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Health Care Reform:

Health Insurance & Affordable Care Act

How to Estimate What You'll Spend on Health Care

How to Estimate Your Costs

How often might you see a doctor or need medicine? An educated guess can help you predict these needs -- and what you'll pay for them. Here are some steps to take to help you figure out how much care you might need going forward.

Look back on past expenses. If you keep medical receipts, go through them. Add up your costs for doctor's visits and medicines. Or ask your doctor for a history of your payments over the last year. Your drug store may have a record of your payments for medicine, too.

Use an online calculator. Some web sites -- such as the Health Partners Cost of Care Calculator – and some web sites that sell insurance -- can show you estimated insurance costs. If you have employer insurance, your company may offer a tool to estimate costs.

Anticipate your family's health needs. Add in yearly checkups for children (which are free), immunizations, and chronic conditions like high cholesterol that need regular blood tests, appointments, or medicine. 

Other expenses might include counseling for mental health and planned surgeries or medical procedures that your insurance might not fully cover.


Ways You May Pay Less Under Health Care Reform

Changes now in place as a result of health care reform may lower your costs.

Out-of-pocket caps, also called an annual limit. If you're buying a plan from your state's Marketplace (also called an Exchange), health care reform puts a limit on your out-of-pocket costs. For 2016, the most you will pay out-of-pocket for services your health plan covers is $6,850. A family will have to pay double that -- $13,700.  Your deductible may count toward this cap. So can co-pays and co-insurance. Those numbers may look very high. But they at least put an upper limit on what you'd have to spend.

Free preventive care. With new policies that comply with health reform, you'll have no copayment, co-insurance, or requirement to meet your plan’s deductible for new baby care, well-child visits, screenings for early signs of disease, like mammograms, and many other services when you receive care from a provider that participates with your health plan.


WebMD Medical Reference

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