Lower your health insurance expenses by up to 50% by making specific changes to your existing policy, and considering additional available discounts. Your medical insurance premium doesn’t have to be high, so we have listed several ideas (below) that may lower your rates. We always show you the lowest personal direct quotes for the nation’s top health plans, both on and off the Marketplace. But we also want to inform and teach you the best ways to pay less for your private coverage.
However, before we begin, there are a few important points to make: Open Enrollments (for persons under age 65) typically take place from November 1 to December 15th. So unless you qualify for an approved ACA exception (divorce, birth of child, terminated from employer, child reaches age 26 etc…) you may have to wait until the Open Enrollment period to alter or update coverage.
NOTE: Seniors that are changing Medigap plans have a different OE period (October 15th-December 7th). Also, when they reach age 65, a 7-month window surrounding the birthday provides ample time to select a Supplement or Advantage plan. Before considering a change, consulting an experienced broker to help review plan differences is highly recommended. Formulary drug lists should also be reviewed, especially, if changing plans.
Also, if you are not currently insured, you may have to purchase temporary coverage until you are eligible to buy compliant plans. These short-term policies are very cheap and you may be able to keep them up to 12 months. So, if you miss an Enrollment window, you don’t necessarily have to go without coverage for the remainder of the calendar year.
Increase your deductible. Often, by raising the deductible from $500 or $500 to $3,000 or higher, your rate can easily reduce by hundreds of dollars per month. Of course, you would have a higher out-of-pocket expense if you submit a major claim. But over time, even with an occasional claim, the change can be very cost-effective, and you’ll have a cheap medical plan. Keep in mind that savings will vary, depending on where you live. The highest available deductibles for Marketplace plans (2017) are $7,150 for individual plans, and $13,300 for family coverage. These amounts increased by $300 and $600 respectively from the prior year.
For example, rates in New York and New Jersey will be higher than Pennsylvania rates. And policies with higher premiums will have larger potential savings opportunities. Regardless whether it’s a Marketplace contract, private coverage or an employer-based plan, the biggest cost reductions come from the most expensive policies. However, Group plans are not as flexible as private coverage, and therefore, you may not be able to effectively consider multiple options, including a high-deductible policy.
Bronze and Silver plans have much higher deductibles than Platinum and Gold plans (on the Exchanges). When comparing Marketplace policies, you should compare the deductible and the maximum out-of-pocket expenses. By avoiding the “Cadillac” Metal options, you’ll save thousands of dollars in premiums. And of course, you can change back to a lower deductible during annual Open Enrollment every year. Organizations such as the Network For Regional Healthcare Improvement (NRHI) are great resources to help improve the healthcare expense trajectory.
Just as importantly…if you know you will be meeting your deductible every year because of an existing condition, you should NEVER raise the deductible. For example, if you are taking multiple prescription non-generic medications, and their monthly cost exceeds $200, only attempt to lower the deductible, not increase it.
Delete maternity coverage if you are currently paying extra for the benefit and are certain it will not be used. Since maternity is required as one of the 10 “Essential Health Benefits” on Exchange-approved plans, removing this benefit applies solely to non-Marketplace plans that are not compliant. NOTE: You should NEVER terminate an existing Marketplace policy to avoid paying for maternity benefits. The financial risk of losing coverage is extremely high, since you may have to wait until January 1 to re-enroll.
The savings will likely be thousands of dollars per year. However, if you become pregnant, you will not be able to add the rider back to the policy until after the delivery. And of course if you are planning to have children in the future, you may wish to keep the coverage in place. Also, in some states, a “stork program” is available that provides maternity coverage for a predetermined flat fee. Not all hospitals offer this benefit, but if available the cost will be substantially less than adding coverage to an individual plan.
It is possible that your policy (Non-Obamacare plans) includes maternity benefits as a basic coverage instead of a rider. Thus, you would have to change policies, instead of deleting a rider. This would involve applying for a different policy with the same carrier or possibly applying for coverage through a new company. It is important to never terminate an existing plan until you have been approved for a new contract and completely understand the differences in the old and new plans.
Important note regarding maternity: Beginning in 2014, maternity was included in the 10 required “essential health benefits” that must be included in newly issued Exchange plans. This was a legislated change that impacted most non short-term plans. So “deleting” this benefit is not possible. And if you terminate specific benefits on a “grandfathered” plan, you may be forced to buy a more-expensive Marketplace plan.
Shop around for health insurance rates every year. If your premium is annually increasing, there may be available affordable options with other reputable companies that are worth consideration. Naturally, the treatment of pre-existing conditions must always be considered. If you are being treated for a major condition, you must always consider your out-of-pocket costs, and how quickly you may reach your deductible. Often, a less-expensive plan may actually have higher total out-of-pocket costs because of higher coinsurance and copays.
During Open Enrollment, you can choose to stay with the current insurer or compare other options that may pay a higher percentage of your medications, tests and other expenses. But since your decision must be made by December 15th, you will need to somewhat predict your medical expenses for the upcoming year.
Many policies are only available during designated “Open Enrollment” periods. There are also many qualified exceptions, which include divorce, termination of benefits from an employer, changing residences, and exhaustion of COBRA. But unless you are using an approved exception (Special Enrollment Period), for many parts of the year, you may be forced to buy a non-qualified temporary policy or a policy with specified limitations.
The section located at the top of this page is designed to allow you to view quotes from most of the large insurers. You may also find that smaller regional companies often have very competitive plans, although you may have to adhere to restrictions within your service area.
It’s also important to accurately estimate your household income when purchasing Marketplace plans. An underestimate will result in a tax bill that must be paid (in full) when you file your federal tax return for the following year. If you overestimate, your monthly premium will be higher than needed.
Consider a Health Savings Account. If you rarely meet your deductible, and providing coverage for catastrophic claims is one of your most important priorities, an HSA may be a viable option. But first, consult an experienced broker, view different options or view some of the best HSA plan content on our website before doing anything. This type of coverage is not suitable if you typically have a large number of non-preventive office visits in the household. Also, if any family member has prescription costs in excess of $300 per month, a Silver, Gold, or Platinum-tier plan possibly may be more cost-effective.
And remember…you can take out a high-deductible policy without setting up the Health Savings Account portion. In fact, thousands of consumers do that every year. You can also buy these plans through both State and Federal Exchanges. $6,550 ($13,100 per family) is the maximum out-of-pocket expense, which has been slowly increasing since 2014. However, you can select lower deductibles. Under new legislation, the tax advantages of HSAs was not removed.
The maximum HSA contribution limit is$3,400 for individuals, and $6,750 for a family. However, if you have reached age 65, and additional $1,000 catch-up contribution is allowed. The minimum allowed deductibles are $1,300 per person, and $2,600 for a family. NOTE: We do NOT encourage purchasing an HSA with a low deductible.
Take care of your health! Even though there are few policies where rates largely depend on the medical fitness of you and your family members, do everything you can to eat right, regularly exercise and schedule annual preventive physician visits. Maintain a normal weight, and if you smoke…stop! If your employer offers wellness and fitness programs, take advantage of those benefits. They usually are free. Seniors may be eligible for additional perks on “Advantage” plans, such as free YMCA memberships and the Silver Sneakers fitness program.
And many times, it’s easy cash reimbursements in your pocketbook. Staying fit will put you in a much better bargaining position when you are shopping for new or alternative underwritten policies. Various healthcare websites will also provide assistance in lowering your premium.
If you are paying for student health insurance through a college or university, consider a quote from a major insurer for comparable coverage. While not all student health care plans through schools are necessarily expensive, it is still worth taking 10 minutes to compare rates and especially coverage. You will see a tremendous range in rates from different schools. And often, the participating network on these plans is insufficient. However, comparing private Marketplace plans allows you to possibly qualify for a federal subsidy, review many more companies, and have access to more physicians and hospitals.
You can view personal student policies from every state on our website. However, we advise that you obtain a copy of the specific details of your university to make sure all requirements are being met. Mental illness, maternity, drug and alcohol rehab/counseling and sports-related injuries are sometimes unexpected requirements. Although private plans will likely offer these benefits, they may require higher copays and/or deductibles.
If your need for health care coverage is temporary (12 months or less), consider purchasing a “short-term” plan. Although pre-existing conditions are not covered, premiums are usually 50% less than many other comprehensive plans, and policies are often approved by the next day. You can cancel coverage at any time, and change to different types of coverage, subject to underwriting approval.
Not all carriers offer this policy, but most of the larger companies have many deductible and coinsurance options. The $500, $1,000 and $2,500 choices are most common. And another nice feature is that the number of medical questions is usually less than 10. Although these plans don’t qualify as “approved Exchange” policies, they will quickly close the gap from the time you lost coverage to the time you are eligible to purchase again. The maximum length of available coverage is usually 6-12 months. Most companies allow one renewal (subject to approval) before no longer offering benefits.
Make sure you are purchasing the right type of medical coverage. Many policies may contain benefits that you don’t need or are unlikely to ever use. By simply comparing benefits and costs, you could save hundreds of dollars each month. If you rarely meet your deductible, changing from a $3,000 deductible to a $6,000 deductible could save a substantial amount of premium over the next five years, even if a major claim is filed.
We are committed to offering quality health care at the most affordable prices. By using the “Free Quote” option, we’re confident you’ll be able to find an affordable plan.