Understanding health insurance costs

Health insurance exists to help offset the costs of medical events, whether they’re planned or happen unexpectedly. A number of factors may play a role in how much you pay for your health insurance. Some costs will vary based on your situation, like your age, where you live — even some of your habits might be considered. In the United States, here are some of the ways your costs may go up or down:

Costs may be lower if
  • You’re younger
  • You have fewer health issues
Costs may be higher if
  • You’re age 50 and over, because you may experience more health issues
  • You use tobacco
  • You include your spouse or dependents, because you’re charged for each person covered by your plan

Those are just a few of the variables that come into play when your costs are calculated. It may help to keep this in mind when you’re comparing costs for health plans.

What are the types of health insurance costs?

Within the health insurance arena, there are a number of costs not paid by insurance, also known as out-of-pocket costs. Those costs include premiums, deductibles, coinsurance and copayments.

But what exactly is a premium? How about a deductible? And what’s the difference between a high deductible plan and a low deductible plan? It’s important to understand the ins and outs of how these costs work before you choose a plan.

Can I get help paying for my health insurance?

There are many federal programs designed to help people cover the costs of health insurance, ranging from Medicare and Medicaid to Affordable Care Act (ACA) or Marketplace plans, COBRA and Dual Eligible plans.

Managing health care costs

Here’s some good news. Did you know there are a number of ways to easily save on your health care costs? Even simple choices, like going to providers in your health plan network, may help you reduce health care costs significantly.

What are HSA, HRA and FSA accounts?

During open enrollment, you may be able to choose plans that offer tools to help you save money to pay for eligible health care expenses. Let’s break down the basics of these common health accounts.

A health savings account (HSA) is a place to put money away — pretax — in order to save for standard medical expenses to self-care treatments to first aid items and medical equipment. An HSA is owned by the employee and remains with them even after leaving a company.

A health reimbursement account (HRA) works in a similar way to an HSA. However, contributions can only be made by an employer, and they own any unused funds, if the employee leaves the company.

Another special account is a health care flexible spending account (FSA), letting you set aside money, before it’s taxed, to help pay for qualified medical, dental and vision care expenses.

Coverage for preventive care and diagnostic care

Why do you need to know the difference between preventive and diagnostic care? Here’s why — insurance coverage is usually different based on the type of care. Preventive care, like well exams and screenings, is often covered at 100% with $0 out-of-pocket costs when you see a network provider. Coverage for diagnostic care, when you have symptoms your doctor needs to diagnose, could have additional costs and will vary depending on your plan.