No doubt about it, health insurance can be a big expense. But there are ways that you can trim your health insurance costs.
Wading through the details of your coverage can be daunting, but regularly reassessing your needs can help save money on health insurance.
Here is a quick summary of some options that may work for you (we’ll talk more about them below):
- Take advantage of workplace health coverage if you can
- Don’t automatically enroll in a family plan with your spouse
- Reduce your health insurance premium
- Reduce your health insurance deductible
- Switch health insurance plans
- Stay in network when you seek medical care
- Take advantage of health insurance discounts
- Work with a health insurance agent
- Use “free” benefits available on your plan
- Consider a short-term health insurance plan
Take advantage of your workplace plan if you can
According to a 2018 survey of Employee Benefits in the U.S. conducted by the Bureau of Labor Statistics, approximately 81% of U.S. workers with access to healthcare benefits participate.
If your workplace offers benefits, taking advantage of them is a potentially easy way to save money on your health insurance. Your employer-sponsored benefits probably include only a few plan options within the same company, but the lack of choice will be balanced by the fact that your employer may share in the cost of the premiums.
If both you and your spouse have group health insurance plans available through work, compare them to see if one is a better fit and/or comes with a smaller overall price tag.
Learn more about your health insurance options as a married couple or newlywed.
Even with your employer pitching in, you might be better off buying your own health coverage if, for example:
- The provider networks for your employer plan doesn’t include your preferred doctors or hospitals
- Prescription medication you need isn’t part of your group plan’s drug formulary
- The premiums and/or deductible is still too expensive.
Knowing your options and keeping track of the details can save you money.
If you’re married you may want to get separate policies
If both you and your spouse are eligible for healthcare benefits at work, figure out whether or not you may be able to lower your out-of-pocket costs by carrying separate insurance policies.
For 2019, the ACA limits total out-of-pocket costs to $15,800 for a family and $7,900 for an individual. The family limit applies to a single policy that covers the family and for insurance purposes, a “family” can be a married couple with or without any children.
If you and your spouse have children and are split on one individual and one family policy, the out-of-pocket limits apply separately for each policy. So, the total out-of-pocket limits would be higher than with a single plan that covers everyone.
But, if one spouse is healthy and the other has significant or chronic medical conditions, two separate policies could still make financial sense. The healthy partner might choose a plan with a lower monthly premium and higher deductible, while the partner with greater medical needs could choose a plan with higher monthly premium but lower out-of-pocket costs in order to maximize the use of their benefits.
The decision to enroll in separate policies could affect your HSA options in the event one or the other of you does not have a qualifying high deductible health plan. With an HSA-qualified high deductible health plan, you can contribute up to $7,000 a year to your HSA if you have “family” coverage (with at least two members of the family covered). As an individual, your HSA contribution limit is $3,500. You and your spouse can each have separate HSAs and separate HSA-qualified health plans (for a limit of $7,000 between the two of you). But if one of you has an HSA-qualifying health plan and the other does not, your HSA contribution will be limited to $3,500.
The decision to enroll in separate policies could affect your HSA options in the event one or the other of you does not have a qualifying high deductible health plan.
With an HSA-qualified high deductible health plan, you can contribute up to $7,000 a year to your HSA if you have “family” coverage (with at least two members of the family covered).
As an individual, your HSA contribution limit is $3,500. You and your spouse can each have separate HSAs and separate HSA-qualified health plans (for a limit of $7,000 between the two of you). But if one of you has an HSA-qualifying health plan and the other does not, your HSA contribution will be limited to $3,500.
Reduce your premium amount
There are a few ways to save money on your monthly health insurance premiums. First you can opt for a higher deductible plan since, generally, health insurance plans with higher deductibles have lower monthly premiums and vice versa. This may be a good idea if you’re healthy and an infrequent user of healthcare services.
If you’re a tobacco user, quitting can often mean lower premiums. Since the implementation of the Affordable Care Act (ACA), insurers can’t base pricing on health conditions or gender, but they can still charge tobacco users up to 50% more.
If you get your health insurance through the Federal marketplace, check to see if you’re eligible for tax credits or subsidies on your major medical plan premiums. If you’ve already checked, for example, during open enrollment, but have had changes to your income or household since then, it may be worthwhile to check again since both impact your eligibility.
Find Out if You Qualify for an ACA Subsidy.
Adjust your co-insurance ratio to trim your monthly premium. Your coinsurance is how much you will pay after you have met your deductible.
A common coinsurance ratio is 80/20. This means that after you pay your deductible, your insurer pays 80% of the bill and you pay 20%. Changing this ratio so you pay more may result in a lower premium.
If you are an infrequent healthcare services user, this could save you money on your monthly premium but you risk paying more out-of-pocket if you have an unexpected accident or illness.
The money you save on premiums could be used on insurance add-ons so you can access healthcare services your ACA plan won’t cover, or supplemental insurance products to help reduce your out-of-pocket costs. Such products may include:
- Dental insurance – Dental plans provide benefits that help pay for a range of dental services that your major medical plan does not cover, from preventive to major care. Get a dental insurance quote.
- Telemedicine – Telemedicine includes access to virtual health consultations with licensed physicians anytime of day and any day of the year. Learn more about Telemedicine costs. Telemedicine is not insurance.
- Gap health insurance – This type of medical coverage pays a lump sum benefit when a covered accident or illness occurs. This benefit can then be used towards your major medical deductible payment. Get a gap health insurance quote.
Reduce your deductible
You can lower your deductible by opting for a higher premium. While it may sound like you’re just moving the costs around, some people prefer predictable monthly costs rather than a larger lump sum payment at the time of an expensive medical treatment. Also, a lower deductible means your coinsurance will kick in more quickly.
If you are enrolled in a silver-level ACA plan, you may also qualify for cost-sharing reductions, including a lower deductible. For example, if your silver plan has a $750 deductible and you qualify for the reductions, your deductible could be lowered to $300 or $500, depending on your income.
With an HSA, pre-tax contributions can be rolled into your plan each year. You and your employer can contribute to an HSA free of federal taxes. You can pay for the healthcare services that aren’t covered in your plan, or pay down your deductible, from the money you’ve put in your HSA.
Medical gap health insurance can also help when it comes time to pay down your major medical insurance policy’s deductible. Gap policies are a supplemental form of fixed indemnity insurance that pays a lump sum benefit for covered accidents and critical illnesses.
Many people apply the lump sum payment towards their major medical deductible to reduce what they pay out of pocket.
Switch health insurance plans
Switching health plans may help you save on your health insurance — assuming it’s during the open-enrollment period or you qualify for a special enrollment period.
There are many reasons to periodically reassess your insurance needs and consider a switch:
- Have you changed the frequency that you visit the doctor?
- Have you changed the number of prescription drugs you routinely take?
- Has someone is your family been diagnosed with a chronic condition?
- Are you planning to start a family?
- Has your household income changed?
- Have one or more of your kids aged out of your insurance plan?
- Does your primary care doctor still take your insurance plan?
- Did your rates go up?
- Did your coverage go down?
Reviewing your needs and the available health insurance options takes more time than automatically sticking with your current plan, but making sure your coverage meets your current needs can help you get more value out of your policy and could save you money.
Want help assessing your needs and understanding your options? Call [phone_number] to speak with a licensed health insurance agent.
Stay in-network when you seek medical care
If your preferred doctors or hospitals aren’t participating in your health insurance plan, you could be paying out-of-network charges. To avoid them, you’ll need to choose a new doctor or a new plan.
Even if your doctor or hospital is in network, additional services that you may require, such as a blood test, may not be included. So make sure that all services and providers are covered in network when you’re obtaining medical care. For any new healthcare service recommended or referral provided during your hospital visit, ask whether it is in network.
Many states have a requirement that plans cover out-of-network services at in-network cost-sharing rates if you need care from a specific specialist who is not in network.
Requirements vary by state for emergency care, but most states require that you not be billed extra if you were taken to a hospital that isn’t in your network.
Take advantage of any available discounts
You might be able to snag some health insurance discounts if you maintain a healthy lifestyle. Your health insurance plan may offer discounts or other incentives based on information from a fitness tracker, for instance.
Other possible health insurance discounts to look for include health club fee reimbursements or reduced membership fees, free weight-loss programs or free telemedicine visits. Check your insurer’s website for available offerings.
Work with a health insurance agent
Health insurance can be complicated, so getting advice from an agent may help you find the lowest cost plan that’s right for you.
Call [phone_number] to speak with an agent.
Typically, health insurance agents get commissions from the insurers based on your premiums. Ask questions and be clear on what you actually need. A good agent will also ask you a lot of questions. They can help fill out the forms and should be available for questions even after you enroll in the policy.
You can still qualify for a premium tax credit and other savings if you enroll with an agent. But to get the savings, they must enroll you in a plan through the ACA public exchange.
Use “free” benefits available on your health plan
If switching plans is not a good idea (or possible) at the moment, you can at least make sure you are getting the most from your existing coverage and monthly premium payments.
If your plan rewards you with a discount for going to the gym, make sure you reach your workout minimum every month. If your plan includes online wellness programs, use them!
And, of course, take advantage of the many preventive services that are mandated by the ACA. Services, tests and screenings available include (but are not limited to):
- Blood pressure screening for all adults
- Cholesterol screening for adults of certain ages or at higher risk
- Colorectal cancer screening for adults over 50
- Depression screening for adults
- Diabetes (Type 2) screening for adults with high blood pressure
- Diet counseling for adults at higher risk for chronic disease
- HIV screening for everyone ages 15 to 65, and other ages at increased risk
- Many Immunization vaccines for adults
- Alcohol misuse screening and counseling
- Aspirin use to prevent cardiovascular disease for men and women of certain ages
- Obesity screening and counseling for all adults
- Sexually transmitted infection (STI) prevention counseling for adults at higher risk
- Syphilis screening for all adults at higher risk
- Tobacco use screening for all adults and cessation interventions for tobacco users
Consider a short term health insurance plan
If paying major medical insurance costs is not possible, you may consider short term health insurance rather than going completely uninsured. But it’s important to be aware of the limitations of these temporary health plans.
In states where they’re available, short term health plans can last up to 364 days depending on your state. However, short term medical plans are not ACA-qualifying, are not guaranteed issue and don’t cover the essential health benefits (e.g., preventive care and prescription drugs).
Short term medical plans are intended to provide coverage for unplanned illnesses or injuries that result in hospitalization. These plans typically have lower premiums than major medical because they provide less coverage.
Plans are often highly customizable so you can choose the benefits you need, and you can apply anytime as these plans are not subject to the annual open enrollment period.
The best way to find out if these policies are available and compare options is to request a quote.
Summary + Next Steps
You do have options for saving money on your health insurance:
- Look for ways to save money on your premiums or your deductible.
- Review your plan to make sure it still fits your needs and make sure to actually use the “free” healthcare services and any additional perks your plan offers.
- Get a quote for a short term medical policy rather than going uninsured if major medical premiums are too expensive – make sure you’re aware of the risks and limitations of such policies.
Call [phone_number] to speak with a licensed agent.