10 Ways to Keep Your Health Care and Insurance Affordable

According to the 2021 enrollment report, 12.0 million people signed up for healthcare or were renewed through a healthcare marketplace. While this is good news for the healthcare system overall, average costs for care are still under the spotlight in the U.S.

Healthcare costs are one of the leading causes of bankruptcy in the United States. One quarter of Americans have to borrow money to pay for a $500 medical bill, and 15% of adults have medical bills they cannot repay within 12 months. Half of the population is worried that they will be bankrupted by medical bills.

If money is tight, these 10 tips can help you get the best value for your money in your current health insurance plan or when shopping around to find an affordable health care option.

What Healthcare Insurance Plan Is Best?

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The type of Health Insurance You Need Will Vary Depending on What Stage You Are in In Life And Your Family's Needs. John Anthony Rizzo / Getty Images

Beware: Lower Premiums May Not Be the Most Affordable Option

You don't want to judge a health plan by the price tag. Even though the first thing you want to know when you buy a plan is how much it is going to cost, the real answer is not always clear. Your financial status and family needs dictate how much you can afford. Your monthly premiums might be low, but your other costs could be very high.

For example, if you choose a high deductible policy, you will pay less in premiums. In a claim, you will pay far more due to the deductible. This might work if: you're in good health; don't have any accidents; everyone on your plan is lucky enough to stay healthy.

But if you choose a low premium/high deductible plan, you may end up paying a lot more. To figure out the total cost of your health insurance, you should look at how much you will have paid by the end of the policy term. You'll have to guess how much all your medical appointments, medications, preventative care, or emergencies could cost based on the general health of the people covered by your policy. 

Some questions you could ask yourself are:

  • Are there any subsidies or tax credits I can get?
  • How much can I afford to pay out of pocket?
  • What are my family's medical needs based on risk, typical injuries, and family history? 

Families with small children, young couples starting out, or seniors will all have different medical concerns. Adapt your choices to what you need, and make sure you readdress your needs every few years.

You shouldn't base your decisions on the premium. The best way to decide is to know what you'll need and base it on how much you will get out of your plan.

How Much of a Health Insurance Subsidy Can You Get?

Subsidies help to lower the costs of healthcare. You can get an idea of what kind of subsidy you can get by using a tool like this health care calculator

Check All Your Options Before Buying 

Before you purchase a health plan, make sure you also explore all the options available to you. For example, if you are not married, but have a domestic partner, find out if you can get covered under their health plan. Laws have changed in the past several years and options may be available to you that you didn’t realize.

Compare the Coverage of Existing Plans

One thing people often overlook is reviewing how two different health plans can work together. For example, if you are married or have a domestic partner, understanding the coverage on both plans and comparing the advantages in each plan can help you reduce costs.

You may also look at coordination of benefits for maximizing refunds on medical costs, read more about coordination of benefits and multiple health insurance policies here.

Health Insurance Waivers

After reviewing your situation, you may decide that you want to sign a health insurance waiver with one group insurer if after comparing plans and costs with your spouse, you determine that one will offer you more advantages.

Some people are even able to get alternative compensation from their employer as a result of waiving the health plan in favor of being added to a spouse's. More>>

What About Health Savings Plans? Are They Still a Good Idea?

We spoke with Caitlin Donovan, Director of Outreach and Public Affairs at National Patient Advocate Foundation, and she had this advice to offer,

"If you have an health savings account, continue to place money into it. Republicans have had a great deal of interest in not only keeping HSAs but expanding their use, so this may be a great benefit for you."

Other Ways to Cut Costs on Healthcare Insurance

The points we will cover below will help you understand the different aspects of what makes one plan more cost-effective than another, and give you additional resources to help you decide.

Get a Health Insurance Broker Who Can Help You

Figuring out how much raising the deductible will save
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The marketplace doesn’t always mean the best prices. Since the marketplace was introduced government regulations have put policies into place that have helped millions of Americans get coverage. However, navigating the marketplace can be confusing and people still need to take the time to compare options carefully. Aside from marketplace options, there are also other options to explore. 

Having someone help with the legwork who understands what you need can make a major difference. This may be the easiest way to work within a budget without having to shop and do all the work by yourself.

Insurance Companies Can Only Help You With Their Products, Brokers Can Help You Across Many Insurers and Discuss Options With You

Brokers do not work for insurance companies, health insurance brokers are mandated to work for you. They are on your side.

It doesn’t hurt to contact a health insurance professional and see what they can find for you. Brokers are usually paid by the insurance company, so you won't have to worry about this aspect of the cost. Some brokers may charge fees, but in general, they make their money off the insurance company by commission.

How a Broker Can Help You

Besides having a vast knowledge of the types of plans available, they can also explain the key differences to you and help find a plan that makes sense for you or your family.

They will be in a position to explain differences in types of plans, like HMO and PPO so you don't have to figure things out on your own. A good health insurance broker can compare your wants and needs to what you can get for your budget.

Health Insurance Claims Help

In addition, when it comes time to making a health insurance claim, they are there to help you and advocate for your needs with the insurance company so you aren't left on your own to figure everything out. Consulting with a broker is a good way to figure out where you can save money and maximize your benefits. This is their job and something you should explore. They can help you every step of the way.

When you look at how much time using the services of a broker can save you, compared with the benefits you may gain from using their experience and market knowledge, this may be one of the strongest ways to find options to save on your health insurance costs.

If you need help to find a broker or want to learn more about what a broker can do for you, you can check out the National Association of Health Underwriters

Manage Your Healthcare Costs: Check Medical Billing, Beware of Balance Billing

more money in your wallet by making smart insurance choices
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Studies have shown that there is a high rate of error in medical billing. Although you may not think this is your problem if you have health insurance, consider that you are often paying a percentage of your medical bills through copays, coinsurance, and deductibles.

When Medical Costs Go Up, Health Insurance Rates Increase

Increased costs to health insurance companies get passed down to consumers by way of rate increases in general. Checking your medical bills for errors will not only potentially save you money on what you are paying out of pocket, but will help keep general health insurance costs down.

When reviewing your medical bills, ask for an itemized billing that lists the supplies, medications, or procedures you are being billed for. And make sure to double-check all the information to the best of your ability including listed copays and deductibles.

Mistakes can happen, and these mistakes can cost you money. 

Beware of Balance Billing, Know Your Rights as a Patient

Among the various tips Ms. Donovan provided, one that many people may not be aware of was about balance billing: 

What Is Balance Billing?

"Balance Billing is where a provider bills a patient for the balance left over after he is paid by the insurance company, she explained, "Know your rights. Certain states have laws against balance billing, If this type of "surprise" billing happens to you, always check to see if you legally have to pay it."

Alternatives to Traditional Healthcare Insurance Options

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Do you find your health insurance policy confusing? You are not alone, here's a guide to help you understand your policy and coverage. skynesher / Getty Images

In our article, How to Get Health Insurance With No Job or Little Money, we cover several resources that are alternatives to the ACA marketplace. There are all kinds of options for you and your family that may save you a lot of money.

Health insurance is something that is very much based on individual circumstances, so checking out the list and exploring general options could prove beneficial for you.

Group Insurance Options You May Be Able to Get as an Individual

A lot of people do not realize that they are eligible for group insurance-type benefits as individuals simply through professional or other member associations. One membership-type plan is The Farm Bureau Health Insurance. Many people think this is only available to farmers, but the insurance plan is based on community, so you can join as a member and be eligible.

How to Find Out About Disease Specific Programs and Assistance

"Ask for help. Hospitals in particular may have programs to help you if you are faced with a large bill you may not be able to pay. There are also organizations, some disease-specific, that offer financial assistance and scholarship programs." - Cailtin Donovan, National Patient Advocate Foundation

Understanding the Basics in a Health Insurance Policy Will Help You Save

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Do you find your health insurance policy confusing? You are not alone, here's a guide to help you understand your policy and coverage. LPETTET/iStock

Understanding what various health insurance terms mean and how they affect you will help you make stronger decisions and save money on your health insurance costs.

When evaluating your health insurance choices, shop around and compare the copay, coinsurance, deductibles, and other factors like lifetime maximums.

Health savings accounts are a good way to plan for the future. But if you have not yet built savings up in one of these plans, you may be in a very difficult position if you don't fully understand your plan.

Negotiating Costs of Services and Discounts

Young girl high fiving Female Doctor in medical clinic
Working with your doctor may help you find alternative solutions to save on costs. LWA/Dann Tardif / Getty Images

We aren’t always in the best mindset when we are sick. Thinking about asking for a discount in the middle of a medical emergency is not our top priority as a patient needing immediate help.

Yet, as healthcare consumers, we can negotiate and ask for discounts. The key is to plan ahead. 

How to Get a Discount on Your Medical Costs

Billing departments, doctors, and health care facilities may be open to negotiation, especially if you offer to do something that will make their work easier. 

  • Ask if you can get a discount for paying in advance if you have a procedure coming up at a future date.
  • Ask if they have a policy where they can allow a discount for paying cash.
  • Speak to your doctor about your healthcare concerns if you have a high deductible or other issues, the doctor may take your finances into consideration and reduce fees.

Every cent helps when you are looking to save money. Be sure and explore these options and make these questions part of your criteria for deciding which health services providers can give you the greatest financial advantages while you are in their care.

Health Insurance Plan Discounts for Using Technology Like Fitness Trackers

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As technology makes data about the state of our health easily available, many insurers are starting to look at using tools like fitness trackers to minimize risk. As a result, some insurance providers may provide discounts or incentive plans that will save you money, or give you financial advantages.

Ask a broker or your employee benefits manager about plans that give discounts using new technologies or with health incentives. One example is "UnitedHealthcare Motion" which offers financial reimbursement incentives of up $1,500 per year. These types of plans provide good opportunities for savings.

Companies may also offer options of contributing to a health savings account as one of the benefits of these types of programs. 

Make sure to inquire about the possibilities every year, since this type of program will become more common over time.

Saving Money on Prescription Drugs With Your Health Insurance Plan

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Prescription Medications and Health Care. Vstock / Getty Images

Before choosing a health insurance provider or renewing coverage, find out where they stand with the prescription medications you normally take. If you have certain prescriptions that you regularly will need to fill, ask for a list from the healthcare insurance provider and see where those medications stand on their list. Find out what kind of coverage your new plan will provide for your prescription drugs; if there are limitations that could affect you, you may want to search for other options by shopping around.

There are often several options for medication that will rank at different costs on your insurer's drug list. By bringing the insurers list to your doctor they may be able to choose options that are more cost-effective for you. 

Manufacturers Programs That Offer Prescription Drug Discounts

Although it may seem impossible to get a discount on your drugs at the pharmacy, Ms. Donovan had some sound advice to offer when it comes to prescription drugs and finding deals,

"Check different pharmacies to see who offers the best price for your prescription. If you fall below a certain income level, the manufacturer may have a program for you to help you access that medication. It never hurts to ask for help and may certainly help."

Cutting Down on Unnecessary Medical Tests, Appointments or Procedures

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Doctors often perform various tests as precautions. Ask your doctor how necessary the tests or procedures they are recommending are. There are sometimes more cost-effective alternatives which may save you money.

By having a discussion with your doctor about what is medically necessary vs. precautionary, you will also let your doctor in on the fact that these are concerning factors for you. Open communication with your doctor will help the doctor work with your situation better and can also cut costs.

Review your past spending on medical costs for preventative care for yourself and your family, and try and plan ahead with the help of your physician for upcoming preventative visits like check-ups and other regular services to see if you can negotiate rates, as discussed in our next point below. Having an understanding of what you can expect can help you find a plan that works well for you.

Negotiate and Compare Health Care Service Options

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Thinking long term about your insurance choices will save you money. JGI/Jamie Grill / Getty Images

Choosing doctors and medical service centers by shopping around and comparing rates could save you a great deal of money.

This strategy to save money relies on two factors. One is the availability of services from different providers in your area, and the second is whether your health plan will allow you to choose from different providers.

A lot of this depends on the type of health insurance plan you have. If your health insurance plan limits your options, then you will also be limited to where you can get services and may pay more.

Once you know what your options are for services, call around and find out what the going rate is for procedures or services you will use.

You will not have time to do this in the middle of a medical emergency. Take the time to find out your options, before a medical emergency occurs.

The emergency room may have higher costs than a local clinic, but if you don’t check into local services in advance, you won’t be in a position to save yourself money when an urgent situation happens.

Lowering Health Insurance Costs and Finding Good Coverage

Understanding health insurance coverage options is confusing. Taking steps to ensure you have access to medical help and regular care will keep you and your family healthy, both physically and financially.