Healthcare is now a big ticket item. Welcome to America. If you're like most Americans, you're shouldering a larger portion of your health care costs. More group health insurers are raising deductibles and are dropping fixed co-payments for coinsurance. With coinsurance, you pay a % of the total costs. This will allow insurers to collect your premiums while giving you strong motivation not to use your health insurance. So you have to be very careful when you do spend.
A list of ways to save on your medical care
Verify all things medical done to you are in-network. That includes Urgent Cares, Doctors, Specialists, Hospitals, Outpatient Facilities, Anesthesiologist, and Surgeons. Your insurer negotiates rates much cheaper than cash payers get charged out of network.
If you need coverage for around 3+ months and you know you won't need to renew (to get past your waiting period), consider a short term policy. They are not guaranteed renewable so they tend to cost one half to one third as much as renewable health insurance.
There are 9,000 community health centers in the U.S. that are mandated to accept you, and will either give you free care or will accept what you can pay. They provide the full scope of primary care (what you'd go to your regular doctor for) and often have dental services too.
The best way to save yourself, your health, and your money, is going for regular checkups, and going in early when you are sick, and not later when it's worse and you might infect others.
Health insurance is mostly for specialty care, which is much trickier and harder to get a price break on compared to primary care.
If you need a walker, wheelchair, reclining bed, or other piece of pricey medical equipment, ask people at your church, senior center, or social club of used equipment that they can sell or donate.
If you need dental, dental schools offer extremely high-quality care for about one third the price you'd pay elsewhere
Negotiate your own rates. Doctors and hospitals have wiggle room on their high priced services. If you must pay cash, haggle.
Visit urgent-cares versus emergency-rooms. Some insurers charge you more for non-emergency visits to the ER, but many will waive most of your payment to an urgent care center.
Unless it's a true emergency, don't check yourself into a hospital on a weekend because many hospital departments aren't open on weekends, and most have reduced staffs, it will take longer to get treated. Schedule your visit for Monday asap.
You may be eligible to receive a comprehensive eye exam and care for up to a year through EyeCare America (run by the American Academy of Ophthalmology), if you are 65 or older, have not seen an eye doctor in 3 years, and do not belong to an HMO or have VA coverage.
The retail markup on eyeglass frames at eye doctors' offices or boutiques can be as high as 1,000%. The cheapest frames are available at large retail stores and optical chain stores, but they are not as well made. Because of the markup,
the price of the frames is very negotiable. If they won't lower the price, get something throw in. like an extended warranty, upgrades lens from plastic to lighter polycarbonate, or scratch resistant lenses.
Most insurers now offers a free 24-hour hotline staffed by a nurse, to answer basic medical questions. Maybe you don't need to visit a facility but something over the counter would help?
Use independent facilities that tend to be lower-cost. When your doctor orders a lab test or x-ray, they write a request form and like a prescription, you should be able to have the test or service done at any facility.
Inquire about 10% to 15% discounts that insurers typically give as incentive to use certain hospitals, and doctors, which meet standards for quality and efficiency.
Switch to generic drugs which are much cheaper than brand name drugs. Plus do you really want to take a newer drug that hasn't had time to be demoted on those bad drug commercials by class action lawyers?
Use chain stores like Walmart and Target to fill certain generic drugs
Find a therapeutic alternatives to the brand name drug. Ask your doctor or pharmacist
Use mail order pharmacies that often provide a three-month supply of drugs for the same price as a one-month supply.
Get a higher dosage pill, then split them. The math works out, trust me. Just know that it's safe to split only certain kinds of medications.
Get your fix once per day. Ask your doctor whether it is safe to instead of taking a pill twice a day, it would be safe to switch to a larger dose once per day
Use preventive care
and screenings. Many insurance plans provide certain preventive-care screenings for free. This could apply to tests, mammograms and colonoscopies, flu shots, vaccines, well-baby and other preventive service.
Sign up for Medicare's new benefits which without co-pays or deductibles, include mammograms, screenings for cervical and colorectal cancer, flu shots, pneumonia shots, and an annual wellness visit and personalized prevention plan
Find out if your large employer offers discounts for participating in wellness programs. They may give you cash or add $75 to your health savings account if you participate in an exercise program, get a health assessment, tobacco-cessation programs, free weight-loss, and stress-reduction programs.
Ask about chronic conditions like diabetes. Your insurer may provide incentives for you to take your medications, visit your doctor and have regular tests.
Make deposits into a flexible spending account which lower federal, State and Social Security taxes. Then use the before tax money to pay out-of-pocket medical expenses through the year, since more company plans are switching to higher deductibles and cost sharing.
If your employer offers a grace period until March 15 to use up the previous year's FSA money, there's a sweet spot in the first few months of the year when you can double up on available funds. Use any money left over from the previous year combined with the current year's full allocation and you may be able to fund much of the cost of such big-ticket items like laser eye surgery or major dental work. Yearly FSA limits will shrink to $2500.00 in 2013.
Combine a health savings account and health insurance which has a deductible of at least $1,200 for individual coverage or $2,400 for family coverage. Then contribute up to $3,050 to an HSA for the year or $6,150 for family coverage, and an additional $1,000 if you're 55 and over. Contributions lower your taxed income and grow tax free and can be used penalty free for medical expenses in any year.
Use HSA money in retirement. You can't contribute to an HSA after you sign up for Medicare, but you can still use the money tax-free for many expenses, including co-payments, deductibles, prescription drugs (including over-the-counter drugs with a prescription), vision and dental care, and a portion of long-term-care premiums based on age ($3,290 per year if you're 61 to 70, for example). You can also use the money tax-free to pay your premiums for Medicare Part B or Part D, or to pay for Medicare Advantage premiums (but not medigap premiums). See IRS Publication 502, Medical and Dental Expenses, at www.irs.gov for a list of eligible expenses.
Have you doctor write a prescription for over the counter drugs since you can no longer use FSA or HSA money for nonprescription drugs (except insulin). This includes pain relievers, allergy medications, anti-fungals and cough-and-cold medicines. You can still use FSA and HSA money for pay for some drug store items like bandages, contact lens solution, hearing aids, reading glasses and first aid kits.
If you have a high deductible health plan, verify you're getting the insurer's negotiated rate even if you haven't hit your deductible yet and are covering the cost yourself. Make sure that all your care is credited towards the deductible.
Every time you go to the doctor, you should receive an explanation of benefits or statement from the insurer
Its estimated that 85% of hospital bills contain errors. Inspect your itemized bill when you go to the hospital or have a major procedure. Inquire about unexplained charges especially when it's full of codes. Compare the bill with your insurers statement. Coverage may be denied if the codes are off properly.
Be sure to get all required authorizations before seeing specialists or obtaining second opinions, and make copies for your records. It's not easy to prove that you tried to get authorizations after the fact, so take notes and keep records. Even use certified mail, return receipt.
Don't let charges mount by ignoring a big medical bill you think is a mistake. Request a 30-day extension from health care providers to stop the collections while you gather the paperwork or authorizations. Doctors and hospitals now use billing software that can send you to collections after 30 to 60
days.
If you can't fix the medical bill on your own, hire a Claims Assistance Professional for $30 to $160 an hour, to can sort through your bills, identify errors, negotiate discounts or settlements, expedite payments and keep doctors, hospitals, insurers and collection agencies at bay. Some will charge a % of the amount they recover. They can also help if your insurer is reluctant to pay for your care, even though it's covered in your policy.
Contact your state's department of insurance, where you can get free advice.
Get a cash discount. Some providers will cut your bill by 20% if you give them cash, and demand the insurer's negotiated rate, and submit the claim yourself so that it adds towards your deductible.
Ask the hospital for a discount if you pay a lump sum right away. Tell them "this is all the amount of money I have." Start off at offering 50% of the bill.
Examine what your carrier covers in emergency care and who to call for approvals. Have a plan in place before an emergency
Use your insurer's website to look up specific fees for services. These tools can show you the retail price for the procedure, the negotiated rate in-network and exactly how much you'll pay based on your plan's coinsurance rates. You can also check quality ratings for doctors and hospitals. You may be able to see the cost of doctors' visits and tests or drug costs and they send e-mail alerts or text messages when a lower-cost option is available or when a pharmacy lowers its prices.
At Healthcare Blue Book. At healthcarebluebook.com you can find fair prices for surgery, hospital stays, doctor visits and medical tests, based on the average fee that providers in your area accept as payment from insurers. The site also provides money-saving tips for each procedure and a pricing agreement that makes it easier to negotiate with out-of-network providers.
At DestinationRx.com you can compare drug costs, find generic equivalents and therapeutic alternatives to brand names and how much you can save through mail order or pill splitting.
Use medical cost-saving apps for your iPhone or Android phone. Some insurers offer phones apps that lets you look up the cost of a medication and lower-cost alternatives -- then inquire before you leave the doctor's office.
Craig Casey is an Writer, Coach, Blogger, Husband, and Former Health Insurance Agent helping people on the web since 1999 with their health insurance problems.
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