What elements most influence the price of health insurance?

As a consumer (or patient), the initial cost for employer-sponsored health insurance is largely driven by overall utilization and the costs of care — the more people that use health services in a pooled group (within the same insurance plan), the higher the overall premiums will be for each individual. Most health coverage in the U.S. today comes through employers, and if you can do that, take advantage of it because, typically, the rates are lower, and pre-existing conditions have fewer restrictions. However, for those consumers who opt for private health insurance (outside of their employers) because of a lack of availability, the initial cost will reflect their specific risks and health behaviors. Smoking status, prior health conditions, age and other factors all weigh into the costs you incur.

Overall, remember that insurance companies are about pooling (or sharing costs) among a fairly large group of people. Once you have a plan, the costs you pay are comprised of three main parts:

- Premiums (monthly fees).
- Co-pays (at the time of a provider visit).
- Deductibles (the amount of money you have to pay first before full reimbursement kicks in).

If you are looking to cut insurance costs, be sure to focus on the big picture by adding up the total of all three types of costs. Once you do that, most importantly, compare the kinds of coverage that your insurer will or will not cover. Many less-expensive plans restrict the use of specialized services, require primary care referrals or pay only a partial amount of the total bill.