Rising healthcare costs are a growing concern for many, especially in the Asia Pacific region, where medical inflation has averaged a significant 15% in 2024. This increase is driven by higher hospitalization costs, increased usage of specific services, and a rise in outpatient visits. For instance, the average number of outpatient visits per member has risen from 7.6 visits per year (2018-2022) to 8.7 visits per year in 2024. Additionally, the costs of physiotherapy, traditional Chinese medicine (TCM), and dental benefits have also seen a sharp increase. These factors have led to substantial premium adjustments for health insurance policies. However, there are several strategies you can adopt to manage these increases while maintaining comprehensive coverage.

Understanding the Factors Behind Premium Adjustments

To effectively manage premium increases, it’s crucial to understand the key factors influencing them. Higher hospitalization costs, driven by rising case severity and professional fees that often exceed 20%, are a significant contributor. Outpatient costs have also increased by 10%, primarily due to higher average costs per visit and more frequent visits. For example, the average cost of an MRI or a blood test has risen, and the frequency of these tests has increased as well. Additionally, the usage of physiotherapy and TCM has surged, particularly due to a rise in musculoskeletal claims. Dental benefits consumption remains particularly high, further contributing to the overall increase in healthcare costs.

Strategies to Manage Premium Increases

1. Deductible Options

One effective way to reduce premiums is by adjusting your deductible. A deductible is the amount you pay out-of-pocket before your insurance coverage kicks in. By choosing a higher deductible, you can lower your premium. For instance, a deductible increase can result in a 20% to 45% reduction in premiums, depending on the deductible level. This can be a significant saving, especially if you are generally healthy and do not anticipate frequent medical visits.

2. Co-insurance Option

Co-insurance is the percentage of the medical costs you pay after your deductible has been met. By opting for a co-insurance plan, you can further reduce your premiums. For example, a co-insurance option can lead to a reduction of up to 16% in premiums, depending on the outpatient level. This can be a practical choice if you are willing to share a portion of the costs with your insurer.

3. Specified Inpatient Providers (SIP) Network Option

Choosing a Specified Inpatient Providers (SIP) network can also help lower your premiums. SIP networks offer a list of selected hospitals for inpatient treatments, and using these providers can result in a 15% reduction in premiums compared to the standard network. This option is particularly beneficial if you are comfortable with a more limited choice of hospitals.

4. Downgrade Plan Levels

If you are open to reducing the level of coverage, downgrading your plan can lead to a significant reduction in premiums. Depending on the outpatient level, this can result in a reduction of up to 33%. However, it’s important to carefully consider the trade-offs and ensure that the reduced coverage still meets your healthcare needs.

5. Double Occupancy Room Option

In Hong Kong, opting for a double occupancy room instead of a single occupancy room can result in a 15% reduction in premiums. This is a practical choice if you are comfortable sharing a room during hospital stays.

Additional Steps to Minimize Medical Inflation

Use Free Telehealth Services

For minor health concerns, consider using complimentary telehealth services provided through partners like Teladoc Health. These services are available 24/7 and offer a convenient and cost-effective alternative to in-person visits. For example, if you have a minor cold or need a consultation for a minor injury, a telehealth visit can save you both time and money.

Discuss Prescribed Tests with Your Doctor

If a medical test, such as an MRI or blood test, is recommended, discuss its necessity and expected outcomes with your doctor. This can help avoid unnecessary procedures and reduce your overall healthcare costs. For instance, if a test is not essential for your diagnosis, you can save on the cost of the procedure.

Ask Critical Questions for Planned Hospital Stays

For planned hospital stays, ask your doctor critical questions about the recovery process, potential complications, long-term consequences, and the experience of the medical team. This can help you make informed decisions and ensure that the treatment is necessary and appropriate. For example, if you are scheduled for a surgery, understanding the risks and alternatives can help you decide if the procedure is the best option for you.

Review Hospital Bills Carefully

Carefully review your hospital bills to identify any unexpected charges. This can help you avoid paying for services you did not receive or were not necessary. For instance, if you notice a charge for a test you did not undergo, you can dispute the charge and potentially save money.

Challenge Over-Prescription

Be mindful of over-prescriptions of medicine, as they contribute to medical inflation and offer little to no health benefits. If you are prescribed multiple medications, discuss with your doctor whether all of them are necessary. For example, if you are prescribed a new medication for a condition you already manage with existing treatments, ask your doctor if the new medication is essential.

Seek Pre-Authorisation

Pre-authorisation is mandatory for planned hospitalisations. This ensures that the treatment is medically necessary, adequate, and cost-efficient. Our medical team is ready to support you in achieving the best outcomes. For example, if you are planning a surgery, pre-authorisation can help ensure that the procedure is covered by your insurance and that the costs are reasonable.

Seek a Second Medical Opinion

Ensure that the prescribed treatment is medically necessary and appropriate for your condition. Consider using complimentary Second Medical Opinion services through Teladoc Health to access experts in various fields worldwide. For example, if you are unsure about a recommended treatment, a second opinion can provide additional insights and help you make a more informed decision.

Conclusion

Rising healthcare costs and premium adjustments can be challenging, but by adopting these strategies, you can effectively manage your healthcare expenses while maintaining comprehensive coverage. Whether it’s adjusting your deductible, using telehealth services, or seeking a second medical opinion, there are several steps you can take to minimize medical inflation and ensure that your health insurance remains a valuable and affordable resource.