Have your health insurance premiums gone through the roof (like ours)? How to lower health insurance premiums and find affordable health insurance.
How to lower health insurance premiums (the kind you pay monthly) has been top of mind for us. I don't know about you, but our health insurance premiums have gone through the roof over the last several years.
I remember when I used to work at a 9-5 job, Paul and I both kept our own employer's healthcare plans after marrying because it was cheaper that way. He was paying about $131/month in premiums, and I was paying about $160/month in premiums.
If I had added him onto my plan the cost would've been much more than $291 we were individually paying, and vice versa.
Now that I work for myself, we are both on Paul's health insurance plan.
He's changed companies, and we had a baby since.
Our monthly premium cost has ballooned to a whopping $630!
And I know that that's considered a “steal” to many other self-employed people without a spouse's employer-sponsored plan to latch onto.
Still, it gives me pause to consider ways for how to lower health insurance premiums.
And guess what? There is, right in front of our noses. We just didn't know it for the first year at his new job.
What is Monthly Health Insurance Premium?
First up, what is the monthly health insurance premium you're paying?
This is a deduction from your paycheck that represents your portion of your health care insurance coverage (typically an employer will pick up the tab on part of the cost to insure you + your dependents).
This is what keeps your health insurance policy active.
Health Insurance Tips and Tricks
I'm going to share with you strategies to lower your health insurance premiums.
It's best to use several of these at once to get the most bang for your buck.
Pssst: Did you know that you don't have to have any military affiliation to get health insurance through USAA Health Insurance + USAA dental insurance? Seriously! You'll want to check it out and see if they can out-quote your employer.
Strategy #1: Use Your Company's Health Incentive Program
Health insurance companies + employers aren't dummies. Especially when it comes to their bottom lines. They realize that when their pool of insured people actively pursue healthy lifestyles, their overall costs will decrease and their productivity will increase.
So many healthcare companies offer wellness programs that give monetary incentives for healthy habits.
In the long term this benefits the insurance company and the employer because they save money when the plan participants are healthier.
You really have to check in with your own health insurance company plan, because these incentive programs tend to vary quite a bit.
Still, here are some program examples:
Some programs offer rewards points you could redeem for gift cards and items. A few programs even allow you to redeem reward points towards reduced co-payment costs.Many healthcare companies offer wellness programs that give incentives for healthy habits. Click To Tweet
Examples of what you have to do to get these:
- Logging in meals you've eaten
- Logging minutes you've exercised
- Logging amount of water you drank
- Watching health-related webinars (about 15-25 minutes each, earning $25/pop)
Psst: You'll want to pair this program with other ways to get paid to walk and do exercise. It's true — there are ways to get cash for exercising!
Our Health Insurance Wellness Programs – Examples
Some also just offer gift cards and merchandise in exchange for reward points you earn, like the last health insurance plan I was on. In exchange for taking a health risk assessment, and logging in eating habits + exercise I earned a total of 23,280 points. With these points I scored a free Starbucks gift card, a yoga mat shoulder holder, a 9” spring form pan (to use in making cheesecakes, an admittedly unhealthy dessert − thanks BCBS!), and two movie tickets to the theater near our home.
With my husband's current job, we have Cigna. Through their wellness program, we are each able to earn up to $450 per calendar year to be used on gift cards and/or premium reduction from doing some of the following activities:
That $900 in premium reductions each year? That's nothing to glaze over!
With this wellness program, we have until October 1 of the year to complete activities in order to reap the premium reduction.
Activities include (each with their own premium reduction price tag − I've provided a few examples):
- Taking a personal health assessment + biometric screening ($150 reduction per spouse)
- Log 16,800 minutes of sleep
- Log 320 glasses of water
- Log 400,000 steps
- Talk to a free lifestyle coach over the phone ($75 reduction)
- Watch several webinars ($25 reduction)
Aside from the fact that getting in shape is going to positively affect our out-of-pocket healthcare spending for years to come, there's an immediate monetary effect as well.
Our monthly premium is $630. With $900 in possible premium reductions this year, we're looking at a possible 8.4% discount on our health insurance − something we would be paying for anyway.
Put another way? We'll almost cover the entire cost of a year's worth of gym membership.
Now that's sweet!
Spill the beans: does your own health insurance company have a wellness program? What does it offer as incentives?
Strategy #2: Get Out of the ‘Disincentive' Category
Beginning on January 1, 2012 there was a change to my healthcare plan at work. Plan participants who used tobacco 5 or more times in the 90 days leading up to the first of the year are now subject to an additional health insurance premium cost of between $30 to $90 per month.
My employer is certainly not the first to institute higher premiums for poor health habits.
According to a study by eHealth, smokers pay 14% higher premiums than the average premium paid by non-smoker employees, and employees in the ‘Obese’ BMI category pay an average monthly premium 22.6% higher than employees with ‘Normal’ BMI. Wal-mart, the nation’s largest employer, also made headlines recently when they began to charge smoking employees an extra $260 to $2,340 per year in healthcare premiums than non-smoking employees.
This is not an unexpected trend considering the times. The connection between ill health and smoking, being overweight, high cholesterol, etc. has been quantified. Smokers cost employers between $3,000-$4,000 more per year in health insurance than non-smokers (though some stats around the web say it is $1,000 per year more—I am sure the truth is somewhere in the middle). Obese employees can cost employers between $1,143 and $6,694 per person depending upon BMI, gender, etc.
Each employee in my office receives a mandatory physical once a year due to the nature of my work, so it would not be a far stretch to assume that one year they might get their information on whether or not we use tobacco, our body mass index (BMI), and any other metric they might use to increase health insurance premiums straight from a doctor.
Do you currently pay a higher premium for any health issues? If so, has it been an incentive for you to change any habits? How do you feel about this trend?
Strategy #3: Increase Your Deductible
Lowering your health insurance costs is often about finding a balance between your premiums and your deductible.
The higher your deductible is, the lower your monthly premiums will be.
The lower your deductible is, the higher your monthly premiums will be.
So, how do you choose which to do?
Know that, if you go with the lower monthly premiums, you need to have money in an emergency fund to be able to cover the cost of your health insurance deductible. After all — just one emergency could have you paying out your full deductible (which is now higher, since you're saving each month).
One suggestion is: if you are relatively healthy, go ahead and get a higher deductible. Do you have chronic conditions? Then you're probably better off with a lower-deductible, but higher monthly premiums.
Strategy #4: Find an Employer Who Covers More of the Cost
I've worked for two different places – one private and one government – with extremely affordable monthly premiums.
My coverage didn't suffer because of this; rather, they chose to cover more of the cost of their employee's health insurance premiums.
One place, covered 100% of the monthly premium for their employees — a tradition the CEO's founding father had started, and he was determined to continue.
When I worked for the state government, my monthly premium was just $130 (just me on the plan). Their policy was to cover most of the employee's, monthly premium, with the cost only increasing a lot once you add on a spouse/family dependents to the plan.
During your next job search, keep in mind how much of a chunk your monthly premiums can eat out of your paycheck, and be sure to ask how much the company covers.
Choose a High Deductible Health Plan HSA: How Do HSA's Work?
I want to build on the idea that plans with higher deductibles will cost you less in premiums each month by devoting this section to high-deductible health plans and why you might want to choose one.
An HSA is a health savings account — paired with a high-deductible health plan — that helps you save up and pay for medical costs, tax-free.
You save money into your HSA (and sometimes your employer matches contributions to your HSA, or deposits a certain amount of money each year into your HSA), pre-tax. This means that you don't pay any taxes on the money that is put into your Health Savings Account.
As long as you spend the money on qualifying, medical expenses, then you will not have to pay taxes on it.
- Money Grows Tax-Free: One of the exciting things about a Health Savings Account is that, unlike a regular savings account, any interest of other earnings on the money you put into is tax-free.
- Account is Portable: Even if you leave your employer, you get to take your HSA with you.
- Each Spouse Gets their Own HSA: There are no joint HSA accounts.
What's the most important part to an HSA? It's having enough money in there to cover your full deductible for each of your family members. This is what you want to build to, as soon as you can.
Coming off of a year with a high-deductible plan, I'd like to talk about ways for you to not lose the family farm if you're on one. Because let's face it, those medical costs can add up quickly, leaving you in no-man's land where you are not close to meeting your deductible yet – and still see hope that you won't by the end of the year – so you're on the hook for all of your medical bills.
How do you keep your medical costs as low as possible so that you don't have to tap your HSA all the time?
Make Strategic Use of Urgent Care Locations
This crazy thing happened while we were on the high-deductible healthcare plan: my poor cat (Lyla Bear) was attacked by a huge dog. I chased the dog off, and in an instinctive act of protection, I grabbed for Lyla. But I should have let her compose herself, because she was lodged in attack mode and bit me deeply.
The four incisions, at first, looked fine. I immediately cleaned them off and used Neosporin on them. But within two days they became warm, inflamed, and infected (I later learned that cat bites are very dangerous).
Fortunately, I did what an insurance rep had advised me to when I asked him for ways to save money off our healthcare costs on a high deductible plan: I went to an urgent care facility instead of to my doctor's. A nurse practitioner saw me, did all the normal stuff, and prescribed me a generic antibiotic. The whole thing cost less than $150.
Leverage Free Elements of the Affordable Care Act
One of the best ways to keep your high deductible plan affordable is by taking advantage of some of the great elements of the Affordable Care Act. Since you have an insurance plan, you can get the following for free (you won't even owe a co-pay):
- Free Annual Physical Exam
- Free Annual Well Woman Exam
- Free Immunizations
- Free Screenings
On our plan, I still got to see my OB/GYN for the year without co-pay or a bill, and Paul went for an annual physical. We leveraged these offerings by scheduling appointments around when we had questions or concerns to ask a doctor anyway. While you shouldn't expect a doctor to offer outside of what is required for these free appointments, there is normally a small conference in the beginning where they ask if you have any issues or want to discuss something. Take advantage of this free time!
For more specific information about what benefits are free, even if you haven't met your deductible yet, check this link out.
Get One of You Off the High Deductible Plan
From talking with insurance reps, I found out some interesting info that could save you + yours some money. If there is one of you that tends to cost more — more prescriptions, more health needs, more at risk, chronic illnesses, etc. — then it could pay to shell out a higher monthly premium for that person to have a lower deductible.
Yes, members of a family can have more than one healthcare plan!
You can keep yourself and the other family members on the high deductible plan and hope that these tips + some luck help you to not pay the entire deductible out of pocket.
Save Up Enough to Cover the Deductible
This is great prevention for losing the family farm…even if you're rolling your eyes because you're wondering who on earth has their entire deductible amount in savings (we did, for the record).
When you sign up for your high deductible plan, you should choose one that you can cover the full deductible on for the people on the plan. So if the annual deductible is $5,000 per person, and there are two of you, technically you should have $10,000 set aside just for potential healthcare problems. Who knows if you might end up in the hospital, in an accident, or with some other surprise health problem that could easily eat up this amount. If you were liable for it, would you be able to cover it, and how?
Having these funds set aside is your cleanest option.
Ask for Lower-Costing Options at the Doc's Office
My husband needed to see a dermatologist for a skin issue that we thought could be serious. Fortunately for us, it wasn't. Still, it needed to be taken cared of with medication.
When he initially went to fill his prescription, Paul's mouth dropped at the staggering cost: $400+.
So you know what he did? He called up his dermatologist and explained the situation–that we have a high deductible and have to pay for all of this out of our pocket. The doctor willingly rewrote a prescription for a generic drug and sent it to our pharmacy. This was a huge savings to us!
If you find yourself in the same position (or before you find yourself in it, like when your doctor is grabbing his script), then don't be afraid to ask for the lowest-costing medication that will get the job done.
For Maternity, Ask for Specific Billing Options
Something else I learned while talking to the insurance rep could help those of you who are pregnant or are looking to become pregnant during the time you're on a high deductible plan.
Yes, through the Affordable Healthcare Act, all health insurance plans must now include maternity. However, some states have extended the time that people can keep their old, non-Affordable Healthcare Act abiding plans for another year — such as our state, Texas — and also, your are still liable to pay for all costs until you reach that deductible.
Through the Affordable Healthcare Act, all health insurance plans must now include maternity.
It turns out that some maternity appointments are considered preventative care. Hurrah! However, lots of doctors like to bundle all of the costs together into one lump sum when you deliver. So you may want to work with your doctor's office to see if they can bill the appointments considered preventative by your insurance company, separately. Otherwise, these appointments might get lost in the shuffle and you could end up paying for them yourself.
FYI: our insurance company mentioned that they have a list of which appointments are considered preventative, and that it depends on how the doctor's office codes the visits. So ask your health insurance company for a similar list to make things easier on your doctor's office (and ultimately to make it easier for them to save you money).
A final thought: I hope that you do not meet your entire deductible for the year, because that means your out-of-pocket costs were high (not to mention the fact that you had some health issues you're dealing with). But if you do happen to meet your entire deductible in a year and there's still at least a few weeks left, then take advantage of the situation. Are there appointments you can schedule in between the holidays instead of next year so that your insurance company can foot the bill instead of you starting at the deductible $0-reset in January? Is there a procedure you've been putting off, but can schedule in this calendar year to save yourself money now that your coinsurance has kicked in?
Finding Financial Assistance for Health Insurance Premiums
You can get subsidies to help you cover your monthly health insurance premiums on the healthcare marketplace. But, there's a catch with this.
You don't have to keep your employer's healthcare plan — you can use the marketplace and enroll during open enrollment or qualifying event. However, you aren't eligible for the health insurance premium subsidies if your employer is offering you a plan.
So, if you're employed and your employer offers a health care plan to you that meets requirements (of offering an “affordable” health insurance plan to you), then you're back at square one to trying and see if there is financial assistance for health insurance premiums.
In other words, you should definitely pay attention to the strategies above, and use those instead to lower your monthly health insurance premiums.
What would it feel like to sit in a room full of strangers (re: not doctors) and discuss that funny-looking skin thingy on the back of your neck, out-of-the-ordinary emotions, weight gain, post-holiday surge in cholesterol, or that thing-I-shouldn’t-mention-here?
Blabbering through your litany of health issues in front of others is a growing trend in healthcare thanks to something called shared medical appointments (SMAs).
First off, let's talk about what these are.
Shared medical appointments are when a group of people with a similar chronic condition – such as diabetes, asthma, or hypertension – are all seen for follow-up care or some sort of management care, all at the same time. The idea is that patients are grouped by common needs, and can benefit from peers going through the same issues.
These appointments are often longer than normal doctor appointments (maybe 90 minutes at a time) to accommodate the group.
The thing is, SMAs are being sold as a way to save money for both patients and doctors. I'm not sure I'm buying it though…
Will Revealing the Innards of My Health in a Room Full of Strangers Save Me Money?
Cartoon courtesy of Cartoon Resource.
I am all about cutting expenses when there's not much sacrifice involved.
But in this case, the savings seem to be more of the un-sexy “eat your vegetables” variety:
- More Exposure to Doctors = Less Serious/Expensive Healthcare Costs Later: The idea is that since you will have much more face time with a doctor (or nurse practitioner) in a 90-minute group session than you normally get with a 10-30 minute individual session, you will learn more health information and avoid serious medical conditions down the road.
- Greater Accountability to Help You Maintain Good Health Habits: Since it is part group therapy session and part doctor appointment, people report following through much more with their exercise and other health goals, leading to overall better health (thus costing less down the road).
Where don't you see savings by making an SMA? The cost and copay of the doctor appointment.
Amazingly, even though you do not get a private session with the doctor, you typically still have to pay the same copay and appointment costs. This leads me to believe that the cost savings (er…profit) is on the doctors' side, because now they can herd together a group of patients with the same conditions into one money-making session.
Now that I think about it…I’ve actually gone to several SMAs over the last few years. Sort of, anyway.
At my old office job we had to get annual physical exams. The first year I worked there we were given an afternoon to go downtown with a specific physician to do the exam, which included a trip elsewhere for the blood work and x-rays. I was totally cool with that.
Then they switched it up on us to save costs.
They brought in a mobile health facility and parked the unit in the back lot for a week. Suddenly I had to wait outside of doctor’s rooms (aka client meeting rooms turned into doctor's offices) with coworkers, chat it up with team members while anticipating needles in areas generally set aside for presentations, and remove articles of clothing a closed-door away from our team leaders.
Then a month later when the results came back, the doctor addressed a room of about 100 of us. We were each handed our individual results (in manila envelopes) while the doc focused on one thing to teach us such as preventing hypertension. Usually he remarked on the overall health of the group (apparently we were eating too many cheeseburgers and refried beans), and then he asked if we had any questions.
True, the doc made himself available afterwards for a period of time if we had any questions we wanted to ask in private.
But the whole thing just left me uncomfortable.
After two years of going through this, I opted to instead go through the process I previously did where I could privately see my doctor without familiar faces and awkward work/personal conversations while waiting to get blood drawn (did I mention we had to bring a urine sample to work as well?). I know it was considered “special treatment”, but I just didn’t think I should have to go through this private process so openly.
Now we know how I feel about SMAs. Granted, they don’t entail people being examined in their undies in front of a group of people, all patients typically have to sign a waiver of confidentiality because of the sharing of private medical information among everyone, and you generally aren't in a group together with coworkers or other people that you know.
But you won't see me scheduling one anytime soon. Would you sign up for one if it was available?
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