The way we purchase health care is unlike most other purchases we make. Many hunt for a coupon that saves them 50 cents at the local supermarket. However, when it comes to health care—a far more complex and expensive service—we rarely ask questions or consider all the options that could save us time and money.
Learn to shop for value when it comes to health care. With little effort, you can save thousands of dollars on your medical bills.
Let’s make a deal. Ask your doctor, hospital or dentist if they will accept less. Studies show that the majority of individuals who bargain succeed.
Know how much it costs. You will be better armed to negotiate discounts when you know the real costs of care. You can find rates on the websites of large insurers like UHC, Cigna and Aetna. Or through services provided by your agent.
Pay in cash. You can routinely save up to 10 percent on your bill by paying in cash up front, and often much more than that. Doctors lose thousands of dollars every year on credit card processing fees, unpaid bills and collection fees.
Look at your bill closely. You will often find mistakes. Keep track of your visits, tests and medications, and compare them against your bills. Request a corrected bill if you find an error and notify your agent. An Agent of Record can act on your behalf to discuss, educate and help resolve issues.
Follow instructions. Follow your health care provider’s instructions for medications. Most medications work most effectively when they are used according to your doctor’s instructions. Ignoring instructions could result in additional prescription costs, extra trips to the doctor or even hospitalization.
Visit a retail health clinic. Retail health clinics are growing in number. They are popping up in high-traffic retail outlets in metropolitan areas around the country. While these clinics lack the personal nature of seeing a family physician who knows your complete medical history, they offer convenience and low prices.
Stay in-network. Your medical costs can increase greatly when you visit a provider who is not in your plan’s network. Make sure your primary care doctor and any specialists you may need to see are in your network whenever possible.
It doesn’t hurt to ask. If you must see a specialist who isn’t within your network, call your insurance company’s pre-certification department and explain why you must use an out-of-network specialist. You can often get your insurance company to agree to pay in-network rates in order to avoid the expensive appeal process. If that doesn’t work, ask your specialist to accept the in-network rate.
Understand what treatment your plan covers. Are you paying for chiropractic care, massage therapy or acupuncture? Check with your agent or your insurance company’s customer service line to make sure you aren’t needlessly paying for health care that is covered by your insurance.
Stay insured. Despite its costs and limitations, health insurance offers you significant discounts on most health care services, as well as protection from astronomical health costs, should you or a dependent suffer a major health event. If you lose your employer-based health insurance, understand your options for retaining health coverage. First, you may be able to extend your current policy through COBRA, which allows you to keep your current coverage for up to 18 months by taking over the employer’s portion of the premiums. Secondly, you may become eligible to enroll in an individual health plan through the Marketplace as part of the Affordable Care Act (ACA), which carries the possibility of several discounts depending on your income.
Fight back. If your claim has been denied, start with a phone call to customer service or your insurance agent. If that doesn’t work, follow your plan’s appeal process. Remember to document everything and keep copies.
Choose your health plan wisely. Choosing the plan with the lowest premiums or sticking with the same plan year to year may not be the smartest option. Anticipate your family’s medical expenses and look closely at each plan option to find the most appropriate and cost-effective one for you.
Consider an HSA. Health Savings Accounts (HSAs) are growing in popularity. They are combined with a high deductible health plan. The high deductible policy protects you from the cost of a catastrophic illness or prolonged hospitalization. You control the savings account and use it for small and routine health care expenses. Although you own and manage the account, employers will often make contributions to HSAs as well. Funds you don’t use grow tax-free and can be rolled over from year to year. For 2016, you can contribute up to $3,350 for an individual account and up to $6,750 if you’re insured under a family plan. In 2017, you can contribute up to $3,400 for an individual account and up to $6,750 if you’re insured under a family plan. If you’re 55 or older, your contribution levels rise by an additional $1,000.
Take advantage of flexible spending accounts. A flexible spending account, or FSA, is an employee benefit program that allows you to set aside money on a pretax basis for certain health care and dependent care expenses. That means you keep more of your money. Your employer may also contribute to your FSA account. The maximum total FSA contribution for 2018 is $2,650.
Don’t skimp on preventive care. Be sure your child gets routine checkups and vaccines as needed, both of which can prevent medical problems (and bills) down the road. Also, adults should get the preventive screenings recommended for their age in order to detect health conditions early.
Discount contact lenses. Discount websites and stores can provide the contact lenses prescribed by your eye doctor, in factory-sealed packaging, at a cost that is up to 70 percent off what you would pay at the retail level.
Chill out. According to WebMD, up to 90 percent of doctor visits are for stress-related conditions. Studies show that relaxation techniques are effective in controlling anxiety, enhancing the immune system and reducing conditions such as high blood pressure, substance abuse and chronic pain.
Quit smoking. Under the ACA, health insurers are allowed to charge smokers 50 percent higher premiums than nonsmokers for new polices sold to individuals and smaller employer groups. Plus, if you quit smoking you can expect to save approximately $2,000 a year on the cost of cigarettes alone.
Get a second opinion. Save thousands of dollars a year on cutting-edge medical tests, which usually are not covered by insurance, by following the guidelines recommended by the U.S. Preventive Services Task Force. You can find these guidelines at www.ahrq.gov/clinic/uspstfix.htm.
Think twice about the emergency room. Don’t go to the emergency room (ER) when your regular doctor or an urgent care visit would suffice. If you or your child is feeling ill on Friday, get into the doctor that day to avoid overpaying at the ER during the weekend.
Information contained in this Associate Release is not intended to render tax or legal advice. Employers should consult with qualified legal and/or tax counsel for guidance with respect to matters of law, tax and related regulations. AJM Associates provides comprehensive benefits advice and administrative services with respect to all forms of employee benefits, individual insurance, Medicare, and ancillary coverage services. For additional information about our services, please contact us at www.ajmassoc.com