Health Insurance is pretty much the only insurance that you purchase with the intention to use it. Here are some of the best tips & tricks that I have learned after a decade of experience as a Health Insurance Consultant. Follow these steps to survive open enrollment to get the best health insurance for the lowest cost.

Open enrollment is the time that you will get to make changes to your health plans each year through your employer as well as through individual health plan markets.

It is hard to ignore the enormous cost of health insurance premiums and the costs of even going to the doctor or pharmacy when looking at your household expenses.

Health Insurance Impact on Your Budget

Insurance protects your assets. Health Insurance protects you financially for that BIG WHAT IF??? The average American earns $44,148 per year and the average pay increase expected for 2019 is 3% or an extra $110.37 per month. A slight increase in health insurance premiums will likely eat up a part of and many cases all of that wage increase. So let’s find the best and cheapest.

Best Health Insurance for You & Your Family

It is nice to start with as many options as you can. Try and get a wide variety of options. Even if your employer only offers one or two health plans to choose from, check what plans your spouse has available through their work. If it is open enrollment for you, the changes that you choose to make may trigger a Qualifying Event for your spouse to be able to make changes too. Also, do a quick check of individual plan options through www.healthcare.gov.

Choose a plan based on your current health situation and how you have used it over the past 3-5 years. Ask yourself if you or your family:

Uses doctors who are Specialists & how often?
Uses an Emergency Room frequently?
Have any planned surgeries or pregnancies in the next 12 months?
What types of medications and how expensive are they?
What doctors and hospitals are important to you to have in-network if you made any changes?

These are important to know because premium savings on health plans typically only come along if you are willing to raise copays on doctor visits, raise deductibles on things like surgeries & emergency room visits, make changes to prescription plans that have more expensive drugs covered at much higher costs, or possibly by limiting the types of hospitals or physicians that you will have in-network.

My personal and family strategy is the following. We purchase health insurance for the ‘Big What If.’ So it is important to me to have access the best hospitals that are near Las Vegas if I was to be diagnosed with something like cancer, need an organ transplant, or just run a million tests to see what is actually wrong with my health. These hospitals include Mayo Clinic in Arizona or Scripps, UCLA, and Cedars Sinai in Southern California. We don’t currently take any high cost medications or have regularly scheduled doctor visits so we are okay with using higher copays or deductible-only health plans. Our health care needs/wants have allowed us to purchase a lower premium health plan with high deductibles and attach a Health Savings Account (HSA) that allows us to save money for future health care expenses when we aren’t as healthy.

Health Benefits from an Employer

Census data from 2015, shows that 72% of workers between the ages of 18-64 obtain health insurance through their employer.

Employers use health benefits for four reasons.

To recruit the most talented workers to their companies.
To retain the most talented workers from leaving their companies.
To help keep their workforce healthy and productive
Because they care about the well-being of their employees and families

Sadly, the fourth reason has greatly diminished as the cost of health care has continued to put huge dents in a company’s profitability AND sustainability.

Companies in virtually every industry offer great health plans to their employees. And these are the companies that are searching for top talent to add to their workforce. Set yourself apart from other workers so can easily qualify to work for the best companies that are willing to offer their workforce the best health benefits.

Individual Health Plan

There used to be a lot of individual health plan options that you could choose from but for various reasons, there are less and less options available. Independent contractors, small business owners, college students, and other working class Americans that aren’t offered QUALITY insurance through their employers have been impacted the most. In basic terms, new Obamacare Regulations that actually improved the quality of the health plans for us, were less profitable or even proved to be a loss to insurance carriers. As a result, they have steadily pulled them back from the market.

If you don’t have an option to find an affordable policy through an employer that offers the quality of plan that you need, then start at www.healthcare.gov and it will take you through the steps to see if you qualify for the various State or Federal Subsidies.

The second route is to look at a Healthcare Sharing Group. There are so many pros and cons these plans that your Shea Insurance Team will have to plan another future post to address these. In summary, Obamacare provided a religious exemption from the individual mandate in its ACA version of Healthcare Reform. This allowed groups to gather under this exemption and ‘create’ some of their own policies and rules. Most of them have an insurance piece to it and most of them are fairly good options. But educate yourself if this is the right option for you and then educate yourself on which company or group is the best fit for you HERE. I must add that most of these plans are not considered insurance and Shea Insurance doesn't 100% advocate in favor of them, but it may be an option that fits for you.

Also, keep a lookout for Association Health Plans that are hitting the market as soon as September 1, 2018. Association Health Plans were basically nixed when the Affordable Healthcare Act / Obamacare was enacted. President Trump signed an executive order in early 2018 that allows Association Health Plans once again.

HSA Strategy – Health Savings Account

I recommend considering an HSA eligible health plan for the two extremes… the healthy as well as the unhealthy that will have a lot of medical expenses. If you consider yourself relatively healthy but take 3 or more maintenance medications to maintain your health, then an HSA may not be the best option. Or possibly you go to the doctor every so often for routine checkups and blood work, then an HSA may not work for you either. The reasons are because you never really get to build up a savings in the HSA and don’t quite have enough medical expenses to ever cap out your insurance plans during the 12 month policy period. Rather a healthy individual, can take advantage of low medical expenses and build up a high reserve in the HSA for future medical expenses by depositing pre-tax funds into their HSA. Furthermore, the unhealthy individuals that continue to have a lot of medical expenses and know that they will most likely cap out their plan deductibles and out-of-pocket maximums can take advantage of using pre-tax funds to pay off those medical expenses.

For more information about HSA accounts, visit my full explanation HERE.