{"id":3514,"date":"2026-05-25T22:32:15","date_gmt":"2026-05-25T22:32:15","guid":{"rendered":"https:\/\/sandiegorelocationnews.com\/index.php\/2026\/05\/25\/why-having-health-insurance-no-longer-guarantees-financial-protection\/"},"modified":"2026-05-25T22:32:15","modified_gmt":"2026-05-25T22:32:15","slug":"why-having-health-insurance-no-longer-guarantees-financial-protection","status":"publish","type":"post","link":"https:\/\/sandiegorelocationnews.com\/index.php\/2026\/05\/25\/why-having-health-insurance-no-longer-guarantees-financial-protection\/","title":{"rendered":"Why having health insurance no longer guarantees financial protection"},"content":{"rendered":"<article><!-- --><!-- --><!-- WPS-5038 -- removed the script from WPS and added the placeholder for trinity player --><!-- --><!-- --><!-- --><!-- --><!-- --><!-- --><!-- --><!-- CONTENT --><!--[--><!--[--><\/p>\n<p>Time was when having health insurance and being financially protected from healthcare costs were the same thing.<\/p>\n<p>Read more <a href=\"https:\/\/sandiegorelocationnews.com\/index.php\/2026\/05\/25\/community-gathers-to-remember-george-floyd-6-years-after-death\/\">Community gathers to remember George Floyd 6 years after death<\/a><\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>That&#8217;s no longer the case according to a new report, the Employee Benefit Research Institute (EBRI)\/Greenwald Research Consumer Engagement in Health Care Survey.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>The survey found that employer-sponsored coverage still dominates, with roughly six in 10 insured individuals receiving coverage through their own employer. But the more significant shift may be this: deductibles have become nearly unavoidable, even in plans that historically shielded workers from major upfront costs.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>In effect, many Americans still have insurance, but they are increasingly responsible for absorbing thousands of dollars in healthcare costs before coverage meaningfully begins.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Among the findings:<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<ul>\n<li>More than three-quarters of insured workers now have a deductible.\n<p>Even among traditional plan enrollees, 70% now face deductibles.<\/p>\n<p>The share of traditional-plan participants with deductibles rose from 65% to 70% in just one year.<\/li>\n<\/ul>\n<p><!--]--><!--[--><\/p>\n<p>The shift is forcing workers to think less like passive insurance buyers and more like financial risk managers.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Here&#8217;s what experts say workers should consider.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<h2>Don&#8217;t evaluate plans based solely on premiums<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Monthly premiums remain the number many workers focus on during open enrollment. Financial planners say that&#8217;s often a mistake.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Robert Biesiada, certified financial planner with Revolve Wealth Partners, said medical utilization should usually drive the analysis.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;If you are an individual that is primarily only seeing medical professionals for preventive care and minor illnesses, a high deductible health plan may make a lot of sense,&#8221; Biesiada said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>He said many high-deductible health plans carry lower premiums than traditional copay plans, and the gap can widen further when employer HSA contributions and tax savings are factored in.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;The lower premiums and potential access to a health savings account may significantly offset the higher deductibles,&#8221; he said.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Even households with higher medical costs may benefit in some cases &#8220;if the premiums and HSA savings offset the deductibles enough,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Michael Angell, associate professor at the College for Financial Planning \u2013 a Kaplan Company, said age and family size should also shape plan selection.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Age is a major factor,&#8221; Angell said. &#8220;A typical 20-year-old generally has different health care needs than a typical 50-year-old.&#8221;<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Younger workers may be able to tolerate higher deductibles and lower premiums. That equation changes as healthcare utilization rises later in life.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Family structure matters too.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Statistically, a family of five is more likely to incur medical expenses than a single individual,&#8221; Angell said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>He also said some couples unnecessarily duplicate coverage by both enrolling in employer-sponsored plans.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;This can be an unnecessary expense, as one policy is often sufficient to cover the family&#8217;s needs,&#8221; Angell said.<\/p>\n<p><!-- --><!--]--><!--[--><!-- --><!--]--><!--[--><\/p>\n<h2>Deductibles aren&#8217;t the only number that matters<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Experts say workers should evaluate deductibles, out-of-pocket maximums, provider networks, prescription drug costs and employer HSA contributions together, not separately.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Expected healthcare usage is often the best starting point.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;They should all be reviewed in conjunction with your personal situation,&#8221; Biesiada said. &#8220;Expected utilization is likely the best starting point.&#8221;<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Workers also need to assess whether they could realistically absorb a large medical bill if the worst happens.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;A positive cash flow or ample rainy\/sick day fund could allow a buffer for higher than expected medical care,&#8221; Biesiada said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>For some households, predictability matters more than minimizing premiums.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Some folks are choosing to pay higher pretax premiums for copay-type plans for the predictable copays,&#8221; he said.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Angell said one of the biggest mistakes consumers make is choosing the lowest-premium option without preparing for the deductible exposure that comes with it.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;A common mistake consumers make is choosing the lowest-premium health plan and simply hoping for the best,&#8221; Angell said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>That can become financially dangerous when a major illness or hospitalization occurs.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;When a serious medical event occurs, they are unable to pay those out-of-pocket costs and often turn to high-interest credit cards,&#8221; Angell said. &#8220;This can begin a downward spiral of unmanageable debt.&#8221;<\/p>\n<p>Read more <a href=\"https:\/\/sandiegorelocationnews.com\/index.php\/2026\/05\/25\/canada-demands-israel-probe-appalling-treatment-of-flotilla-members\/\">Canada demands Israel probe \u2018appalling\u2019 treatment of flotilla members<\/a><\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<h2>Stress-test the worst-case year<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>The experts said workers should stop assuming healthcare costs will remain stable from year to year.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Instead, households should model what a bad healthcare year would actually look like financially.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Biesiada said workers should begin with their own medical history and anticipated care needs.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Workers should take their personal healthcare history and upcoming care as the guideline as to which plan option may be suitable,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>He also noted that workers can typically reevaluate coverage annually during open enrollment if their needs change.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Angell offered a simple benchmark for financial preparedness.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Here is a simple test: if you do not have enough money in your HSA to cover your full deductible, your HSA is underfunded,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Without that reserve, workers may be forced to tap retirement accounts or accumulate high-interest debt during a medical emergency.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;Without a fully funded HSA, you will most likely be forced to rely on savings, credit cards, or retirement accounts during a medical emergency,&#8221; Angell said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>He noted that while some 401(k) withdrawals for medical expenses may avoid early-withdrawal penalties, they generally remain taxable as ordinary income.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<h2>Rising deductibles are changing consumer behavior<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Higher deductibles are also changing how workers use healthcare.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;Folks are more aware of potential higher costs and changing their behaviors on how they access care,&#8221; Biesiada said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Telehealth usage has increased partly because of lower costs, he said, and workers are paying closer attention to provider networks.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;People are also being very mindful of staying in-network to keep their costs lower,&#8221; he said.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Angell said advisers are seeing some workers delay or avoid care because they fear the financial consequences of using their insurance.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Yes, advisers do see this happen,&#8221; Angell said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>He said middle-class households often face the greatest pressure because they may not qualify for public assistance yet still lack sufficient reserves to comfortably absorb large deductibles.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Many middle-class households &#8230; are caught in a difficult position: too affluent to qualify for assistance, yet without enough financial reserves to comfortably absorb significant out-of-pocket medical costs,&#8221; Angell said.<\/p>\n<p><!--]--><!--[--><\/p>\n<h2>Open enrollment mistakes can become expensive<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Workers also make avoidable mistakes during open enrollment.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>One common error, Biesiada said, is assuming the most expensive plan automatically provides the best protection.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Depending on their needs, they may be paying very high costs for benefits they are not utilizing,&#8221; he said.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Families may also overlook more cost-effective ways to split coverage between spouses.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;It may make sense for one employee to stay on a plan by themselves while the other covers the dependents,&#8221; Biesiada said. &#8220;A family plan may not be the most cost effective.&#8221;<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Angell said another overlooked gap is disability insurance.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;One common mistake workers make during open enrollment is failing to also enroll in disability insurance coverage,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Health insurance may pay medical bills, he noted, but it does not replace lost income if an illness or injury prevents someone from working.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<h2>The broader financial lesson<\/h2>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>The experts said rising deductibles strengthen the case for larger emergency reserves, more disciplined HSA funding and more conservative assumptions about healthcare costs before Medicare eligibility.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>Biesiada said healthcare costs continue rising across the board.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>&#8220;Premiums, deductibles, and maximum out-of-pocket limits have steadily gone up,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Angell said HSAs remain one of the most tax-efficient savings tools available.<\/p>\n<p><!--]--><!--[--><\/p>\n<p>&#8220;Perhaps the best-kept secret about HSAs is that balances can be carried into retirement and used to help cover Medicare out-of-pocket expenses,&#8221; he said.<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<p>Among the recurring recommendations from advisers:<\/p>\n<p><!-- --><!--]--><!--[--><\/p>\n<ul>\n<li>Fully fund an HSA whenever possible<\/li>\n<li>Maintain at least three to six months of emergency savings<\/li>\n<li>Compare total potential annual healthcare costs, not just premiums<\/li>\n<li>Reevaluate expected healthcare utilization annually<\/li>\n<li>Consider disability insurance during open enrollment<\/li>\n<li>Pay close attention to provider networks and out-of-pocket maximums<\/li>\n<\/ul>\n<p><!-- --><!--]--><!--[--><\/p>\n<p><i>The Arena Media Brands, LLC THESTREET is a registered trademark of TheStreet, Inc.<\/i><\/p>\n<p>Read more <a href=\"https:\/\/sandiegorelocationnews.com\/index.php\/2026\/05\/25\/toyota-has-a-secret-to-make-lexus-cars-more-fun-and-better-to-drive\/\">Toyota Has A Secret To Make Lexus Cars More Fun And Better To Drive<\/a><\/p>\n<p><!--]--><!--]--><!-- --><\/p>\n<p>This story was originally published <span>May 25, 2026 at 2:37 PM<span>.<\/span><\/span><!-- --><\/p>\n<p><!-- --><!-- --><!-- --><\/article>\n","protected":false},"excerpt":{"rendered":"<p>Time was when having health insurance and being financially protected from healthcare costs were the same 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