Medical insurance premiums change every year. And unfortunately, rates tend to increase most years. This is due to higher costs associated with healthcare treatment, such as doctor’s charges, facility fees and room charges of hospitals and other providers. Although recent federal ACA legislation allows many consumers to qualify for lower costs by utilizing subsidies and instant tax-credits, many others are watching premiums substantially increase.
New technological advances in medicine save lives and improve quality of living. But they also can be costly to consumers. We help you reduce your premiums and show you companies that will charge less for their coverage in your area. Often, a major national carrier such as Aetna or Blue Cross may offer the lowest rate. But often, it may also be a local regional company or a C0-Op.
The top portion of the page provides you with the opportunity to quickly compare the policies that are likely to be able to help you cut your costs. Entering your zip code and other information will be required. But don’t worry. We don’t want or need personal financial information such as your social security number. And it doesn’t take long for you to view and compare low rates.
Has Obamacare Raised Or Lowered Your Premium?
Obamacare (Affordable Care Act) has improved the quality of individual and group plans. But at what cost? Now that there is no cap on lifetime payable benefits and mandated preventive coverage is required, both private and employer-sponsored policy premiums have risen. Maternity benefits must be included on all qualified on and off-Marketplace plans, regardless of your preference. The same applied to pediatric dental, mental illness, and various other items that ordinarily, you may have chosen to exclude in the past.
Additional changes resulting from future government regulations could further strain medical rates. Ultimately, someone must pay for these changes and it appears (for now) it is wealthier Americans. Persons with income below the Federal Poverty Level can usually obtain affordable coverage during Open Enrollment periods. This change helps many consumers who otherwise might not be able to purchase a policy. In fairness, that has been a major positive change.
One of the big variables was whether each state or the Federal Government would pay to enact many of the new programs. The State Exchange programs which help facilitate the purchase of online medical insurance are very expensive to operate.
Since the cost of setting up and maintaining these programs has been hundreds of millions of dollars (per state), naturally, there is current discussion and confusion regarding who will ultimately continue to pay for them. Most states have decided to let the federal government handle the setup costs.
Currently, there are only 13 states that manage their own Exchanges. They are Washington, Vermont, Rhode Island, New York, Minnesota, Massachusetts, Maryland, Kentucky, Idaho, District of Columbia, Connecticut, Colorado, and California.
What Can You Do About Your Costs?
Consumers, however, can often effectively reduce their medical insurance premiums. Naturally, the most common method is to lower or eliminate coverage. With the new Exchanges, the “Bronze” plans are the least expensive and the best option to minimize your cost. NOTE: For persons under age 30, although a special “catastrophic” plan is offered, in many states, the rate is actually higher than many Bronze-tier policies.
Typically, we don’t recommend altering your benefits unless you fully understand the impact of the proposed changes and the “worst case scenario” that can result. And sometimes, if you delete a benefit, you may not be able to get it back, or you may have to wait for an “Open Enrollment” period which could be the following year.
For example, if you decide to change your private healthcare plan by substantially increasing your catastrophic deductible up to $6,850, your potential costs (with coinsurance) could be as much as $13,700. If you were to have two major claims in successive years, are you prepared to pay more than $25,000 out of your own pocket?
While the $3,000 (or more) savings per year would have been nice, in retrospect, changing your policy could create some major financial hardship. Although many hospitals will negotiate the amount you owe and the terms of how it is paid back, it could take a decade to completely entirely erase the obligation. Although predicting your actual medical expenses the following year is impossible, we help you create the most likely scenarios, so the most cost-effective plan is purchased.
We Review, Shop, and Compare – So You Save Money
Shopping and comparing to find new medical coverage can be time-consuming so it’s best to let the experts do all of the legwork for you. And yes…that’s where we can help! Whether you have pre-existing conditions, or you’re in perfect health, we’ll be able to evaluate dozens (often hundreds) of available plans in your area, and advise you if it’s feasible to reduce your premiums in a way that won’t jeopardize your long-term health care.
And we also try to point out situations where your payments are tax-deductible (possibly an HSA). If you qualify for a federal subsidy, your premiums will be reduced. If your income prohibits you from government assistance, outside/Exchange options should be considered.
How Are Insurance Premiums Calculated?
Actually, there are a number of factors. Of course, since medical conditions do not impact your premium, pre-existing conditions are covered on Marketplace plans. If you don’t have any existing conditions, don’t smoke, don’t take any medications and you have a normal BMI (Body Mass Index), you should consider a Bronze-tier plan, unless you qualify for a federal subsidy.
Conversely, If you have been treated for cancer, diabetes or heart disease, there’s a good chance you will meet your deductible. Maximum out-of-pocket expenses (MOP) should be the primary determinant when choosing a plan. Contact us, and we will review your best policy choices.
As expected, your smoking status, age and state of residence will also influence your rate. If you’re a young healthy male in Ohio, you will be paying a ridiculously low rate. If you move to New Jersey, for example, you will see a significant increase in your premium. However, there is no difference in male or female rates, assuming the same age.
We’ll continue to monitor rates of health care providers and publish the latest information that may help you stabilize and possibly lower what you pay for your own coverage. It seems as if every few months, there’s a new rule or regulation that impacts what you pay or a new mandated benefit you must purchase.