Article Topics:

Health care costs rising: How to get smart about paying for insurance

Family examines medical bill

In the run-up to the passage of the Affordable Care Act, a chorus of Washington politicians promised that the ACA would bring health costs down.

That’s not happening.

For health care consumers who don’t receive government subsidies, health care insurance premiums will rise by 11% on average in 2016, according to a recent study from HealthPocket.

Average deductibles are up, too – to $5,371 in 2016, HealthPocket reports.

See also: 5 insurance predictions for consumers

In real-dollar terms, a 50-year-old health care consumer who paid $364 in premiums in 2015 will pay $405 in 2016. If that 50-year-old is paying for a family plan, he or she can expect to pay $13,292 in out of pocket costs this year, compared with $11,601 in 2015.

Why are your health care costs rising?

According to the American Academy of Actuaries, drivers of 2016 premium changes include: the underlying growth in health care costs, the phase down of the transitional reinsurance program, and how assumptions regarding the composition of the 2016 risk pool differ from those assumed for 2015.”

With both premiums and out-of-pocket health insurance costs jumping this year, what’s a consumer to do the next time he or she has to sign up for health insurance?

The answer, health insurance experts say, is to get a “big picture” look, then act accordingly.

“Consumers can really cut costs if they shop around for options,” notes Joel White, president of the Council for Affordable Health Coverage, in Washington, D.C. “Right now, health insurance exchanges generally present premium information. Due to rising cost-sharing obligations, however, it is necessary for consumers to take a deeper look at their total out-of-pocket exposure, rather than just premiums.”

How you can control rising health care costs

To help cut costs, White advises consumers to sign up for wellness programs.

“These programs provide discounts of up to 30 percent to to 50 percent on premiums while promoting healthier lifestyles,” he says. “These are things like smoking cessation programs or diabetes management programs. They're proven to lower costs, and can improve your health, as well as your pocketbook's.”

Usually, these programs are only available through employers. But the Council for Affordable Health Coverage is “working hard to extend these discounts to individual policies,” White adds.

See also: Obamacare in 2016: What you need to know

Chris Lokken, an employee benefits consultant at Johnson Insurance in Sturtevant, Wisconsin, advises consumers to focus on value. Do that, he says, and health care costs can come down.

“Make sure that you are getting the 'best value' in care for your dollar,” he says. “Costs for visits for little things like sore throats, can be a lot less if you use an online health visit or convenience care clinic versus a doctor visit, emergency room or urgent care.”

More tips to help you temper costs

It’s also vital to know your health care plan options well ahead of actually signing up. “Many health insurance plans have this information on their web portals, so get familiar with how they work,” Lokken says.

Another tip: Doctors likely won't approve, but cutting prescription drug dosages can help cut costs, Lokken says. If you take a prescription drug, split the medication in half, if possible. “If it’s 20 mg, for example, and you split it, you save instantly by getting two months of medication for the price of one,” he says. 

Last, maybe the most thing to remember is that insurance is a scale, says Susan L. Combs, president of Combs and Company, a New York City-based insurance provider. “Either you pay more money on the premium, so that you pay less when you need care, or you pay less money on the premium, so that you pay more when you need care. The best way to save money is to take a realistic look on how you have utilized the care in the past and then not spend money on the services that you don’t need.”

That's good advice if you're battling soaring health care insurance costs this year or any year.

A version of this story originally appeared on

See also: Americans still hold strong feelings about Obamacare and its future

Obamacare penalty calculator

Use our quick calculator to estimate your penalty for not having health insurance.

How many adults are in your household?

Step 1 / 3

Get Free Health Insurance Quotes

Get Free Health Insurance Quotes

Submit Your Question!