Apples to apples?

Sticking with last year’s plan might not make sense, and in some cases might not be possible if employers have switched offerings. So health insurance specialists say employees should be prepared to do some research.

“It really is an exercise of understanding your personal situation, your finances, and how much you use health care or anticipate using health care,’’ said Sara Taylor, health and welfare strategy leader at consulting firm Hewitt Associates.

Figuring those things out can be daunting. Two years ago, a survey by eHealth Inc. found that most Americans would rather go to the gym and a third would prefer to do their taxes instead of figuring out their health insurance options. But given today’s economy, health insurance specialists say, it really pays to take the time to examine the different offerings.

“The fact is, it’s a big purchase and there’s probably nothing more personal than health insurance,’’ said Vin Capozzi, senior vice president for sales and customer service at Harvard Pilgrim Health Care.

Q. What kind of plans are out there?

A. Most plans fit into four categories, although not all employers offer all four: Preferred provider organizations, health maintenance organizations, point of service plans, and high-deductible plans. All the plans have different premiums and out-of-pocket costs such as deductibles, copays, and co-insurance.

HMOs appeal to people who prefer premiums that may be a little lower and who like a plan that makes many choices for them when it comes to specialists or hospitals. Most HMOs do not set a deductible amount that consumers must pay before coverage kicks in, but there may be deductibles for some services in an HMO plan, such as hospital stays, day surgery, chemotherapy, or allergy treatments, after which there is no charge.

PPOs allow more choices in doctors and hos pitals than HMOs. POS plans, which may have higher premiums and have more costs shared by employees, offer even more choices of providers. Both PPO and POS plans tend to have a general annual deductible that must be met before the plan pays for services.

As the name implies, high-deductible plans can require policyholders to make payments of up to $2,000 for an individual, or $5,000 for a family, before the plan starts paying a share of the bills.

That share, called co-insurance, can be a 90 percent/10 percent split between plan and consumer, compared with an 80 percent/20 percent split in PPO or POS plans. Monthly premiums are about 20 percent lower for high-deductible plans than the other plans.

Copays are common for HMO, PPO, and POS plans: $20 to $50 for doctor visits within the plan’s provider network. Copays vary for prescription drugs, and expensive drugs may require a higher copayment.

Q. What do I need to know so that I can pick the right health plan for me?

A. No matter which plan you choose, expect to pay more of your health care costs: Last year, 21 percent of companies cut back on the health benefits they offered, according to a national survey by the Kaiser Family Foundation, and 15 percent increased the employees’ share of premiums.

Begin your research by first looking at health care expenses from the past year to see how much you spent and what you spent it on.

Besides premiums, also add up what you paid for doctor visits, trips to the emergency room, hospital stays, medications, physical therapy, and medical equipment.

Then, factor in any new diagnosis you or your family members might have, especially if it will require periodic doctor visits or regular medications. Also consider the risks you or your spouse might face on the job.

Of course, some health needs can’t be anticipated: “You don’t plan for falling out of a tree and breaking your leg, but people who have chronic conditions have a general sense of going to the doctor often or not,’’ said Taylor, of Hewitt Associates.

Brian Pagliaro, senior vice president of sales and client services at Tufts Health Plan, said a person who has several children who go to the doctor often may be better off paying higher premiums and having a flat copay each time they visit a physician. On the other hand, older workers who earn more money may want to choose a high-deductible plan. Healthier workers who don’t plan to have lots of medical expenses may want to get a health savings account, which would allow them to sock away pretax dollars for such expenses for years in a sort of pay-as-you-go way.

“The employee has to consider where he or she is in the life cycle,’’ Pagliaro said.

Q. What counts toward my deductible?

A. It depends. Many preventive services, such as mammograms, immunizations, and certain lab tests, carry no charge. Copays may not count toward the deductible, but the cost of an X-ray might. After the deductible is met, payments may drop to zero.

Many plans do have a maximum for out-of-pocket spending, but there are different definitions for what counts toward that cap. Massachusetts has rules governing out-of-pocket spending as part of its minimum creditable coverage standards. It caps out-of-pocket expenses for core medical services at $5,000 for an individual and $10,000 for a family, but the cap applies only to costs of $100 or more, said Georgia Maheras, private market policy manager of the advocacy group Health Care For All. That means $20 copays for doctor visits, no matter how many you have, don’t count.

People who can afford to pay up to $2,000 for an individual deductible, or $5,000 for a family deductible, might want to see if lower monthly premiums - and potentially more generous co-insurance payments after meeting the deductible - would result in lower costs over a year. If you think your costs would be lower than the deductible and that you can leave that pretax money to collect interest, you may come out ahead.

People who make many doctor visits would be less likely to benefit, because copayment costs might quickly end up being greater than the savings in lower premiums. You will still face a share of some costs through co-insurance, where the insurer pays 80 percent of a hospital stay, for example, and the consumer pays 20 percent.

Q. What about prescription drug coverage?

A. If you know that you will need a certain drug, check to see if the plan covers it and at what cost.

One way to save on drug costs is to use mail-order services, which may have lower prices, said Maheras, of Health Care For All. Ordering a three-month supply would cost less than refilling the prescription once a month with copays at a retail pharmacy. But don’t forget that Wal-Mart Stores Inc., Target Corp., and some big pharmacy chains offer cheap generic drugs.

Some employers give employees with chronic conditions, such as diabetes or high blood pressure, discounts on the medications they need to take daily, said Taylor, of Hewitt Associates.

“It is much more cost effective to receive and take the medications than not take them because you cannot afford them,’’ she said. “It’s good for employees and good for employers.’’

Q. Is there such a thing as too much insurance?

A. Yes, says Taylor, and Paul Matthews, a principal at consulting firm Towers Perrin. They said people should take a closer look at high-deductible plans, which are less popular in Massachusetts than in the rest of the country.

“We know people are overinsured,’’ Taylor said. “Most people don’t have enough claims or use the medical plan [they have]. They have a really great opportunity to switch to high-deductible plans, save money on premiums, and still receive very adequate coverage.’’

Matthews said employees tend to be risk-averse in their plan choices. “It’s a nice savings opportunity for people if they select the plan that really meets their needs rather than the . . . 100-year-flood level of insurance they generally take,’’ he said. “This is a pretty good year for people tightening their budgets to take a fresh look at the plans their employers are offering.’’