If you want to buy health insurance through the Affordable Care Act exchanges, the time to choose a plan for 2018 has arrived.

But you’ll have to act fast: The open enrollment period is just six weeks long, compared to 12 weeks in previous years.

That’s just one aspect that makes this open-enrollment season—the fifth since the ACA was rolled out—more challenging than usual. For some people, cost is another. Premiums on the lowest cost Silver plans sold on the federally run exchanges are up an average 35 percent over 2017, according to the Kaiser Family Foundation, a health policy research group.

You’ll feel those higher costs if you don’t qualify for subsidies intended to help make buying health insurance more affordable. You don’t qualify if you make more than $48,000 if you’re buying individual insurance, or $98,000 if you’re insuring a family of four.

More on open enrollment

But most people who buy individual insurance on the exchanges do qualify for financial help, so they will be insulated from the steep increases.

In fact, in an unintended consequence after the Trump Administration cut off a key funding source for ACA insurers, many people who qualify for financial subsidies will find comprehensive plans more affordable or will be eligible for insurance with no premium at all.

Whatever your financial situation, here’s how to make sure you get the best plan to cover your healthcare needs. 

Know Your Enrollment Dates

Although the window for signing up for health insurance was cut in half this year, from 12 weeks to six for the 39 exchanges that use the federally run Healthcare.gov platform, there are some exceptions. Nine exchanges, including D.C., have extended the sign-up period, as late as January 31, 2018. You can find state deadlines here.  

Find Out If You Qualify for Financial Help

Eight out of 10 people qualify for financial subsidies to pay their monthly insurance premiums. And six in 10 people can get help paying out-of-pocket costs for deductibles and copays. Most people can find plans with premiums between $50 and $100 per month and many can find plans for less than $50 a month, according to the Department of Health and Human Services. See what you qualify for here

Don’t Default to the Same Plan as Last Year

Plans, prices, and financial assistance change every year and most people can save money by shopping around. But about one-quarter of people simply “auto-renew” to the plan they’re currently in (or a similar plan if their insurer isn’t offering that insurance), according to the Kaiser Family Foundation. Checking out your options is especially critical this year. You will be automatically renewed in your current or an equivalent plan if you don’t act by midnight on Dec. 15. 

Confused about choosing a health insurance plan for 2018?

Send us your questions about signing up for job-based insurance, Medicare or a plan sold on the ACA exchanges. 

Understand Your Options

The various types of plans to choose from—Bronze, Silver, Gold, or Platinum—have different premiums and deductibles. Gold and Platinum plans have the lowest deductibles but the highest monthly premiums. Silver and Bronze plans have the lowest premiums but the highest deductibles.

You must choose a Silver plan to qualify for cost-sharing reduction subsidies, financial help to help you afford your deductibles and copays. This is above and beyond the help you may get to afford your premiums. If you earn $12,000 to $30,000 a year as an individual, or $25,000 to $62,000 as a family of four, you qualify for CSRs, so you should buy a Silver plan.

In a weird twist, the fact that the Trump Administration has stopped funding the CSRs has made it possible for all people eligible for help paying premiums to get an even better deal. It is possible they could buy Bronze insurance with a $0 premium or a Gold plan for less than what a Silver plan would cost.

A new analysis by Avalere Health found that there will be free plans available in almost all counties where federal exchanges operate. Free plans are mostly Bronze but are also some no-premium Gold and Silver options too.

That’s because the premium-support help that people get is tied to Silver plan costs, so those subsidies—which can be used to buy any plan—are much bigger this year.

One caution: Bronze plans have big deductibles—nearly $6,000 on average for an individual and $12,000 for a family, according to HealthPocket.com. That’s what you pay out of your own pocket before insurance starts to cover a portion of your bills. So if you go this way, make sure you have the money to cover a steep deductible.

Consumer Reports is working with National Public Radio's WNYC to make sure We’ve Got You Covered during open enrollment. We'll help you find the best health insurance plan to fit your needs, answer your questions and explain the challenges consumers face choosing health insurance for the coming year.

Find Out Which Plans Cover Your Doctors and Medications

Doctors don’t necessarily accept the same insurance plans year to year, and the specific prescription drugs your insurance covers can also change. Call your doctors to see what insurance they will accept in 2018. You can also find that information using lookup tools on HealthCare.gov. Using the tool, select the doctors, hospitals, and prescription drugs you use. When you view plans, you’ll see which plans cover them in network. 

Estimate Your Healthcare Costs

Understanding your healthcare needs is a big part of estimating your healthcare costs. No one can predict a medical crisis, of course, but if you have a chronic condition or take a medication regularly, your healthcare costs will likely be higher than those for someone who is health-problem free.

In general, if you go to the doctor a lot, choose a plan with lower out-of-pocket costs because copays and coinsurance can add up quickly, perhaps outpacing what you spend on premiums. Use tools like FairHealthConsumer.org to estimate your yearly healthcare needs.

When you log in to HealthCare.gov, you can identify your expected use of medical services as low, medium, or high, and be steered to a plan better suited to your needs.  

See If You Qualify for Medicaid

There is no open enrollment period for Medicaid, the government health insurance for low-income people. You can sign up any time of year if you qualify. But many people don’t realize they do. If you use the ACA exchanges during open enrollment and are eligible for Medicaid, you will be automatically enrolled. You can check here.  

Look Beyond the Exchanges

If you don’t qualify for financial help to pay your premiums and out-of-pocket costs, you might do better shopping off-exchange this year because some states encouraged insurers to boost premiums only on Silver plans sold on the exchanges. An “off-exchange” plan is one that you purchase directly from an insurance company or an insurance broker.

Just make sure you are getting a plan that is ACA compliant or you will pay a penalty for not having qualifying coverage. There is still coverage that doesn’t meet ACA standards out there, such as short-term coverage, limited-benefit plans, and critical-illness plans.

Some 5.4 million people bought off-exchange in 2017 but almost half of them could have qualified for subsidies if they had bought through HealthCare.gov or their state exchange. So make sure you compare both on- and off-exchange plans. If you think your income will fluctuate or change during the year, you should buy on-exchange. If you don’t, and you lose your job, say, you won’t be able to get subsidies until you sign up for an on-exchange plan during the next open enrollment period. 

Know Where to Turn for Help

Call center representatives at Healthcare.gov are available to help 24/7, every day (except Thanksgiving) at 800-318-2596 to answer questions. Assistance is available in many languages, too.

If you want in-person help, you can enter your ZIP code at the Get Covered America Connector tool to make an appointment. You can also find free help in your community by visiting LocalHelp.HealthCare.gov.  Consumers Union, the policy and mobilization division of Consumer Reports, created HealthCare Launchpad, a site listing enrollment assistance resources by state.

Understand What Happens If You Don’t Have Insurance

Don’t want insurance? If you do not sign up for ACA health insurance and don’t have coverage from another source, you may have to pay a penalty of $695 per person and $347.50 per child or 2.5 percent of your household income, whichever is higher. The penalty is waived if you don’t qualify for financial help and would have to pay more than 8.05 percent of your household income for coverage from either your employer or the cheapest available ACA bronze plan. Here’s how to know if you have an exception to the penalty