Supporting your health while meeting your budget needs is uniquely challenging in today’s world. With the costs of healthcare projected to rise to a 13 year high, what you’ll pay for care is an essential factor in evaluating a health plan. Whether it’s your current plan or plans you’re considering, taking the time to understand the total costs of your care can keep both your health and budget covered.
Itemizing Health Plan Costs
When you think of costs associated with a health plan, you likely think of what comes out of each paycheck for the monthly premium. Monthly premiums are an important consideration, however, there are other costs to note. These costs include:
- Monthly premiums. The monthly payment made for an insurance policy.
- Deductible. What you pay each year before your health plan shares costs. Review your Summary of Benefits and Coverage (SBC) to see what payments are counted towards your deductible.
- Coinsurance. The percentage of costs for care you are responsible to pay and is billed to you after the service is performed by the provider or facility.
- Copayment or Copay. The fixed amount you pay for medical services, such as office visits or prescription medicines. It is usually paid at the time of your appointment.
- Out-of-Pocket Costs. What you pay for healthcare expenses, including things like deductibles, coinsurance, or copays.
- Out-of-Pocket Maximum. The most you will pay for healthcare expenses in a year.
- Prescription drug costs. Costs for prescribed drugs depend on what tier the drug is in, whether it’s brand or generic, what pharmacy you go to, and more.
Consider Cost Balance
The costs of a health plan need to be considered in relation to each other. Some plan, like High Deductible Health Plans (HDHP), offer a lower monthly premium, meaning you’ll pay less per paycheck. However, you may pay more for care overall if you have significant health needs. Conversely, a plan with higher premiums will usually have lower deductibles, lowering the total amount you’d pay for care over time. They typically work best for those who use health coverage often and those living with chronic conditions. As you consider the different costs of a health plan, balance the costs with your current health needs to, ultimately, protect your budget.
Where to Find Cost Information
Your best source of information is your health plan’s SBC. It’s an easy-to-understand overview of benefits and coverage provided by a health plan. The SBC gives you a snapshot of what costs you can expect to pay throughout the year for care under your health plan. You can use this document to compare the total costs of care you can expect with each plan you’re considering — if you decide your current plan isn’t right for you or simply want to see your options.
Questions? We Can Help.
As you review your plan and maybe other plan options during Open Enrollment, we’re here to help make the process as easy and simple as we can. Reach out to the VEBA Advocacy Team at 888-276-0250 (Monday-Friday from 8 am-5 pm).
VEBA Resources
MyVEBA Portal: Easily view your current health plan information through the MyVEBA app or online portal. Download the app for Apple or Android, or visit the MyVEBA Portal for desktop access.
Benefit Contacts: For assistance with specific carrier benefits or issues, such as claims or coverage details, visit vebaonline.com/benefit-contacts to contact them directly.
Get Support: The VEBA Advocacy Team can help you review your health plan and discuss it with you in depth. Call 888-276-0250 or visit vebaonline.com/contact for assistance. For urgent requests, use the “Urgent” box on the contact form.
