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Three Common Health Insurance Hurdles and Solutions

Are you one of the millions of Americans who kicked off 2014 with a brand new health insurance plan? Whether you receive health benefits through your employer, health insurance exchange or an individual plan, there are bound to be some changes, or surprises, included with your new policy. Namely, covered individuals find that their deductibles increased, their choice in doctors downsized and medications are more expensive. These are not small changes. So how does one handle this? targeted the three main concerns previously mentioned and created resolutions for each in their article, "Solutions for 3 Health-Insurance Challenges." Let’s take a look at how you can make these big changes more manageable.

1) Increase in deductibles

Employers that provide health benefits for their workforce are managing the jumps in health care expenditures by shifting some of the inflated costs to their employees. Those increases typically show up in their deductibles. As stated in the above article, “The Kaiser Family Foundation reports that 38% of covered employees have a deductible of $1,000 or more for single coverage (up from 18% five years ago), and 15% have a deductible of $2,000 or more (up from 5% in 2008).”

What to do?

Review all details of your benefits plan, keep medical receipts and push major medical costs to the end of the year, if it’s safe to do so. Also, compare costs for hospital tests versus standalone centers to see if you could shave off extra cash.

If you have an individual plan with a deductible of at least $1,250, or a family plan with a deductible of $2,500 or more, you may want to consider opening a Health Savings Account (HSA), if eligible. In 2014, those with the above criteria may open an HSA that allows you to save tax-deductible money to pay for deductibles or other out-of-pocket medical fees, tax-free. Best part? You can’t lose that money you set aside. 

2) Less choices

Just like employers and individuals, health insurers are seeking ways to lower costs as well, and unfortunately, that means shrinking network size. And if you dare go out-of-network, you could pay, a lot!

What to do?

Find out if your doctor is in your insurer’s network and also in your particular plan. If you go in for procedures you also need to make sure any specialists included in your surgery are also in-network.  If you are shopping for a new doctor, use the insurer-provided website tool to help narrow down your search and save time. And lastly, if you need to see a specialist who is out-of-network, ask about your insurer’s appeals process. It’s possible they will cover all of the cost, as if they were in-network, or only require you to cover a small portion.

3) Increase in medication cost

Insurers now have a tiered-process when it comes to medication. Even if your drug is covered under your plan, you may be paying significantly higher than in year’s past. Generic drugs typically fall under the least expensive tier, but each drug is rated and categorized to determine your payment portion.

What to do?

Ask your doctor about generic medications, or cheaper alternatives. You can also skip the drive-through pharmacy and start a snail-mail order. And lastly, which requires a little more time, your doctor may have a sound reason why you need to be on a certain medication and could file an appeal to help with cost.

You will find more important specific details in the Kiplinger article that you may want to review. Health insurance is tricky, especially with so many new changes that each new year brings. To fully understand your options, be sure to contact a health benefits professional at BenefitMall to make sure you get the most out of your time, money and insurance plan.  

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