plan to see what you'd pay in premiums plus cost-sharing. Confirm your providers are in-network and your drugs are on the formulary, since out-of-network surprises dwarf premium differences. Factor in extras tied to the plan, like an employer HSA contribution or wellness credits. Finally, match the plan to your risk tolerance: a low deductible buys predictability, a high deductible buys lower premiums and HSA access. Pick once a year, deliberately — you're usually locked in until the next enrollment unless you have a qualifying life event.