Understanding why insurance premiums rise

While it is common for the amount you pay to go up or down each year, it is not always clear why those changes happen. While the general way premiums are figured is mostly based on how much medical services cost and how many were used by our members – there are many other things that can impact what you will pay for insurance, including:

Prescription drug costs

Premium dollars help cover the medications our members use, and keep them affordable. However, from 2007 to 2017, the amount of money we paid to cover prescription drug costs nearly doubled. This increase in costs has a direct impact on members’ premiums.

Healthcare advancements and increasing patient demand for services

New, state-of-the-art equipment and testing offer tremendous benefits to our members, from catching health issues quicker to making care and treatment easier on the patient. While advances in healthcare technology help to keep Kansans healthy, they also often cost more, at least in the near-term. Because these advancements are so successful, many Kansans choose this type of care, which in-turn can increase premium costs for members.

We also continue to see the demand growing for more and varied services by our members. Sometimes these services are over utilized and ultimately drive costs without improving accuracy of diagnosis, treatment recommendations or overall quality.

Government rules changes

Local, state and federal rules and laws also affect the cost of your insurance plan. For instance, at the federal level, lawmakers are continually looking at drug pricing and individual insurance plans; both of these could lead to major changes in premium costs.

Aging population

As the average age of people with health insurance rises, so do their healthcare costs. As people age, they often have more health care needs which are often more expensive; however, increasing drug costs and advances in medical technology lead to even higher price tags for patients.

Lifestyle choices

Tobacco use, poor diet and physical inactivity can lead to serious, long-term health issues. Lifestyle choices can often lead to heart disease, type 2 diabetes, lung disease and some cancers, which make up about 86% of healthcare costs.

Cost shifting

To help offset the cost of treating underinsured and uninsured patients, hospitals and health systems often “shift” the cost to insured patients.

Blue Cross and Blue Shield of Kansas efforts to minimize healthcare costs

While we cannot completely stop medical and prescription drug costs from increasing, we make every effort to keep insurance affordable for our members. We look at data to better understand what is driving Kansans’ health care costs and where to focus our efforts to improve your health and control costs for members. We also remain committed to offering programs to help manage health conditions, as well as wellness programs that reward you for healthy lifestyle choices.

Finding and selecting a high-quality individual health insurance plan takes time and consideration. Learn more about our individual and family health insurance plans on our website, or call us directly for help at 800-438-1565.

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