With the cost of many Affordable Care Act (ACA) plans projected to jump anywhere from 20% to 200% next year, open enrollment season suddenly feels like a high-stakes sprint.
The good news: You still have levers to pull. Whether you are buying on the exchange or re-upping through your employer, these strategies can help blunt the impact of higher premiums and keep your overall health care spending in check.
1. Consider switching to a bronze plan
Bronze plans sit at the low end of the ACA pricing ladder, and in most states they are calibrated so a typical federal subsidy will cover much of the cost. That alone can shave big dollars off your monthly bill.
Before you jump, weigh what you might give up. Bronze policies cap annual out-of-pocket costs at about $9,200 for an individual and $18,400 for a family, but most skimp on dental and vision coverage. If you schedule regular cleanings or depend on prescription eyewear, the cheaper premium can vanish quickly in real-world expenses.
Still, for healthy households that rarely visit the doctor, the math often works out: You trade richer benefits you rarely use for a far lower fixed cost each month. Just be sure to have a small emergency fund to cover the higher deductible if an accident strikes.
2. Run the numbers on high-deductible health plans
Employers and insurers increasingly steer people toward high-deductible health plans (HDHPs) to tame runaway premiums. In side-by-side comparisons, a bronze HDHP can run roughly 40% less than a gold plan—about $1,700 cheaper a year for single coverage and $4,700 for a family.
That discount isn’t free money. You pay every medical bill until you hit the deductible. If you take daily meds or expect a surgery, do the back-of-the-envelope math on prescriptions, doctor visits and rehab sessions before you commit.
On the other hand, if you mostly need an annual physical and the occasional urgent care visit, the premium savings can dwarf the risk.
3. Max out a health savings account
The hidden superpower of an HDHP is that it generally makes you eligible for a health savings account (HSA). For 2025, you can stash up to $4,300 in an HSA if you are covered by a high-deductible health plan just for yourself, or $8,550 for a family, plus a $1,000 catch-up if you are 55 or older.
Contributions reduce your taxable income, the balance grows tax-deferred, and qualified withdrawals are tax-free—a triple benefit few other accounts offer.
If cash flow allows, pay small medical bills out of pocket and leave the HSA balance invested in a low-cost index fund. Letting that money compound untouched for years can turn the account into a stealth retirement health care fund.
Not all HSA providers allow you to invest your balance, but providers like Lively do.
Already on an HSA-qualified plan? You generally have until April 15 to make a prior-year contribution and still claim the deduction. That last-minute move alone can shave hundreds off your tax bill.
4. Claim the self-employment health insurance deduction
Freelancers and small-business owners often swallow higher premiums without realizing the tax code offers relief. If you have self-employment income, you can deduct 100% of the premiums you pay for medical, dental and even qualified long-term-care policies for yourself and your family.
Because the write-off lives “above the line” on Form 1040, you get the benefit whether or not you itemize deductions. Lowering your adjusted gross income can also unlock other tax perks that phase out at higher income levels—an extra, indirect bonus many filers overlook.
Make sure to keep clear records of every premium payment, especially if you juggle coverage between an ACA plan and a spouse’s employer plan during the year. A quick spreadsheet beats frantically combing through bank statements next April.
5. Total your real annual health care cost
Premiums grab the headlines, but they are only one piece of the bill. Before you lock in a plan, sketch out a realistic forecast of the coming year:
- Expected doctor visits, therapy sessions and routine screenings
- Prescription costs—look up your meds on each plan’s formulary
- Dental check-ups, eyeglasses and contacts if those are not covered
- One wildcard expense: an ER visit
Plug those numbers into each plan’s deductible, co-pay and coinsurance structure. Many shoppers discover that a silver plan with predictable co-pays ends up cheaper overall than a rock-bottom bronze option once real usage is factored in. Others find the reverse is true. Ten quiet minutes with a calculator can keep you from leaving thousands on the table.
6. Look for ways to offset the increased costs
If none of these tips will help, there’s still one more thing to try. Cut expenses in other areas and/or make extra money with a side gig to offset the increased expense.
Here are two quick ideas.
Look for big bills you can reduce by shopping around. For example, when it comes to car insurance, shop quotes from at least five insurers. New insurance shopping tools like this one make comparing rates quick.
You can also see if you can get a better deal on home insurance with this free insurance comparison tool.
And while you’re at it, consider raising deductibles, asking your company about available discounts and bundling policies, which could save on both home and car policies.
Earn a little extra while you’re watching TV. Lots of companies let you earn money for testing apps, playing games and taking surveys. One that’s been popular among our readers is FreeCash, but there are plenty of others out there.
Looking ahead
Sticker shock at open enrollment does not have to wreck your budget. Treat each tactic as a lever: Pull one, two or all of them, depending on your health profile and cash flow. With a little advance work, you can dull the edge of next year’s premium spike and keep your focus—and your dollars—on what matters most.
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