How to Hold Down Health Insurance Costs?

We won’t know for sure until the rates are published later this fall, but the news is that health insurance companies nationwide are seeking to increase their policy rates by 20 to 40 percent or more. The reason given, according to an article in the New York Times: “new customers under the Affordable Care Act turned out to be sicker than expected. Expect pressure from the federal government to see some of these increases scaled back, while federal subsidies and tax credits available with certain plans purchased though the federal or state exchanges will provide some financial assistance. But whether you buy from an exchange or get your family healthcare plans direct from a carrier, you can hold down your out-of-pocket health insurance cost by taking full advantage of the free preventative services all ACA-qualifying plans must provide without charging you any copay, coinsurance or deductible.

What You Don’t Know Gets Expensive

A big benefit of the ACA, and one of the first implemented, was access to a very big menu of free preventive services, based on the old adage that an ounce of prevention is worth a pound of cure. Strictly speaking, they are really “free” because American taxpayers ultimately foot the bill, but not using them is a waste of everyone’s money. Yet, here we are, more than four years into this perk and a whole lot of people are either unaware of the benefits or don’t know how to take advantage of them. A Kaiser Health Tracking Poll in March 2014 found that only 43% of the population were aware of the benefit and were therefore likely to avoid preventive service because of concerns over added costs.

Who Gets What?

Adults with ACA-qualifying healthcare insurance are entitled to 15 basic services, although women’s preventive services cover 22 benefits. For minor children, the list is 26 items long, with some services further qualified by the age of the child. With kids’ health care costs growing faster than those of the general population, and newborns between 0 and 18 days rising the fastest, taking advantage of every screening, immunization and behavioral assessment offered just makes good sense.

What’s Covered?

You can find a comprehensive list of what benefits your health insurance entitles you to at HealthCare.gov, but this list will give you a general idea.

Basic preventive services:

• Immunization
• Alcohol and tobacco misuse screening and treatment options
• Blood pressure and cholesterol screening
• Obesity and Type 2 diabetes screening
• Depression screening
• Colorectal cancer screening
• HIV and STD screening

Additional preventive services for women:

• Contraceptives
• Well-woman visit
• Screening for anemia and osteoporosis
• Prenatal care
• Mammograms and breast cancer screening

Preventive services for children:

• Developmental assessments for children under age 3
• Behavioral assessments at 0 to 11 months, 1 to 4, 5 to 10, 11 to 14 and 15 to 17
• Autism screening
• Immunization vaccines for children from birth to age 18
• Newborn hearing screening
• Vision and oral health screenings
• Depression screening

Most preventive services can be provided during a yearly physical or a well-woman visit. Be aware that while the preventive services are provided at no charge to you, the office visit might involve copay if the primary reason you made the appointment was for something other than preventive care. And, if further treatment is required as a result of a screening, that will probably involve out-of-pocket costs to you as well. If you’re not sure what you need, what you’re entitled to and what if any costs are involved, ask when you schedule your appointment or contact your insurance provider.

You can compare plans and quotes for individual and family healthcare policies here, and learn about short-term health insurance coverage here that can protect you until you’re eligible for Open Enrollment.