What to Do If Your Health Insurance Is Too High

3/8/2013, 9:42 a.m.

Not long ago, a man complained to the D.C. Department of Insurance, Securities and Banking that his insurance company had bumped the premium for his small-group policy by a third. It could have been worse; the insurer had actually wanted to raise prices by more than half, an increase the department denied.

Another person who buys his own health insurance was told his monthly premium would jump from around $200 a month to more than $250, or by almost a third. The department is questioning that insurer about this sizable bump.

Increases in health insurance rates actually slowed nationally last year, according to the Kaiser Family Foundation, to about 4 percent growth, not because insurance companies charged less or the cost of care slowed but because people went to the doctor less in a weak economy.

And still, premiums for a family hit almost $16,000, the foundation said.

"We're seeing people make more consumer-oriented decisions, going for less expensive treatments or deferring surgery," said Julie Stone, senior consultant at Towers Watson, an employer benefit-consulting firm.

As rates rise, District residents complain more to the Department of Insurance, Securities and Banking, which regulates insurers in the District.

The department is limited in how much it can hold down insurance premiums because the main driver of increases is the increased cost of health care. There are, however, a few things you can do to hold your insurance costs down.

First, it pays to be healthy - no smoking, no obesity, no heart disease, no diabetes. If you have been healthy all of your life, your premium will be lower than someone with health issues.

Some of us have congenital conditions we can't do anything to prevent - and all of us, of course, are simply getting older. Republicans and Democrats argue about whether the new Affordable Care Act - the president's health-care reform law - will save people money. But several new rules look promising: One requires that your insurance company has to spend at least 80 percent of your premium on medical costs and not keep it as profit or spend it on advertising or the like, another is that many preventive services are required to be provided without co-pays or deductibles, so it costs you nothing to do what you need to do to keep from becoming ill.

Health-care exchanges such as the one the District is creating are also part of health-care reform and are designed to hold down insurance costs for people who buy their own insurance or for small companies by creating a transparent market where prices and services are easy to compare rather than a murky market dominated by only a few large insurers. These exchanges open at the beginning of next year.

Other groups are pushing to improve the quality of American medical care, which lags many other nations, as a way of cutting health-care costs and hence holding down the dramatic growth in insurance premiums. If the hospital cures you the first time, in other words, you don't have to go back and wrack up even more costs.