8 ways to reduce your medical costs
Accessing health care isn’t like going to the grocery store or buying a new phone, where you can just go somewhere else if you can’t find what you’re looking for at the right price. Instead, you often find out how much a service will cost after you have already used it.
Price concerns prevent some people from seeking treatment. To increase pricing transparency, a new government rule requires hospitals to provide clear and accessible online pricing information on 300 “purchasable services” in a “user-friendly format,” according to the Centers for Medicare & Medicaid Services (CMS). Yet this rule still won’t give you an estimate of your individual costs, which you need if you want to try to keep them down.
While there are no quick fixes to lowering your medical costs in our complex system, there are questions you can ask to help you manage your health care costs.
Should I tell my doctor about my financial problems?
Doctors don’t want to base patient care on the money they have. But in practice, ignoring a patient’s financial situation can lead doctors to make a recommendation or prescribe care that a patient cannot afford, says Eric Ellsworth, director of health data strategy at Consumers. ‘Checkbook. Be sure to let your doctors know if you are under financial pressure, as they likely won’t ask you about it.
Call your insurer or use their website when you are at the doctor’s office to find out if you can afford medication. Many insurers have online prescription drug tools where you can plug in your medications to see if they’re covered. If you don’t use insurance to pay for the drugs, you can find the retail price on a website like GoodRx. GoodRx also provides coupons, but keep in mind that drugs you buy with coupons do not count towards your insurance plan’s deductible or annual limit.
“If you put the price up on the drug in the office and say, ‘Hey Doc, this drug looks like it’s costing me $ 400,’ at least you can discuss it, ‘says Ellsworth. “Maybe there are other options the doctor hasn’t thought of.”
When planning a procedure, try to get details of any additional costs that might come into play. You can factor that into your overall cost, he adds.
It’s also important to know where you stand in your health insurance plan deductible, and your doctor won’t know (we’ll talk about that in a bit). The deductible is the amount you have to pay each year before your insurance takes effect and provides more comprehensive coverage.
Do I have the right health insurance plan?
The right insurance plan can go a long way.
“The most important tool in your toolkit for avoiding a big medical bill is having the right insurance plan and understanding how it works,” says Caitlin Donovan, spokesperson for the National Patient Advocate Foundation.
Look beyond your monthly premium when choosing a plan, to your deductible and cost-sharing, such as copayment and coinsurance. As long as you’ve saved the money to cover a medical expense that arises before you hit your deductible, a high-deductible plan with a Health Savings Account (HSA) may be a better choice for you than a plan with a lower deductible. High-deductible plans often have cheaper premiums than lower-deductible plans, and the HSA is a powerful way to save. But if you live paycheck to paycheck, then a high deductible plan with an HSA that you can’t afford to fund won’t work for you.
Whatever your health insurance plan, make sure you know the ins and outs of it. An important factor is knowing how much you tend to spend on healthcare each year and when your deductible is reset; If you know you’ll hit your deductible at some point, saving significant expenses afterward will save you money, says Donovan.
Before extended procedures, call your insurance company to make sure everyone providing care is networked, Ellsworth says. Some insurance plans do not offer any coverage outside of their network of providers, while others cover it to a lesser extent than network treatment. (If you go under anesthesia, don’t forget the anesthesiologist, a category of provider that often goes unnoticed and can result in a surprise bill). And get to know your insurance company’s doctor and drugstore search and pricing tools, ideally before going to the doctor. That way, you can walk into your doctor’s office armed with information and find out how much – or at least roughly – a procedure is going to cost.
Do I still have to use my health insurance?
Sometimes it can be a good idea not to use your insurance. Health care providers often offer discounts if you pay up front, as this saves them from having to deal with an insurance company. For example, a couple in Idaho with a high deductible found an imaging center where their daughter could do x-rays for $ 55 in cash up front, compared to $ 228 if they had billed it through. ‘insurance, KTVB’s 7Investigates reported.
The same goes for prescription drugs: some insurance plans offer affordable co-payments while others require you to pay a high deductible before your out-of-pocket expenses go down.
If you’re a long way from reaching your deductible but nearing the end of the year (or whenever your deductible resets), paying cash can save you money. Just keep in mind that if you don’t use your insurance, what you pay doesn’t go towards your deductible. So it probably doesn’t make sense if you are at the start of your insurance cycle for the year.
Can I shop for drugs and devices?
If your doctor tells you to use a medical device, such as a wheelchair, brace, or bracelet, shop around. It will almost always be cheaper to buy these items at your local pharmacy or from an online retailer like Amazon than through your doctor’s office or the hospital system, Donovan says.
As mentioned, you can also shop when it comes to prescriptions. Websites like GoodRx can help you find the lowest prices by comparing costs at drugstores and grocery stores, as well as providing you with coupons.
What if my medical bill contains an error?
Half of all medical bills contain errors, estimates the National Patient Advocate Foundation. And Donovan says she’s never seen an error in favor of the patient.
When you receive a medical bill, wait to pay it until you receive your Explanation of Benefits (EOB) from your insurance company. Sometimes providers will mistakenly bill you directly before sending it to your insurer. Once you get your explanation, compare it to your bill to make sure nothing looks wrong and no care is included that you didn’t actually receive, says Donovan.
If you have any problems, or just want clarification, call your insurer.
Can I benefit from external financial assistance for medical costs?
If you are receiving care in a hospital, ask if you are eligible for financial assistance. Many hospitals won’t tell you in advance, but financial aid could help you go from paying a high bill to paying nothing at all, Donovan says. Eligibility may depend on the size and income of your household.
There are also organizations that will provide financial assistance for co-payments. The PAN Foundation, for example, helps eligible patients pay for drug costs, copayments, insurance premiums, and travel costs. Other organizations include the Patient Advocate Foundation, The Assistance Fund, and Good Days.
Do I have to open an HSA?
A Health Savings Account (HSA) saves you pre-tax money for future medical expenses and is available to people with eligible high-deductible insurance plans. Most workplaces that offer one of these insurance plans also offer an HSA, so check with your employer on how to take advantage of this benefit. If you don’t have an HSA through an employer, you can still open one through a financial institution like Fidelity Investments.
It is a tool worth using if you are eligible, as it offers a triple tax advantage: in addition to making tax-deductible contributions, an HSA will allow you to accumulate tax-free income and to save money. ” make tax-free withdrawals for qualified medical care. expenses. There is no time limit on these funds, so if you don’t have a lot of immediate needs, you can save them for medical expenses in retirement, including Medicare premiums, copayments, coinsurance and deductibles. Remember that if your children are not covered by your insurance, you can still use your HSA for their expenses as long as they are in your care.
From feminine care and over-the-counter medications to sunscreen and at-home COVID-19 testing, there’s a ton of qualifying expenses you’re probably already buying. You can find what is eligible on HSAstore.com.
Do I have to open an FSA?
Instead, your employer may offer a Flexible Spending Account (FSA), which allows you to set aside pre-tax dollars for eligible health care expenses by contributing regularly. The contribution limit in 2021 is $ 2,750 per employee. Keep in mind that unlike an HSA, you have to use your FSA within a certain time frame or lose money. But if you plan well, these tax benefits could help save you money – you can calculate exactly how much and determine what expenses are eligible on FSAstore.com.
Similar to an HSA, many items already in your cabinets are likely FSA qualified. You can even use the account to pay for gasoline to and from your medical appointments.
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