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  • Northeast Wisconsin
  • August 2018
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Consumers changing health insurance

Three words are changing health care and insurance more than anything else: consumer, cost and choice.

Consumers are becoming proactive due to higher costs, and demanding more choices to improve their health and lower costs.

More than ever before, consumers are asking the following questions:

  • What is my cost?
  • What is my benefit?
  • What is my risk?

The patient is no longer passively receiving care, but rather actively choosing their care as a consumer based on cost, benefits and risks. Today, the consumer faced with paying thousands before insurance pays, wants to know about cost and better choices to lower cost. In 2018, the annual maximum out-of-pocket limit that consumers pay may be up to $7,350 per person.

For example, if a prescription medicine costs $300 per month, has only a small health benefit and a high risk of side effects, the consumer with a high deductible plan is going to ask questions and think twice about what is best for them.

The same is true for lab tests, scans and other medical treatments; consumers are asking for more information to make better decisions based on cost, benefit and risk. In the past, doctors could say, “Don’t worry about cost, because your insurance will pay the bill.”

Consumers are also noticing that monthly insurance premiums can cost more to lower the deductible amounts. Paying $400 more per month to move from a $5,000 to a $1,000 deductible does not make sense as the additional premium costs $4,800 for a $4,000 lower deductible.

Consumers paying higher costs will also demand greater choice beyond medical care covered by insurance.

Consumers have more choices for self-care to find what works best for them at the best cost by asking the following questions:

  • What are my options for nutrition?
  • What are my options for fitness?
  • What are my options for stress-relief?

The emerging consumer-centered choices based on costs, benefits and risks present both challenges and opportunities for everyone. Consumer, cost and choice are three words that will change health care and insurance to be centered on the consumer for better health at lower cost.

John Ulness

John Ulness is co-owner of Ulness Health Insurance & Wellness in Appleton. He helps people in Wisconsin understand their health insurance options to control costs and enroll. He can be reached at 1-800-386-0876 or [email protected]

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