The United States runs the most expensive healthcare system in the developed world — $4.5 trillion in 2022, roughly $13,500 per person, double the average of peer nations, and rising faster than headline inflation. The structural defense is not to optimize within the standard plan menu but to architect coverage for the actual tail exposures: a catastrophic illness or accident, access to top-tier providers and specialists when speed matters, and the gap between losing employer coverage and starting Medicare.
The market splits into medical, dental, and vision. Medical covers the catastrophic outcomes and is the one to get right; dental and vision are essentially prepaid maintenance plans whose economics are covered in their own subsections below (section “Dental Insurance”, section “Vision Insurance”). The medical-plan taxonomy — HMO, PPO, EPO, POS — describes network restrictions; the more important variable is the deductible level and the in-network provider list. The provider list is what determines whether you can actually see the specialist you want when you need them; the network reading should precede the premium comparison.