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4 in 10 People With Employer-Provided Health Insurance Still Face Affordability Issues

By Christy Bieber - Feb 12, 2020 at 6:16AM

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Here's what to do if you're one of them.

When politicians talk about healthcare, there's a lot of focus on reducing the uninsured population or making health insurance more affordable to people whose jobs don't provide it. And these are important goals.

But it's not just the uninsured or those buying on the individual market who struggle with their care costs. In fact, a Kaiser study last year found as many as 40% of people with insurance through an employer still face problems affording the cost of their care.  

Affordability problems included difficulties paying medical bills before meeting deductibles, surprise medical costs, expensive prescription drugs, and challenges paying premiums. Co-pays were also a problem.

If you find yourself in a situation where your employer provides coverage but you still can't make the math work when paying for healthcare, there are a few things you can do.

Doctor talking with patient about medical care.

Image source: Getty Images.

Explore all your options for coverage

If you're having trouble covering your deductible, or your prescriptions aren't paid for by your insurance, your current insurance policy may not be a good fit for you. During your next open enrollment period, see if your employer offers other policy options and consider whether different coverage could make sense. If you have a lot of medical needs, paying high premiums for a policy with more coverage and a lower deductible could possibly save you money. 

You could also explore coverage outside of what your employer provides, through your spouse's work, or through an Obamacare exchange. However, if your employer subsidizes your insurance coverage, these other options may cost you much more, so they likely wouldn't be worth it. 

Talk with your benefits administrator about your policy's shortcomings

You may not be the only one at work who finds the insurance coverage insufficient to meet your needs, but your employer may be unaware if no one speaks up.

You can mention to the benefits administrator that you believe your policy could provide better coverage. There's no guarantee this will lead to change, but it's possible your company might be willing to look into offering other policies during the next open enrollment period -- especially if numerous employees indicate the current insurance isn't working well. 

Save for care in a dedicated savings account

With almost any insurance coverage, there are going to be at least some out-of-pocket costs. Rather than waiting until you need care and struggling to come up with the money, save a small amount each month in a dedicated healthcare account.

If your employer offers a flexible spending account (FSA) or if you have a qualifying high-deductible health plan and can contribute to a health savings account (HSA), you can get tax breaks for putting money into these accounts.

Just be aware that while HSA funds accumulate if you don't spend them during the year, money put into an FSA is generally use-it-or-lose-it, so don't invest more than you expect to spend on care. 

See if your doctor has suggestions for saving

Medical care providers can often find ways to help you reduce expenses if you let them know you're having problems covering the bills.

Sometimes, your doctor could recommend a cheaper treatment or could perhaps get you drug samples or coupons. They may also be willing to allow you to sign up for a payment plan with a low interest rate for bigger medical bills you incur. 

Don't let finances derail your health

Whether your health insurance coverage comes from an employer or you purchased it yourself, you aren't alone if you have trouble coming up with the money to pay out-of-pocket costs.

The key is to make sure you have a policy that's a good fit and to save enough so that when you get sick, you can get the help you need. You don't want to be forced to go into debt for medical services, but it's always most important to make sure you're getting the care you need to stay healthy. 

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