Health insurance premiums can be confusing. You might expect them always to be the same, and after hours of comparing insurance providers, it can be frustrating to realize that the cost of coverage has increased when it’s time to renew. Why the sudden change?
Like most types of insurance, health insurance costs are subject to increasing, even when you’ve always paid your bills on time. It’s not anything you did — premiums rise due to the economy, rising medical costs, and other factors.
Overview of Health Insurance Premiums
Your premium is a fixed amount of money you pay to have health insurance. Each month, the premium you pay counts toward your deductible, or the amount of money you have to pay to your insurance provider before they pay for anything.
Some health insurance plans have an annual premium — you pay the total cost upfront at one time. But most operate on a monthly payment plan.
You can expect your premium to be a monthly bill that you’ll pay until you reach our out-of-pocket maximum. This is the total amount of money you have to pay out of your own pocket before the insurance provider pays 100% for covered services.
After you meet your deductible, you’ll pay your premium along with copays or coinsurance. This is a set amount for medical services, like $50 for a doctor’s visit.
You can think of premiums as a monthly fee for having health insurance — and each time you pay it, you are lowering the amount you owe toward your deductible.
Factors That Influence Health Insurance Premiums
The cost of health insurance is always changing, and it’s usually impacted by economic factors. The economy decides how much things cost, and it affects everything from your groceries to your medical expenses. When people say the economy is going up — a process known as inflation — it can cause health insurance prices to rise as well.
Other factors of increasing health insurance premiums include:
Demographic Changes
Depending on the population, health insurance providers will adjust their rates. For example, since younger people tend to have fewer health problems than older adults, they’ll usually have lower premiums.
Older adults, and populations with a large aging population, often have higher healthcare costs to match the medical needs of the people in the area. This is why people often find location plays a role in how much they’re charged for coverage.
You can also find this in group health insurance plans. Companies with more young employees tend to offer plans with lower premiums.
Regulatory Changes
Regulations to federal policies and health insurance laws can influence how much providers charge for coverage. For example, insurance providers can be mandated to pay a specific amount of services, which can make them charge more in premiums.
Rates are continuing to rise on the federal Affordable Care Act exchange, also called the Marketplace. These rates are impacted by a wide range of factors, and the regulations behind them can make them more expensive than some private health insurance options.
For example, ACA plans have higher premiums for young people and are more affordable for those who are older or need additional medical support.
Lifestyle Habits
If you drink, smoke, or are overweight, your health insurance premiums can be higher. This is because insurance providers consider each person’s risks before offering them coverage. People more likely to suffer an illness or disease due to their lifestyle habits (such as diet or tobacco use) are therefore more expensive to insure. So, your premiums may go up if you have a higher risk of health complications.
Regional Considerations: Florida’s Impact on Premiums
Floridians can find themselves paying more for health insurance in some areas. For example, if you do not have a lot of doctors or hospitals nearby, your premiums may be more expensive compared to a city like Miami.
Likewise, in areas that have a lot of people with higher health risks or medical needs, the cost of insurance also goes up, even if you don’t have any underlying conditions.
Because Florida has some unique risks, like climate-related concerns due to sun exposure and hurricanes, the cost of health insurance could increase.
Changes in Personal Circumstances
As we touched upon earlier, your lifestyle can affect how much you’re charged for health insurance premiums. Medical inflation is one reason you may pay more for premiums. Others include:
Individual Health Status
If you are diagnosed with a chronic condition, like diabetes or cancer, then your premiums will likely increase. People who need more healthcare or prescription medications will find their health insurance costs go up compared to their pre-diagnosis price.
Location
If you moved since you bought your health insurance policy, your new zip code could cost you more money. Zip code can affect premiums because the cost of healthcare increases or decreases depending on where you live.
State-specific regulations and local health risks can also increase premiums. Residents who are new to Florida may find that their premium is higher or lower based on where they came from, even if they keep the same provider and don’t make any changes to their plan.
Modifications in Coverage Needs
Similar to your health status, coverage needs can also affect your cost. If you get married or have a baby and want to cover your spouse or child, then you will pay more for health insurance.
If you need access to specialists and want to expand your coverage options, expect your premium to increase to access more services.
The Role of Insurance Providers
Market competition causes insurance providers to compete with one another. This can be good for consumers, but at the same time, it makes it harder for providers to generate a profit. Premiums can go up when providers are paying a lot of money to cover health insurance costs for their customers.
How to Lower Health Insurance Premiums
If you’re worried about the cost of health insurance, there are a few ways to try and lower your monthly costs.
Review Coverage Options
When it’s time to renew, make sure you explore other options. Consider a new plan with your current provider, but don’t rule out other companies, either. You may find that a competitor is able to offer you a better deal, or at least keep your premium the same.
Explore Government Programs and Subsidies
Subsidies are financial aid programs that can help you afford health insurance. If you qualify, then the government will pay a part of your premium for you. You’ll cover the rest. This can lower the overall burden of health insurance and allow you to stay covered, even on a budget.
The Florida Health Insurance Subsidy offers monthly assistance ranging from $45 to $225 per month.
Medicaid is a public health insurance option for people who earn under a certain amount; Medicare is available for adults 65 and older.
Get Personalized Health Insurance Quotes in Florida
Our team of experienced agents can match you with the best health insurance plans based on your needs and budget. We also provide dental, vision, and life insurance options that can connect you with the perfect provider.
