NEW YORK (MainStreet) -- For self-insured health care consumers, it's been a rough several years since the Affordable Care Act rolled into reality.
In one sense, self-employed health care plan participants have acted as guinea pigs, as they were on the front line of the Obamacare's rocky rollout. High premiums and deductibles, balky online sign-up experiences and a rash of insurers whose quick entrance and exit from the market forced self-insured consumers to look for new plans every year, all rankled the self-ensured.
According to eHealth.com, more than 60% of self-insured health care customers say they "would have difficulty paying their deductible in the event of a medical emergency."
Another study -- by ConnectedHealth, an online benefits technology firm -- states that although consumers do their best to select a plan that's cost efficient, "a large price tag is also Americans' biggest health care complaint." After purchasing their own health insurance, 44% experienced out-of-pocket costs that were higher than expected, including 51% of parents, the report notes.
According to ConnectedHealth, $334 is the "average amount of money Americans allocate each month to pay premium, co-pays, prescriptions and other out-of-pocket health costs."
Rochelle Odesser, a vice president and financial planner at Madison Planning Group in West Harrison, N.Y., is both a self-insured health care consumer and someone who advises firm clients on selecting the best health insurance plan. "I am concerned about costs, premiums, doctors and hospitals available in the plan that I choose as well as my own health and what concerns I have," Odesser says. "As an older adult, not yet eligible for Medicare, I'm concerned about what exams and tests are covered, and hidden costs in lab fees or fees for other tests that were not anticipated. These extra fees are a big concern for me, as I've run into unanticipated fees for labs that were part of my annual check-up and follow up tests that were prescribed by my doctor, but not covered."
For self-insured consumers looking for a better health care plan experience, the options may be limited, but there are options on the table. "In health insurance there really isn't any 'deal cutting,'" says Gavin Prout, a vice president at Toronto-based Special Benefits Insurance Services. "Just know that its premiums that really drive up health care costs."
Keeping an eye on premiums linked to health care plans when you're choosing one is "step one" in any health care insurance due diligence campaign, Prout says.
Putting a lid on prescription drug costs can also cut health care costs for self-insured consumers. "We see 21% of Americans paying 5% of their income on out-of-pocket health care costs," says Doug Hirsch, CEO at GoodRx, a Santa Monica, Calif.-based prescription drug services provider.
Plus, with more and more pharmacy benefit managers cutting previously covered drugs, the amount Americans spend on medication and out-of-pocket costs could increase.
"Most Americans don't realize that prescription prices vary greatly from pharmacy to pharmacy, even within the same neighborhood," says Hirsch. With a company like GoodRx, users enter their prescription and zip code and within seconds are provided with the local pharmacy with lowest price available.
"For example, 30 20mg tablets of generic Lipitor can range from around $10 at Walmart to $76 at Rite-Aid," Hirsch adds.
The self-insured demographic can also go the local route, and should spend some serious time reviewing ACA rules changes next year.
"Look at your state's health exchange for plans that meet your needs and review the prices in contrast to similar plans in the traditional health insurance market for comparison shopping," says Hector De La Torre, executive director of the TransAmerica Center for Health Studies. "Keep in mind that you must purchase insurance through an exchange in order to receive subsidies, if you're eligible."
De La Torre also advises health care consumers to research potential increased costs for your current health coverage, and not just the premium. "You may need to shop for a better overall deal while considering your deductible; co-insurance, the portion you pay after the deductible is covered; and out-of-pocket maximum, the maximum amount you pay each year before insurance kicks in and covers everything afterward," he says.
Even though many self-insured health care consumers feel they've gotten a raw deal, that's no reason to sit on the sidelines for the next sign-up period beginning November 1, 2015. Get cracking, and cover all cost-cutting bases on your health care plan -- you'll feel better in the morning for taking direct action to save on health insurance costs.