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10 Ways Employees Can Beat Rising Healthcare Costs

By Ashley Ebeling
From Forbes on Tuesday, November 8, 2016
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Health insurance premium increases at large U.S. employers are running 5% for 2017, according to the National Business Group on Health.

If you’re married, look at both spouses’ plan offerings. You’re comparing your full out-of-pocket costs, taking into account premiums, deductibles, and co-insurance. One thing to look for is whether there is a surcharge to cover your spouse if he or she has access to coverage to their own employer (a third of plans in the NGBH). Another is wage-based cost-sharing—some employers kick in more for lower-paid employees, so it might be a lot cheaper to go with a lower-paid than higher-paid spouse’s plan. Some employers extend this wage-based assistance to premium contributions, health account contributions and out-of-pocket maximums, even deductibles.

Compare Rx benefits. Putting limits on pharmacy benefits, in particular specialty pharmacy benefits, is one of the top tactics employers are using to counter rising healthcare costs. For example, you might have to pay the difference between a brand name drug and the generic, or certain brand name drugs might be excluded altogether. So If you have specific prescription needs, make sure you compare Rx benefits on an annual basis, warns Steve Wojcik, vice president of public policy with NBGH. With a high-deductible plan, you typically pay the full price of prescriptions until you meet your deductible, so take that into consideration when choosing tiers and plans.

Use online tools and coaching. Most employers are using online tools like the cartoonish ALEX health coach that guides employees through open enrollment. It’s a bit like Turbo Tax for open enrollment. More plans are online (no more Explanation of Benefits stacking up in file folders), with automatic links to healthcare accounts like HSAs and FSAs. And more plans are offering dial-in nurse coaches. “When you need care, they can help you navigate to lower costs quality providers,” says Wojcik. Call in; know your options.

Go to a center of excellence. Treatment at these vetted hospitals typically costs less (and is of better quality) than you can get elsewhere. The use of these centers is growing, not just for transplants, but things like bariatric surgery and fertility. In the next few years, Wojcik says, they will be commonplace for more treatments like knee, hip and spine surgery, cardiac care and cancer care.

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