How to lower health insurance costs

1.

Determine if you are eligible for a premium tax credit (subsidy)

If you buy your own health insurance, you may be eligible for a premium tax credit, also known as a subsidy. This is financial assistance from the federal government that can be used to lower your monthly premium.

Enhanced premium tax credits are the expanded version of the premium tax credits. When the American Rescue Plan Act was passed in 2021, it expanded health care premium tax credit eligibility to include more people who buy ACA health insurance plans. It also increased the amount qualified individuals received.

At this time, enrollment and eligibility may be changing for premium tax credits in 2026. In addition, the federal government has not yet renewed Affordable Care Act (ACA) enhanced premium tax credits for 2026. They are set to expire Dec. 31, 2025. These federal government decisions could significantly impact monthly ACA health insurance premiums beginning January 2026.

Premium tax credits are determined by your household size and income, which is why it’s important to be as accurate as possible when filling out your application and report any income or household changes each year.

You may also qualify for cost-sharing reductions, which help lower out-of-pocket costs like deductibles, copays and coinsurance.

2.

Consider an HMO plan (Iowa only)

If you live in Iowa and are looking for quality health insurance that’s less expensive than traditional plans, 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 out-of-pocket costs.

There are many common misconceptions about HMO plans, especially around finding in-network care. With an extensive in-network provider network across Iowa, Wellmark makes finding in-network care easy. And our HMO plans provide members with access to emergency care nationwide.

3.

See an in-network provider

Another way you can lower your health insurance costs is by staying in-network. Wellmark has agreements with in-network doctors and hospitals to ensure you have access to high-quality care. Regardless of your plan, staying in-network can help you save.

4.

Try no-cost virtual care

Virtual visits make it easy to get the care you need from anywhere, so you don’t have to worry about going out of network. See a board-certified provider for most common illnesses and mental support, and even get medication prescribed, with just your phone, tablet or computer. The best part: virtual visits are included in most Wellmark plans at no cost to you. Try a virtual visit today.

5.

Consider a high-deductible health plan

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, then a high-deductible health plan may be the right choice for you. With this type of plan, you will pay lower monthly premiums in exchange for higher deductibles and out-of-pocket costs.

Because you are responsible for the full cost of care until your deductible is met (excluding preventive care), this type of plan encourages you to have meaningful conversations with health care providers to determine care options and cost-saving opportunities.

6.

Open a health savings account (HSA)

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.

Also, the funds you contribute to your HSA stay with you, regardless of changes in employment, insurance carrier or retirement.

7.

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. Wellmark members can see what drugs your plan covers, find generic alternatives and search for in-network pharmacies when you log into myWellmark^®.

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.

8.

Use your benefits

Take advantage of the benefits included in your plan, like preventive screenings and health and wellness savings programs, as these benefits lower your health insurance costs by preventing future illness and injuries. If you’re looking for one-on-one help, take advantage of the Wellmark Case Management Program. Case management nurses and social workers offer personalized guidance and support to individuals with severe, complex conditions, behavioral health concerns or experiencing a high-risk pregnancy.