Compare health plans with AI before you enroll

Who is this for?

This page is for someone staring at a health-plan packet during fall enrollment and wanting the words in plain English before they choose. You might be looking at a job's benefits, a HealthCare.gov plan, or a Medicare plan. You bring the document. The chat reads only that document. You decide.

This is not insurance advice. This is not medical advice. A chat does not know your health, your doctors, or next year's claims. It must not tell you which plan to buy, which drug to take, or whether you will get sick. If you want a person, Medicare.gov says you can call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) or a State Health Insurance Assistance Program (SHIP). SHIP counseling is free, and Medicare.gov says SHIPs are not connected to any insurance company or health plan. Find your local program at shiphelp.org or call 877-839-2675. Marketplace shoppers can search HealthCare.gov's local-help directory. That directory includes agents, brokers, and assisters. A broker is not the same thing as a SHIP counselor. You still choose.

The dates are not one season for every program. Medicare.gov's Open Enrollment page says Medicare Open Enrollment is October 15 to December 7, and changes are effective January 1 if the plan gets your request by December 7. Medicare's joining-a-plan page also lists a Medicare Advantage Open Enrollment Period, January 1 to March 31, only if you are already in a Medicare Advantage Plan. HealthCare.gov's dates page says that starting November 1 you can apply for 2027 coverage. On that page, Open Enrollment starts November 1, December 15 is the last day for coverage that can start January 1, Open Enrollment ends January 15, and coverage for people who enroll December 16 through January 15 can start February 1 if they pay the first premium. A job-based plan has its own dates, printed on the notice from your employer. Those dates are not the Medicare dates and they are not the Marketplace dates.

HealthCare.gov's page for the Marketplace in your state says how you apply depends on whether your state has its own Marketplace, and it tells you to pick your state. The same page says Oregon residents will use ExploreHealthOR.gov to enroll in 2027 coverage starting November 1, and to keep using HealthCare.gov for 2026 coverage information. If you do not live in a HealthCare.gov state, follow your state's official site. This page does not list every state's dates.

A confident paragraph is not a checked fact. The habit of marking what came from the document is Catch facts the AI made up.

What do you need before you start?

Gather the paper or the PDF before you open a chat. You already have it, or you know who must send it.

• The Summary of Benefits and Coverage (SBC) for each plan you are comparing. HealthCare.gov's SBC page says you have a right to this short summary, and to a Uniform Glossary, for individual and job-based plans, including grandfathered plans. The page says you can ask your insurance company or group health plan for a copy, and that Marketplace plan pages link the SBC. The same page says the SBC includes coverage examples for diabetes care and childbirth. Those examples are illustrations in the form. They are not a prediction about you.
• If you have Medicare and you are already in a plan, the Plan Annual Notice of Change (ANOC). Medicare's ANOC page says your plan sends it each fall, it includes changes in coverage, costs, and more that will be effective in January, and you should get it in September. If you do not get it, contact your plan. Medicare's publication Understanding Medicare Advantage Plans says the ANOC includes changes in coverage, costs, provider networks, and service area, and that the plan sends a printed copy by September 30.
• A list you write yourself: doctors you want to keep, drugs you take (name and dose), and the kind of care you actually used last year. A quiet year, a normal year, and a rough year come from that list. They are not a diagnosis.
• The official place you will verify doctors and drugs after the chat. For Medicare, that is Medicare.gov/plan-compare and a call or a directory from the plan. Medicare's helpful-tools page says you can enter the prescription drugs you take to get an estimate of monthly and yearly drug costs. Medicare's page on how drug plans work says to review the formulary before you join. The formulary is the plan's drug list.

You do not need a paid AI plan. You do need the document. A chat that "knows Medicare" and has not seen your packet is guessing.

Leave the Medicare card, the member ID, and the Social Security number out. Keep your data private with AI.

How do you gather the document?

Open the SBC or the ANOC. If you are comparing two plans, get both documents, not a memory of last year's plan. Write today's date at the top of your notes. Plan details change, and a screenshot from a friend is not your plan.

For a job, ask human resources or the benefits site for the SBC for each option. HealthCare.gov says job-based plans must provide it. The enrollment deadline on the employer's notice is the deadline. Do not borrow the Marketplace dates.

For Medicare, read the ANOC for the plan you have now, then use plan-compare when you are ready to see other plans in your area. The chat is the reading partner. The enroll button stays on Medicare.gov or with the plan.

For the Marketplace, preview plans on HealthCare.gov or on your state's official Marketplace. HealthCare.gov says the SBC is linked on the plan page. Download it. Do not ask the chat to remember a plan from its training.

If a word stops you, open the Uniform Glossary from the SBC page before you ask the chat to define it. A definition the chat invents is how "deductible" and "out-of-pocket limit" get swapped.

How do you decode it in plain English?

Paste the cost table, not your member number. Ask the chat to quote the document and to mark anything it cannot find. A translation that adds a benefit is not a translation.

You are helping me read a health plan document. This is not insurance advice and not medical advice. Do not tell me which plan to choose. Do not guess my health.

Document: [SBC or ANOC]. Plan name printed on it: [name]. Year it says it covers: [year].
I pasted the pages below. Use only those words.

For each of these, quote the line you used and then say it in plain English:
- monthly premium
- deductible
- copay or coinsurance for a primary visit, a specialist, urgent care, the emergency room, and a generic drug, if the document lists them
- out-of-pocket limit, and whether it is for one person or a family
- what the coverage examples say, if this is an SBC (diabetes care and childbirth are the two HealthCare.gov names)

If a row is not in my paste, write NOT IN THE DOCUMENT. Do not fill it from memory.
Do not say a doctor or a drug is covered. You cannot see the network or the formulary.
Then stop.

[paste the tables]

Read the quotes against the PDF with your finger on the line. If the plain English says "free" and the document says "no charge after the deductible," put the document's words back. That difference is the whole bill.

Three places to use the same decode. Copy the one that matches you, fill the brackets, and send only that.

Work, when the packet came from your employer:

This is my job's open enrollment. This is not insurance advice and not medical advice. Do not tell me which plan to pick.

I have two Summary of Benefits documents from my employer. Enrollment deadline printed on the employer's notice: [date]. Do not use Medicare or Marketplace dates.
Plan A name: [name]. Plan B name: [name].
Paste is below.

Make a two-column table. Each cell is a short quote from the document, then plain English. Rows: premium, deductible, out-of-pocket limit, primary care, specialist, emergency room, generic drug.
If a cell is missing, write NOT IN THE DOCUMENT.
Do not say my doctor is in network. Do not say a drug is covered.
Then stop.

School, when you are learning the document and a teacher assigned the reading. You write anything you turn in. Follow your teacher's rules.

This is for learning. Do not write anything I will turn in. Follow my teacher's rules. This is not insurance advice and not medical advice.

I am reading this Summary of Benefits, from the class packet or from the sample linked on HealthCare.gov:
[paste]

Ask me to explain, in my own words, premium, deductible, and out-of-pocket limit.
Wait for my explanation. Then tell me which sentence matches the document and which sentence does not. Quote the line.
Do not write a paragraph I could turn in. Do not tell me which plan a family should buy.
Then stop.

Life, when the packet is Medicare or the Marketplace:

This is not insurance advice and not medical advice. Do not tell me which plan to join.

Document: [ANOC or Marketplace SBC]. Plan name: [name].
I will confirm doctors and drugs myself on the plan's directory and, for Medicare, on Medicare.gov/plan-compare.

Quote every cost change the document says will happen in January. Under each quote, one plain sentence.
If the document does not mention my drug or my doctor, write NOT IN THE DOCUMENT. Do not look them up from memory.
Then give me three questions I should ask the plan or a SHIP counselor. Questions only. No recommendation.
Then stop.

[paste]

How do you compare three kinds of years?

A yearly cost is the premium times 12, plus what you would pay out of pocket in a year you describe. You describe the year from your own life. The chat does the arithmetic with numbers it can point to. It does not predict that you will have a hospital stay, and it does not invent a copay to make the math tidy.

Use three pictures, and name them yourself:

• A quiet year means the care you already know you will use if nothing unusual happens. You might type "one checkup and the prescriptions I already take." That is your sentence. It is not a forecast.
• A normal year means the visits and fills you actually had last year. You type the count. "About the same as last year" is too vague. "Four primary visits, one urgent care, these drugs" is a list the document can price.
• A rough year means one expensive situation you want to price. Use a coverage example printed in your SBC, or a bill you already received. Do not ask the chat to invent a diagnosis. HealthCare.gov says the SBC's coverage examples are diabetes care and childbirth. If your question is not one of those, and it is not a bill you have, write the services yourself and accept NOT IN THE DOCUMENT when the SBC does not price them.

Compare yearly cost for plans I paste. This is not insurance advice and not medical advice. Do not rank the plans and do not tell me what I should do.

My three years, written by me. Do not add visits.
Quiet year: [what I expect if nothing unusual happens].
Normal year: [the visits and drugs I actually used last year].
Rough year: [one situation, using an SBC coverage example or a bill I already have].

For each plan and each year, show:
- premium times 12, using the premium printed in the document
- the out-of-pocket amounts you can support with a quoted line
- a total only if every dollar in it came from the document or from premium times 12
If a service I named is not priced in the document, write NOT IN THE DOCUMENT and do not guess a copay.
The out-of-pocket limit is a cap printed in the document. It is not a prediction that I will hit it.
Do not say which plan is better.
Then stop.

Check the multiplication yourself. Twelve times the premium is a calculator, not a medical opinion. If the chat's total includes a copay you cannot find, delete the total. Ask for a tool, not an answer if you would rather see the arithmetic in a table you can redo. You still type the premium.

A household budget is a different job. The rent and the grocery list live on Make a monthly budget. Do not paste a health guess into that budget as if it were a bill you already owe.

How do you build a doctor and drug checklist?

The SBC and the ANOC can tell you that a network or a drug list changed. They are not the live directory. Medicare's joining-a-plan page says to check that the plan covers your prescriptions, and to ask your doctors and pharmacies if they are in network with the plan. Medicare's page on how to get services says that if you have a Medicare Advantage Plan you check with the plan whether your provider is in network, and that if you have drug coverage you check which pharmacies are in network. Original Medicare is a different rule on that same page: you ask the provider if they take Medicare.

Ask the chat for the checklist. Then you make the calls. The chat does not make them.

Build a checklist I will use to verify doctors and drugs with the plan. This is not insurance advice and not medical advice. You cannot see the current network or the formulary. Do not say anyone is in network. Do not say a drug is covered.

My doctors: [names].
My pharmacy: [name].
My drugs, name and dose: [list].
Plan I am checking: [name]. Program: [job plan, Marketplace, or Medicare].

Give me a checklist with one row per doctor and one row per drug.
Each row has a blank for "I checked on [date]" and a blank for what the plan or the office said.
Tell me where a person goes to check, in this order when it fits the program:
- the plan's own provider directory and drug list
- for Medicare, Medicare.gov/plan-compare, where I can enter my drugs
- a phone call to the office or the pharmacy to ask if they are in this plan's network

Add a last row: talk to a person before I enroll. For Medicare, name SHIP (shiphelp.org, 877-839-2675) and 1-800-MEDICARE. For the Marketplace, name HealthCare.gov/find-local-help and the official site for my state.
Do not fill in the blanks. Then stop.

Print the checklist or copy it into a note you control. A row without a date is a row you have not done. Networks change. A "yes" from last fall is not a yes for January.

When you want the choice laid out without a recommendation, use the same stops as Ask for options and tradeoffs and Pressure-test a decision. You still pick.

What does a worked example look like?

You have a job plan and a Marketplace SBC on the table. You are not on Medicare. Your employer's notice says enrollment ends on a Friday you circled. You do not type that date from memory of a coworker. You type the date printed on the notice.

You paste Plan A and Plan B cost tables. You delete the member ID in the header first. You ask for quotes, then plain English. The chat says Plan A primary care is "a small copay." You look at the SBC. It says a dollar amount after the deductible. You replace "small" with the document's line. Small is not a number.

You write your three years. Quiet: one annual checkup and two generics you already take. Normal: last year's four primary visits and one urgent-care visit. Rough: you use the childbirth coverage example printed in the SBC, because that example is in the document, and you are pricing the example, not predicting a pregnancy. Where the SBC does not price a service you care about, the cell stays NOT IN THE DOCUMENT. You do not let the chat borrow a copay from the other plan to fill the hole.

You do not enroll from the table. You open each plan's directory, you call the clinic, and you search the drug list for the two generics. Then you decide. If you want a person to sit with the Marketplace application, you use the local-help directory. The chat's table is the reading. The directory is the check.

What mistakes should you avoid?

These are the misses that waste the result. Skip them before you send anything.

Common mistakes

• Asking "which plan is best" with no document pasted.
• Treating a chat's memory of "typical" copays as your plan.
• Using Medicare dates for a job, or Marketplace dates for Medicare.
• Assuming the SBC lists your doctor. It is a summary of benefits, not a directory.
• Pasting a Medicare number or a photo of the card so the chat can "look you up." It cannot, and it should not have the number.
• Letting a coverage example become a prediction. Diabetes care and childbirth on the SBC are examples in the form.
• Calling a broker's suggestion the same thing as SHIP counseling. Medicare.gov says SHIPs are not connected to a plan. A broker may be.

When should you not use AI for this?

Close the chat and use an official source or a qualified person when any of these is true.

• You need to know if a symptom is an emergency. Call emergency services. Do not ask a plan-comparison prompt.
• You are choosing a drug or a treatment. That conversation is with your clinician. The formulary question is "does this plan list the drug my clinician already prescribed," which you confirm with the plan.
• You are in a Medicare Advantage Plan and the question is the January-to-March window, a Special Enrollment Period, or a late-enrollment penalty. Read Medicare's joining-a-plan page or call 1-800-MEDICARE. Do not let a chat invent the window.
• The document you have is last year's SBC and this year's packet has not arrived. Wait for this year's document, or get it from the plan. Comparing a stale PDF produces a confident wrong total.
• Someone online is offering to enroll you if you read them your Medicare number. Medicare and SHIP will not need you to paste that number into a random chat.

What should you keep private?

Paste plan names and cost tables. Do not paste your Medicare number, Social Security number, member ID, account number, or a photo of an insurance card. A drug name and dose is enough for a checklist. A full medical history is not. If the packet is your employer's and the company told you to use a work tool, use that tool. The rest of the rule is Keep your data private with AI.

What should you check before you use it?

Answer each line before you enroll or before you tell a family member the chat "said this plan is cheaper."

Director check: look before you use it

• Can you point to the quote for every dollar? If the line is not in the SBC or the ANOC, it is not a cost yet.
• Did you separate premium times 12 from care you might use? A low premium with a deductible you have not read is not a cheap year.
• Did the chat name a doctor or a drug as covered? Ignore that sentence. Check the directory and the formulary, or Medicare.gov/plan-compare.
• Are you using the right calendar? Medicare fall Open Enrollment, the Medicare Advantage window, Marketplace dates, and your employer's deadline are four different clocks. Read the one that matches your coverage.
• Did you leave a member ID in the chat? Remove it. Do not continue the comparison in that thread.
• Do you want a person? For Medicare, SHIP is free and is not a plan. For the Marketplace, start at HealthCare.gov or your state's official site.

What is one extra tip?

When the comparison is a table you want to recalculate, ask for that table on Ask for a tool, not an answer and check twelve times the premium on paper. When the reply could belong to any shopper, paste one row of your own document and use Show the AI an example so the next table matches that row's shape. The pattern is the columns. The content is your plan, not the sample.

One extra tip

A product you can return is a different comparison: Compare two products before you buy. A month of rent and groceries is Make a monthly budget. More home guides are on Life and Health plans.

Official pages to keep open: Medicare Open Enrollment, joining a plan, the ANOC, plan compare, HealthCare.gov dates, the SBC, and the Marketplace in your state.