Your guide to budgeting for healthcare costs

Adults often feel the pressure to act responsibly with everything related to their well-being and their wallets. And nothing says “adulting” quite like budgeting for medical expenses. It’s easy to think that health insurance will cover the majority of medical-related costs and thus can be overlooked in your budget—a copay here, a deductible there… all can be handled without much ado, right?

Not so fast. Medical expenses should be a top budgeting priority, with out-of-pocket costs on the rise and the always-present risk that an unexpected medical expense could put a ding in your spending plans. Consider this: On average, healthcare costs account for about 8 percent of annual household spending, or nearly 7 percent of pretax income, according to the Bureau of Labor Statistics. Even if your health insurance kicks in to cover an expense, your budget for healthcare costs still needs to include your premiums (AKA the amount you pay for your health plan).

How do I budget for healthcare costs, you ask? Fair question. This can sound like a lot. To better plan for healthcare costs, consider these five steps:

1. Determine your total healthcare budget

When budgeting for medical expenses, it may be helpful to bucket your healthcare costs into three categories:

• Fixed Premium: This is the set amount you pay for your health insurance. If you get health insurance through work, this expense may be deducted automatically from your paycheck.
• Routine: These are your anticipated healthcare costs, even if they fluctuate. Think your copay for your annual checkup or the cost of a regular prescription.
• Unexpected: These costs can be difficult to predict, like an unplanned trip to the emergency room or an urgent medical procedure.

When it comes to planning for healthcare costs, your medical and spending history is key. “The best place to start in determining how much to budget for healthcare costs is to look at how much you actually spent on healthcare previously,” suggests CPA and personal finance blogger Logan Allec.

You can start by reviewing all of your receipts from your insurance company and healthcare providers and going through your bank and credit card statements to flag any healthcare costs you paid out of pocket over the past year, Allec says. (If you didn’t save all of last year’s receipts, don’t stress. You can contact your insurance and healthcare providers for documentation.) The final number you come up with is a good start for determining your annual fixed and routine healthcare expenses. (Those unexpected curveballs mentioned earlier? See tip 3.)

When budgeting for healthcare costs, Allec also says to anticipate if you’ll have any extra costs this year that you didn’t encounter last year. For example, are you scheduling a surgical procedure or expecting a child? Make sure you understand how much you will have to pay out of pocket by reviewing exactly what your insurance covers annually, and factor that into your plan for healthcare costs.

2. Put your health at the top of your priority list

Once you’ve estimated your annual healthcare costs, consider how you prioritize them against your other essential expenses, says Todd Christensen, blogger and financial educator.

As a guide, Christensen says that healthcare expenses should fall between necessities like your mortgage or rent, taxes, food, transportation and phone. “If you have a hard time paying for prescriptions but make monthly payments to your cell phone provider, then you have prioritized your personal communications over your health,” he adds.

From budgeting for your insurance premiums to preparing for doctor visits and ordering prescriptions, think of paying for healthcare expenses as a “need” instead of a “want,” Christensen says. By adjusting your mindset to give your health the significance it deserves, budgeting for medical expenses will become second nature.

3. Set up an emergency fund

Remember those unexpected healthcare costs that are tricky to plan for? When creating a budget for healthcare costs, Christensen suggests creating an emergency fund. An emergency fund is an account that is set aside to help cover an unexpected financial or medical emergency, such as a procedure or medication that is not fully covered by your insurance plan.

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Experts typically recommend saving at least three to six months of living expenses in your emergency fund so you can pay for unexpected expenses without having to take on debt or dip into savings earmarked for other financial goals. But, according to Christensen, if you’re starting an emergency fund from scratch, it’s best to start small and focus on a goal that’s attainable for you.

“Initially, the amount is less important than the commitment to just do it,” Christensen says. Managing the account, however, does require some discipline. For example, going on a 10-day wellness retreat, however therapeutic the massage sessions may seem, probably does not qualify as an emergency.

4. Take advantage of health savings accounts

In addition to your emergency fund, there are also special health savings accounts—funded by you or your employer—that can help you cover your health expenses and plan for healthcare costs. Here are three common health savings tools to consider:

• A Health Savings Account (HSA) can be for you if you’re enrolled in a high-deductible health insurance plan (HDHP), which is a plan that offers lower premiums in exchange for a higher deductible. An HSA lets you put money away on a pre-tax basis for eligible healthcare expenses, including certain dental work, eyeglasses and prescriptions. Contributions can come from you, your employer, a relative—anyone who wants to fund the account. Also, the funds roll over from year to year with an HSA, which makes it a great long-term tool for budgeting for medical expenses. Note there is an annual limit for how much you can contribute.
• Whereas an HSA can be funded by you and your employer, a Health Reimbursement Arrangement or a Health Reimbursement Account (HRA), is funded solely by your employer, and funds can be spent on predetermined medical expenses. What’s left over in the account can be rolled over to the next year. If you leave the company, however, you can’t take the funds with you.
• With a Flexible Spending Account (FSA), you can have a certain amount of money taken from your paycheck, pre-taxed, and deposited into an account that’s used for qualified healthcare expenses. Both you and your employer may contribute to this plan, with a maximum contribution allowed by law. Unlike the accounts above, FSAs don’t generally roll over at the end of each year. Check with your employer for your plan’s specifics.

5. Evaluate health insurance choices carefully

To budget for healthcare costs effectively, consumer finance leader Trae Bodge suggests you take the time to evaluate your health insurance options to find the best plan for you and your family. For each plan, you’ll want to carefully consider the type of plan (are your preferred doctors, hospitals and pharmacies covered?), as well as the cost of premiums, deductibles, copays and prescriptions. Your health history may also be an important factor when considering different coverage options.

“If family members go to the doctor frequently or have multiple prescriptions, it may be better for your budget to opt for a more expensive plan, given the coverage provided,” Bodge says.

If you’re an entrepreneur or self-employed, you can shop online for health insurance plans. You should also look at comparable plans directly through insurance providers to better budget for healthcare costs, Bodge says. You might be able to save by choosing a smaller insurance company over a larger one or by signing up directly with the provider, Bodge adds.

Plan for healthcare costs today

When it comes to budgeting for medical expenses, a little planning today can go a long way toward providing for a more financially secure tomorrow. With a healthcare budget firmly in place, you’ll be better empowered to make decisions that are good for your health—and your wallet.

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