US health insurance: what to do now to save on medical services in 2020 year

On November 1, November 2019, open registration for the 2020 Health Care Plans for the year will begin. Within a month and a half, Americans will be able to first or re-register or change their insurance plan at the Health Insurance Marketplace.

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According to health experts, while the cost of health insurance in the workplace is falling, insurance premiums remain a burden for many working Americans. Therefore, experts recommend that employed US residents review their insurance plans during the open period to make sure that they do not miss the opportunity to save, writes New York Times.

Employees themselves should take the time to review insurance plans, said Tracey Watts, senior partner and national health policy leader at Mercer.

“They have to do their homework,” said Watts.

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A study by the Kaiser Family Foundation showed that the average annual cost of family insurance increased by 5% in the 2019 year and amounted to almost 21 000 dollars, with workers paying 6 015 dollars and the rest being compensated by employers. The survey involved more than 2000 large and small employers.

And the National Healthcare Business Group, which is conducting a survey of large employers, expects that next year the total cost of medical benefits will increase by 5%.

A deductible is also important - that employees must pay for their medical care before insurance covers it. According to the Fund, the average size of a single franchise is now 1655 dollars, which is twice as much as 10 years ago.

Large employers say they are expanding their health insurance plans beyond high deductible plans. Only a quarter of the employers surveyed (compared to 39% in 2018) said that next year they would only offer employees plans with a high deductible.

Employers said they usually add a “preferred provider” plan, or PPO, which allows employees to seek help from doctors online for less. Such plans often have higher premiums, but lower deductibles.

What can employees do to manage their expenses?

Watts said workers must compare plans proposed by their employer and make calculations: from the total annual cost of insurance, any employer payments must be deducted to get the basic cost of each plan.

“People are often afraid of big deductibles,” she said. “But high-deductible plans usually have lower insurance premiums and may be accompanied by employer contributions — often to a special, tax-free savings account for healthcare.” This may make them less expensive than PPOs. ”

Employers often transfer employee contributions to health savings accounts, or HSAs, associated with high deductible plans. Workers can use the money if they need it, or save it if they don't. The account balance transfers and remains with the employee, even if he or she changes jobs.

But choosing a higher deductible and rate can be risky if the family does not have enough funds to cover the deductible and pay for treatment or care if necessary.

“It's not always that straightforward,” says Matthew Ray, Assistant Program Director for the Kaiser Foundation Healthcare Market.

The problem is that some medical needs are unpredictable.

“Nobody says: I plan to get cancer next year,” said Caitlin Donovan, spokeswoman for the Patient Protection Fund, a nonprofit group that helps people with serious illnesses.

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However, according to Donovan, workers should at least try to evaluate what they think they will spend money on before choosing a plan. For example, consider prescription drugs that they regularly take or the procedures they plan to take.

“Work with what you know,” she said.

Check if your plan will still cover your specific prescriptions, and if your doctor and hospital will remain in your covered network (where costs are lower) for the coming year. Call them back to confirm this.

“Online catalogs are known for their inaccuracy,” Donovan notes.

In addition, if you are married, consider whether a spouse's health plan can be cheaper, she advises.

If you choose a plan with a high deductible, try to invest as much money as possible in the HSA. If you do not use it, you can leave money and even invest it in the future. HSA money can be used to pay for child care and care, even if it is covered by another health plan.

At a minimum, it would be nice to invest the money you save on insurance premiums in order to switch to a plan with a high deductible, recommends a specialist.

Another way to save money: many employers will offer a premium discount or deposit extra money into a savings account if employees agree to an examination or health check. The idea is that identifying factors such as smoking or high blood sugar can help to prevent health problems that are more serious and costly to treat.

Here are some questions and answers about 2020 coverage:

• Can I save by using virtual visits to the doctor?

Employers are increasingly offering workers treatment at doctors located elsewhere using technology, including real-time video chats and remote monitoring using mobile applications.

The cost depends on the details of your medical plan. According to Watts, as a rule, a person with a high-deductible plan pays between 40 and 50 dollars for a visit to a virtual doctor, compared to 70 dollars for a clinic visit and about 140 dollars for a primary care doctor.

• How much can I deposit into a medical savings account in 2020?

The maximum contribution for next year is 3550 dollars for individuals and 7100 dollars for family coverage. (People aged 55 years and older can contribute an additional 1000 dollars). In order to qualify for HSA in 2020, an insurance plan must have at least 1400 dollars per person and 2800 dollars per family.

Some employers offer savings on healthcare costs with a flexible expense account. The FSA allows employees to save pre-tax salary to pay for healthcare costs that their insurance does not cover. These accounts have lower contribution limits (2700 dollars for 2019 year; Internal Revenue Service has not yet approved a limit for 2020 year), they cannot be transferred from one employer to another and limit the amount of money that can be transferred from one year to the next. A household with an income of 59 000 dollars would save about 1000 dollars during the year by selecting the full amount of the FSA contribution for the 2019 year.

Both the HSA and the FSA can be used for a wide range of health care expenses - details in the publication IRS 969.

• What if I do not have health insurance due to my employer?

Federal health insurance markets and state markets created by the Affordable Care Act continue to sell health insurance plans to people without coverage at the workplace. Obamacare exchanges offer 11 insurance (often with subsidies to cover costs) to millions of customers.

The federal HealthCare.gov website reports that open registrations for 2020 should begin on November 1 and will last until December 15. Some states have their own trading floors and extend the deadlines, for example, until January 15.

A spokesman for the Medicare and Medicaid Services Center, who oversees HealthCare.gov, said the Affordable Care Act lawsuit should not have affected open registrations this year. The Affordable Care Act goes through a federal court that cast doubt on Obamacare's long-term fate. But it is unlikely that the lawsuit will affect the policy for next year, says a spokesman for the Kaiser Foundation.

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