How You Can Save Thousands On Health Insurance & How EZ Can Help

If you feel like healthcare costs are out of control, you’re not alone. It seems like costs are constantly rising, making it hard for many to afford a health insurance plan or their medications. Because of this, many people end up going without health insurance and avoiding doctor visits, which can mean missed diagnoses and delays in treating major health conditions. But health insurance doesn’t have to be unaffordable or unattainable. EZ knows how to save you thousands on health insurance without sacrificing coverage, so you can remain insured and healthy, while saving money at the same time.

man in a suit with bar graph going up with a money sign

Opt For A Higher Deductible Plan

Your first option for saving money? Cut your monthly premium by switching to a high deductible health plan. One of these plans could work for you if you don’t go to the doctor often, or if you don’t need any ongoing treatments, because if this is the case, you probably won’t ever need to meet your deductible. High deductible plans can be risky, though: if something ends up happening to you, you’ll have to pay a lot out-of-pocket to meet your deductible. 

Go With A Lower Drug Formulary Tier

pill bottle sitting on top of a dollar bill with pills on the bill too
Save money on your prescription medication by opting for a different drug tier.

Another way to lower your healthcare costs is by taking a look at your prescription drugs, and at your plan’s drug formulary. If your doctor is prescribing  you a name-brand medication that has a high copay, check to see if there are any less expensive generic drugs available – you could end up saving 30-50%. 

Check your plan’s drug formulary (the list of medications included in your plan, and their costs), as well, and see how your insurance company classifies your medications. Every plan’s formulary has four different pricing tiers, and each insurance company – and every plan! – has a different formulary, so comparing them all can get quite confusing. EZ’s agents are here to help, though – our agent will go over your medical needs, and compare plans and their drug formulary tiers to help you find a plan with affordable drug costs.

Enroll In A Wellness Incentive

If you are enrolled in your employer’s health insurance plan, find out if they offer any wellness programs or incentives. Some companies will offer a lower premium to employees who participate in wellness challenges or other incentivized programs. This could end up saving you a lot of money, or could even get you free coverage!

Use A Health Savings Account (HSA)

If you decide to opt for a high deductible health plan, or if you already have one, then start contributing to a health savings account (HSA). HSAs are only available to those with a qualified high deductible health plan, and they allow you to put money aside tax-free to pay for qualified healthcare expenses. You will accrue tax-free interest, and you will also be able to withdraw money from the account tax-free. Not only are these accounts triple tax-advantaged, but the funds in your account rollover automatically each year and continue to grow until you use them! 

white question mark in a blue circle
Before getting any lab work or tests done, make sure to ask it it is covered!

Make Sure Tests Are Covered

Avoid surprise medical bills – before you agree to any tests ordered by your doctor, make sure that they are covered under your plan. Be aware that, even if your doctor prescribes a test, such as blood work to confirm a diagnosis or rule out health conditions, it may not be covered. If it isn’t, ask your doctor for other options. 

Not knowing what’s covered in your plan can end up costing you thousands of dollars. If you find that you are often being sent for tests that are not covered, consider finding a different plan that offers more coverage. Our agent can compare plans for you and find a plan that offers the coverage you need to get any necessary tests done, so you can avoid surprise bills – and save money.


If you receive a high bill from your doctor’s office or hospital, don’t automatically assume that it is correct – as many as 8 out of 10 times, higher than expected medical bills have some type of error. If a bill seems off to you, then contact your provider and ask them to go over it with you and explain why it is so much. If your high bill is not due to a billing error and you are having trouble paying it, then negotiate with your provider – ask if they can lower the bill, or if they can offer you a monthly payment plan.

african american man with his daughter on his lap checking her temperature while sitting in front of a laptop with a doctor on the screen.
Telehealth can save you hundreds of dollars by avoiding a doctor visit copay or emergency room visit.

Utilize Telemedicine

Going to the ER should be your last resort. When you are not feeling well or need immediate care then you should consider more affordable options like urgent care or telemedicine. Telemedicine is a great option, because it allows you the convenience of speaking to your doctor over the phone and getting prescription medication sent over to your pharmacy. This eliminates having to pay a doctor visit copay, or a huge hospital bill. If your plan doesn’t offer telemedicine, EZ can help you find an affordable plan that does offer this option.

Health insurance is not cheap, but that doesn’t mean that you can’t find an affordable plan. EZ understands the need for affordable health insurance, especially in times of uncertainty. Don’t stick with the plan that you already have if it’s too pricey, or doesn’t offer the coverage you need. One of our agents can find you a more affordable plan with just as much coverage, or more. We can easily compare all available plans in your area within minutes, at no cost to you. Taking advantage of our free services is just another way you can save money with EZ. To get started, enter your zip code in the bar above, or to speak to an agent directly, call 888-350-1890.

Group Health Newbies: Don’t Be Caught Off-Guard When Shopping for Your Business’ Plan

If you’re a newbie shopping for group health insurance for your small business, how are you feeling about the whole process? Confident? Nervous? Confused? We get it, there’s a lot of feelings to feel when it comes to picking a plan. But we’re here to guide you, and steer you past some of the common surprises and pitfalls that may come your way.

You Might Need More Info Than You Thought

caucasian hand holding a pen filling out a survey
Conduct an anonymous employee health survey prior to shopping, so that you know what your employees want in a plan.

We’ll start you off with an easy one. When it comes to getting accurate quotes, you used to be able to simply provide the age ranges of employees. Now you need to have their exact date of birth, as well as the dates of birth of any spouses or dependents they want to cover. Don’t be caught fumbling around for info, make sure you’ve collected all of your data before even looking for a plan. We would suggest conducting an anonymous employee health survey prior to shopping, so that you have all of the facts at your fingertips, as well as a good idea of what your employees are looking for in a plan.

A Provider You Thought Was Covered Isn’t

A lot of people are attached to a certain doctor or healthcare provider. When choosing a plan, you need to pay close attention to the network that is offered, especially since many plans are reducing the size of their networks to cut insurance costs. You could end up with unhappy employees who are unwilling to enroll in your plan if the network is too small or if their doctor isn’t included. And if this is your second time offering insurance, pay extra close attention to any changes made to the network; plans can change from year to year, so the providers that you were sure were covered, may not be. 

Your Employee Isn’t Eligible

time sheet
Employees are usually required to work at least 30 hours to be eligible for certain plans.

This one might really come as a surprise. You’ve decided to offer healthcare to all of your employees, but that doesn’t mean that all of your employees are eligible. The state your business is in, your insurance company’s rules, or even the policy you choose can dictate the number of hours an employee must work to be eligible for your plan. Employees are usually required to work at least 30 hours to be eligible for certain plans; they must also satisfy a waiting period before they are covered. It could be disastrous to extend coverage to an employee who signs up, only to find out later that they were ineligible for the plan. They could end up saddled with a giant medical bill even though they thought that they had insurance.

You Need to Communicate with Your Employees – A LOT

Keeping your employees informed about their health coverage is not a courtesy, it’s an absolute must. You need to provide a Summary of Benefits Coverage (SBC) to participants and beneficiaries prior to enrollment in the plan, at renewal of the plan, within 90 days of a special enrollment period, and within 7 business days of a written request. 

You also need to give each employee covered under the plan a Summary of Material Modification (SMM) when there are changes made to their health benefits. We know, that sounds like a lot of paperwork, but it’s important that you familiarize yourself with all of these notices. Remember, EZ’s agents can help you manage all of the crazy insurance admin that you have to deal with! 

Prescription Drug Pricing Is Complicated!

If your employees are counting on prescription drug coverage in their group health plan, then you’re going to want to take a closer look at how your chosen plan covers medications. All drugs are priced differently, and generics cost less than brand name medications, but what you might not know is that the same drug may be priced differently by different insurance companies. The same drug might even have a different copay on different plans with the same company. Familiarizing yourself with different plans’ drug formularies can help to cut down on prescription price surprises.prescription drug bottles

One more thing that you might not have realized in regards to prescription drug coverage is that some plans now actually have a separate drug deductible. Just as with a general deductible, your employees would have to meet a set amount of drug expenses out-of-pocket before their plan would begin covering the cost of prescription medications. Again, this is where an employee health survey would help to give you an idea of what your employees need, and what you need to avoid when looking at healthcare plans.

A High Deductible Isn’t Always a Bad Thing

Yes, a high deductible can sometimes be a burden to employees, especially those with lower incomes, and you might think that if you’re providing healthcare you should avoid any plans that might pile high out-of-pocket costs onto your employees. But you might be surprised to find that some employees actually prefer these lower premium plans, especially if they rarely use medical services and are just looking for a safety net in case of emergency. This is especially true if you pay a higher percentage of their (low) premiums (meaning you’ll still be saving money), choose a plan that is HSA-eligible, and then contribute to those health savings accounts. HSAs have tax advantages for both you and your employees, and having that money put aside means that employees will be able to cover a surprise medical expense. 

The list of things you need to know about healthcare plans as an employer can seem endless, and it may feel like you are constantly being surprised by some new rule or protocol. But we promise, you’ve got this! And we’re here to support you, simply contact one of EZ’s knowledgeable agents and you’ll have all the answers to your insurance questions at your fingertips. We can also sort through all of the plans on offer and get you instant, accurate quotes so you can find the best plan for your business and your employees – and we’ll do it all for free! No hassle, no obligation, and no surprises! To get started with us, enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Out-of-Pocket Maximum Explained

Medical bills can be a huge source of stress. They can seem like they are never ending, but there is actually a limit on how much you can spend on out-of-pocket healthcare costs. The out-of-pocket maximum, which is the annual limit that you are required to pay for covered health services, is your financial saving grace. Each health insurance plan has different out-of-pocket maximums. Understanding yours will help you get a better handle on how much you will be paying out-of-pocket with your policy. 

What Is an Out-of-Pocket Maximum?caucasian mans hand pointing at the end of a br that says maximum

An out-of-pocket maximum is the amount that you will have to pay for covered health services. Once you reach that amount, your insurance will pay for all covered services. All copayments, deductibles, and coinsurance count towards your out-of-pocket maximum. However, your  monthly premium payments do not go towards your out-of-pocket maximum. 

How It Works

If you need a medical procedure, generally you and your  insurance company will each pay a portion of the cost. You will pay enough to meet your annual deductible, and your insurance company will pay for the rest of the procedure, unless you have to pay coinsurance as part of your policy. If your plan does require you to pay coinsurance then you will also have to pay 20% (usually) of the cost of the procedure, even after meeting your deductible.

After you have met your deductible, you will continue to pay copays and coinsurance until you meet your out-of-pocket maximum. After you meet your maximum, insurance will then pay 100% of any medical costs. You will not have to pay for copays or coinsurance after meeting your maximum. 

calculator on paper with a pen sitting on top of it in the paper.
After you have met your deductible, you will continue to pay copays and coinsurance until you meet your out-of-pocket maximum.

Here’s an example to illustrate how out-of-pocket maximums work. Let’s say Mary has a health insurance plan with a $2,000 deductible, a 20% coinsurance requirement for all care after meeting the deductible, and a $5,000 out-of-pocket maximum. She has to have surgery and the total hospital bill is $20,000. The costs will break down like this:

  • Mary will pay her $2,000 deductible, leaving $18,000 of the bill. 
  • Her coinsurance requirement is 20% of the $18,000, which is $5400. But because Mary’s plan has an out-of-pocket maximum, she and her insurance company will end up each paying part of this cost.
  • Mary has already paid $2,000 to meet her deductible, and her out-of-pocket maximum is $5,000 so instead of owing $5,400 in coinsurance payments, she only owes $3,000 ($2,000 deductible + $3,000 coinsurance = $5,000 maximum out-of-pocket payment). 
  • Her insurance company will now cover the remaining $13,000 of the cost of the procedure.

Do All Plans Have a Maximum?

All plans that meet ACA standards have out-of-pocket maximums. For 2020, that number is $8,2000 for individuals and $16,400 for families. Some plans may have a lower maximum, but none will be higher than those amounts. Plans with higher monthly premiums generally have lower out-of-pocket maximums, while plans with  lower monthly premium plans, like  catastrophic or high-deductible health plans, have higher out-of-pocket maximums. 

In order to find the right plan for your needs and budget, you have to take into account everything that it has to offer, including things like out-of-pocket maximums. Doing all the research alone is time-consuming and can cause confusion and missed opportunities. EZ will make the process quick and painless; we’ll explain everything clearly, give you real-world examples of how the plan would work for you, compare quotes, and calculate costs for you. We will set you up with one agent that will help you find the right plan for your medical and financial needs. To start saving, enter your zip code in the bar above, or to speak to one of our licensed agents, call 888-350-1890.