Last year, consumers felt the pinch as premiums and co-pays on their Florida health insurance rose.  Some Florida health insurance plans were up by 3.5 percent last year, which was the lowest amount of increase for more than a decade.  Even with rate increases slowing, some HMOs in Florida saw profits at near record levels.  While not all HMOs made a profit, some saw a 16-percent increase.

For some HMOs, last year brought the second consecutive year of double-digit income growth.  Despite the recession, that industry came close to its 2004 record for total income of approximately $710 million. 

Half a dozen HMOs in fact lost income last year.  The biggest loser, with a $38 million loss, was the Sunshine State Health Plan that backs Florida’s Medicaid program.  Actually, 70 percent of Health Maintenance Organization profit resulted from Medicare.  Federal health care reform is expected to lower payments to the Medicare HMOs in the near future.

Many of us feel helpless when faced with “big business,” but maybe we can follow the trend that employers are adopting to help cope with rising FL health insurance expenses.  The number of HMO customers has been declining because employers are moving away from HMOs to other types of health plans that save them money.

Are Some Florida Health Insurance Plans More Competitively Priced Than HMOs?

Health insurance for Florida can be complicated for the novice.  HMOs or Health Maintenance Organizations are a type of managed care that only covers care by providers who agree to treat patients in accordance to the HMO’s guidelines and restrictions.  They are then rewarded with a regular stream of consumers.  Typically, HMO plans pay nothing for any fees from out-of-network providers.   HMOs are not the only type of managed care, though.

Florida health insurance also offers Preferred Provider Organizations or PPOs.  That’s another kind of managed care where health care providers have agreed to provide medical care at decreased rates to an insurance company’s policyholders.  PPOs usually have some coverage for members who select providers from outside the network, but the substantial discounts on health care are to be found with in-network providers.

Both HMO and PPO plans have a range of deductibles.  Until health care reform, studies indicated that people were foregoing necessary care that could have prevented deterioration in their health, such as yearly exams and screening procedures for cancer, diabetes and heart disease.  

While older Florida health insurance policies aren’t required to comply with the new reform standards, policies obtained after health care reform cover many kinds of preventive care at no cost to policyholders.  That makes it practical to switch to a plan with a higher deductible in exchange for lower premiums.

How Do Florida Health Insurance Deductibles Affect Premiums?

Typically, premiums decrease as the deductible increases.  That just makes sense because the insurer is counting on the policyholder to pay for a pre-determined amount of his own medical care.  In Florida, health insurance plans add tax advantages on top of premium savings with certain policies that are qualified to be combined with what are known as HSA.

Not all high-deductible plans work like this, but specific plans with deductibles from $1,200 to $5,950 for individual coverage or from $2,400 to $11,900 for family coverage let you begin a Health Savings Account (HSA) that earns tax-free interest.  

You can take money out to cover braces or other dental services, physical therapy, alternative medicine like homeopathy, or an assortment of health-related expenses that are qualified for HSA withdrawals.

Within government limits, you can deduct whatever you put into your HSA from your federal and most state taxes, too.  Individuals may deduct up to $3,050 and families may deduct up to $6,150 of HSA deposits made by April 15 as an “above the line” tax deduction on the previous year’s income taxes.  You don’t even need to itemize to take the deduction.  If you have other expenses in a specific year, you’re never required to contribute anything to yourHealth Savings Account.

When you know which kinds of plans, like PPOs, provide the affordable health care fees and how to get low premiums in exchange for high deductibles, you can fight the high price of health insurance for Florida.