6 ways to manage your individual health insurance costs
Understanding your health insurance costs is an important part of choosing coverage that fits your health care needs and budget. This article explores how you can better understand these costs and the strategies you can use to determine the most affordable plan option for your needs.
How do health insurance costs work?
At a minimum, most health insurance plans require you to pay a monthly premium. Besides your monthly premium, you’re also typically responsible for copays and coinsurance. And in most cases, you’ll need to meet a deductible before your plan starts to pay their share of health care costs.
Many people only look at the monthly premium when choosing a health insurance plan — but that doesn’t always mean that plan has the lowest costs overall. All out-of-pocket costs, like copays and coinsurance, impact the total cost of your health care, and they all need to be considered when choosing a health insurance plan.
What affects my monthly premium?
If you buy your own coverage through the Health Insurance Marketplace®, your monthly premium amount is influenced by your plan type, income, household size, where you live, your eligibility for premium tax credits (subsidies) and other factors. While it might be tempting to simply choose the health insurance plan with the lowest monthly premium, you may find that plan is not always the most affordable option when considering your total health insurance costs.
For example, a plan with a lower monthly premium may have a higher deductible or higher out-of-pocket costs. Depending on the care you expect to use, a plan with a higher monthly premium could cost less overall.
Find a Wellmark individual or family plan in your budget
Wellmark’s online shopping tool makes it easy to find and compare plan benefits and costs. See what options are available in your budget.
How does my deductible impact my health insurance costs?
Your deductible is the amount you must pay before your health plan begins to pay their share of costs. When shopping for a plan, be sure to pay attention to the deductible amount and consider if the deductible fits your budget.
How to choose a plan that fits your budget
It’s important to think through the services you know you’ll need throughout the year and choose a plan that meets those needs.
Do you visit the doctor often? Do you or your family members have any health care needs that require a specialist? Do you take any high-cost prescription drugs? Answering these questions before shopping will help you narrow down your choices.
Ways to manage your health insurance costs
Did you think about the questions above? These cost-saving strategies can also help.
1.
Explore all your plan options
Wellmark offers several types of individual and family health plans. When comparing plans, look at network access, the monthly premium and the other costs you’re responsible for paying.
If you live in Iowa and are looking for quality health insurance with lower out-of-pocket costs, consider a health maintenance organization (HMO) plan. With an HMO, you will select a primary care provider to help coordinate your care. HMOs offer lower rates with specific health care providers in your state, and the savings are passed on to you through less expensive monthly premiums and lower out-of-pocket costs.
A high-deductible health plan may be a more affordable health insurance option for you if you have a solid understanding of your future medical needs or plan to use a health savings account (HSA) to pay for your care. With this type of plan, you will pay lower monthly premiums in exchange for higher deductibles and out-of-pocket costs.
See what other Wellmark individual and family health insurance plans may be available in your area.
2.
Open a health savings account (HSA) to help manage your out-of-pocket health insurance costs
Certain plans, like high-deductible health plans, can be paired with an HSA. These are special savings accounts you use just for health expenses. Plans that pair with a health savings account have higher deductibles, so their premiums are lower.
With an HSA, you set aside pre-tax money to pay your medical, dental and vision expenses. You can decide how much you want to contribute annually, as long as it’s equal to or less than the contribution limit the IRS sets for HSAs each year. If money is still in your account at the end of your plan year, it will automatically carry over to the next plan year.
The funds you contribute to your HSA stay with you, regardless of changes in employment, insurance carrier or retirement.
3.
See if you’re eligible for federal financial assistance
Depending on your income and household size, you may be eligible for a premium tax credit (subsidy). This is financial assistance from the federal government that can be used to lower your monthly premium.
Another financial resource from the federal government is cost-sharing reductions. These reductions help lower out-of-pocket costs like deductibles, copays and coinsurance for qualified individuals and families.
4.
Use in-network providers
One way you can manage your health insurance costs after you’re enrolled is by using in-network providers and facilities. Regardless of your plan, staying in-network can help you save. Wellmark has agreements with in-network doctors and hospitals to ensure you have access to high-quality care. You can also avoid going out-of-network with virtual visits. Most Wellmark plans have coverage for virtual visits with in-network providers. Wellmark members can find in-network providers and facilities with the secure member portal, myWellmark.
5.
Save on prescription drug costs
If you’re looking to save on prescription drug costs, consider switching to a generic brand if possible. Generic brands have the same active ingredients as brand-name prescription drugs but cost much less. When comparing individual and family health plans, review each plan's prescription drug coverage and pharmacy options. Depending on the plan you choose, your prescription drug costs may vary.
Consider ordering your prescription drugs through a mail order pharmacy, which can be an effective cost-saving option. Additionally, your primary care provider or pharmacist can help identify other opportunities to save on prescription drugs.
Taking your prescriptions as directed can also help you avoid spending more on additional prescriptions.
6.
Use your benefits to lower your health insurance costs overall
After you enroll, be sure to take advantage of all the benefits included in your plan, like preventive screenings and health and wellness savings programs. These benefits lower your health insurance costs by preventing future illness and injuries. Specific programs, like the Wellmark Case Management Program, offer personalized guidance and support to individuals with severe, complex conditions, behavioral health concerns or experiencing a high-risk pregnancy. They can also make sure you’re using your plan to the fullest and direct you to resources to help manage your health costs.
Explore Wellmark health plans in your budget
Wellmark plans include several benefits that give you more value for your money, such as:
- Savings on gym memberships and other wellness products with Blue365®.
- Tools that help you manage your health care spending like myWellmark®.
See what Wellmark individual and family plans are available in your budget.
Still have questions? A licensed Wellmark agent can help you find a plan that fits your health needs. Get connected by finding a licensed Wellmark agent in your area.
Disclaimers
Blue365® is a discount program available to members who have medical coverage with Wellmark. This is NOT insurance.