Health insurance costs are rising. If you can't afford insurance - or if you need to re-enroll in a higher-deductible plan - here are five big considerations.
Health insurance costs are taking the biggest jumps in years, according to the Wall Street Journal. A recent report projects that costs for employer coverage will rise by around 6.5% for 2024, while premiums for people who have individual insurance plans sold under the Affordable Care Act are expected to rise by about 6% next year.
Health insurance costs are some of the biggest expenses for American families, and this significant increase could result in many individuals either not being able to afford insurance or needing to enroll in a higher-deductible plan. If you find yourself in either situation, below are five important considerations for the future.
1 . Understand Your Current State of Health
The first step in making strategic health insurance decisions is understanding your current state of health. This involves undergoing regular health check-ups, screenings, and lab panels to assess your health conditions accurately.
It's also important to talk to your provider about your results so that you understand what the numbers mean. Not only does this help you to decide what kind of insurance you'll need, but it also enables you to take proactive steps to get healthier. For instance, implementing a weight loss program or taking medications to manage chronic conditions could help reduce future medical expenses.
Once you have a clear picture, you can make lifestyle changes, such as losing weight or quitting smoking, to reduce your health risks—and hopefully your health spending.
2. Shop Around for Care
We shop around for flights, appliances, or a new jacket - so why not health care? While comparison shopping for routine care services like doctor’s visits, imaging tests, lab work or minor procedures may seem like a foreign concept, it can actually save you hundreds (or even thousands) of dollars.
Why? Because the medical facilities or providers recommended by your insurance company may not offer the best prices for the services you need. This is because insurance companies negotiate rates with healthcare providers, and those negotiated rates are not always the most cost-effective for you.
Rather than assuming that using your insurance is the most cost-effective option, consider calling up a few facilities near you to compare prices, or see if they offer discounts for paying in cash; you might be surprised at what you find, and you won't need to sacrifice quality for affordability.
3. Don't Delay Routine Care
While it might be tempting to skip a routine check-up or delay a diagnostic test to save money, this can actually end up costing you more in the long run. Preventative care is generally less expensive than emergency care, chronic disease care or the advanced treatments required for conditions that have progressed due to neglect.
Additionally, earlier detection of issues can often result in more effective treatment and a better prognosis. Don’t delay, and get the care you need when you need it.
4. Consider a Hybrid of Self-Insured and Catastrophic Care Insurance
A high-deductible insurance plan combined with a self-insured approach can be a wise choice if you don’t have pre-existing conditions that require frequent trips to the doctor or costly medication.
This is essentially a "hybrid" model where you self-pay for routine medical expenses while having a "safety net" insurance with a high deductible in case of severe illnesses or accidents, like cancer or a broken leg. The high-deductible plan usually comes with lower premiums, making it more affordable in the short term. You can then budget for routine medical expenses out-of-pocket, giving you more control over your healthcare spending.
5. Utilize Self-Pay Options When Possible
Self-pay, also known as cash-pay, is a payment option for health care that bypasses third parties like the government and insurance. This allows patients to avoid the opaque billing practices, paperwork, and long wait times that can come with traditional health care. Instead, benefits of self-pay care often include faster access to care, transparent and affordable prices, and the freedom to choose a healthcare provider that best suits their needs.
For example, patients on self-pay platform Sesame are able to read provider ratings and view appointment prices before booking, the average time between making a Sesame appointment and seeing a provider is just over 2 hours, and the average cost of an appointment in 2022 was just $37.
Self-pay care benefits providers as well as patients - many healthcare facilities offer discounts for paying in cash, since it allows them to circumvent the timely - and costly - administrative burdens of billing codes, claims, and prior authorization paperwork for insurance.
The rising costs and complexities surrounding health insurance can understandably create stress and concern, but it’s important to remember that you do have options and control over your health care.
Self-pay options like Sesame can empower you to make informed choices that are not only affordable but can also lead to better health outcomes. By making strategic decisions about when to use insurance, when to pay out-of-pocket, and where to purchase care from, you can navigate this challenging landscape more successfully - without forgoing the care you need.
