Why Healthcare Belongs in Every Financial Plan

One of the biggest blind spots in many household financial plans is not what people spend. It is what they leave out, such as healthcare.

Many families already have some form of financial plan, even if they would not describe it that way. They budget for housing, groceries and childcare. They save for retirement and set aside money for emergencies. Yet healthcare often enters the financial conversation only when something happens: a diagnosis, a new prescription or an unexpected trip to the emergency room.

That reactive approach is understandable. It is also worth changing.

As a chief financial officer, I am trained to look beyond today’s expenses and consider how decisions made now affect long-term financial well-being. The strongest financial plans prepare for what is likely while preserving flexibility for what is not. Healthcare must be part of that process.

Over a lifetime, healthcare can be one of the largest expenses a family faces, yet it is often among the least planned for. The scale helps explain why. U.S. healthcare spending reached $5.3 trillion in 2024, or $15,474 per person, according to the Centers for Medicare & Medicaid Services. At the household level, 44% of U.S. adults say it is difficult to afford their healthcare costs, according to research.

Personal planning alone cannot solve the broader challenge of healthcare affordability. That requires sustained work across the healthcare system. But planning can give families more visibility into their options and help them make informed decisions before costs arise.

In that sense, healthcare planning is financial planning.

Treat open enrollment as a financial checkpoint

Open enrollment is often treated as an annual administrative exercise. It is better understood as an important financial checkpoint.

The monthly premium is the most visible cost, but it is only one part of the equation. Families should also consider the deductible, copayments and coinsurance, the out-of-pocket maximum, prescription drug coverage and the provider network. They should think about the care they are likely to use and the financial exposure they could manage if circumstances change.

The plan with the lowest premium may not produce the lowest total cost. Choosing well means balancing expected healthcare needs with protection against what cannot be predicted.

Open enrollment is also an opportunity to consider whether a plan still fits. A change in health, employment or family circumstances can alter what coverage makes the most sense. The choice should reflect the year ahead – not simply repeat the choice made last year.

Keep planning after you enroll

Selecting a health plan is the beginning of the process, not the end.

Many people avoid thinking about healthcare because it can feel complicated and unpredictable. That uncertainty is precisely why continued engagement matters. Staying current with recommended care and understanding how your plan works can support long-term health while reducing avoidable financial surprises.

The importance of planning becomes even clearer when healthcare needs and costs persist over time.

An internal analysis of more than 22 million members enrolled in Elevance Health affiliated commercial plans found that people with at least $100,000 in annual claims represented less than 1% of members in 2025, yet accounted for 34% of total claims spending.

The multiyear analysis also found that 13.6% of high-cost claimants remained in that category for three consecutive years. Nearly three-quarters experienced the same major health condition throughout that period.

These figures are not a reason to assume the worst. They are a reminder that a serious health condition can create needs and costs that extend well beyond a single year. Understanding your benefits and preparing for ongoing care can make a difficult situation easier to navigate, both financially and practically.

Use information before you need it

Good financial decisions depend on having the right information before a commitment is made. Healthcare should be no different.

Before scheduling non-emergency care, confirm that both the provider and facility are in network. Review available cost estimates, determine whether prior authorization is required and ask questions when coverage is unclear. When clinically appropriate, comparing care options and locations can also help make expenses more predictable.

Many health plans now offer digital tools that allow members to estimate costs, identify in-network providers and better understand their coverage before care is delivered.

For example, Elevance Health affiliated health plans offer a Find Care tool that provides estimated prices for hundreds of common procedures and office visits while helping members locate in-network providers. In an internal analysis, use of the tool was associated with a 33% reduction in out-of-network provider use and average member savings of $185.

These tools cannot eliminate every uncertainty, and they do not replace clinical judgment. But they can help people make decisions with more information…before receiving care rather than after the bill arrives.

Think beyond this year

Healthcare planning should not stop when the calendar turns.

Retirement offers one of the clearest examples. Some research estimates that a 65-year-old retiring in 2026 can expect to spend an average of $185,500 on healthcare and medical expenses throughout retirement. The estimate assumes enrollment in Original Medicare and Medicare Part D and does not include long-term care, most dental services or over-the-counter medications.

That figure is a planning benchmark, not a forecast for any one person. Actual costs will vary based on health, longevity, location and other circumstances. Its value lies in illustrating the scale of an expense that is too important to overlook.

No one knows exactly what healthcare will cost years from now. But uncertainty does not prevent us from planning for other important financial goals. We save for retirement without knowing precisely how long it will last. We build emergency funds without knowing when we will need them. Healthcare deserves the same discipline and should be revisited as circumstances change.

Healthcare belongs in the plan

Financial planning has never been about predicting every expense with certainty. It is about preparing for what can be anticipated while preserving flexibility for what cannot.

Making healthcare part of a financial plan cannot eliminate every unexpected cost or solve the broader affordability challenge. It can, however, help families choose benefits more thoughtfully, use available information sooner and approach changing healthcare needs with greater confidence.

Healthcare is not separate from financial well-being. It is one of the forces that shapes it, and it belongs in every financial plan.