Having insurance may make it easier to get health care, but that doesn’t always translate to medical bills you can afford. High deductibles, copayments and coinsurance mean some people are avoiding medical care altogether to save money. But regular medical care is important, and you shouldn’t have to sacrifice your health to save money. By tackling your health care strategically, you may be able to avoid that tough decision.
More than 90 percent of Americans have health insurance, leaving 29 million still without coverage, according to the latest data from the federal government. But in a 2014 Associated Press survey of insured adults, one in four said they were not confident they could afford care if they or someone in their family had an unexpected medical need.
If you fear that a future medical expense may too steep, the following steps may help:
1. Find the right plan.
Saving on health care begins with selecting the right insurance plan. Consider how much the monthly premium will cost, but don’t choose your plan based on that factor alone. Instead, evaluate all of your options.
A plan that trades lower premiums for higher out-of-pocket cost — like a high deductible health plan (HDHP)— may make sense for someone with relatively few expected medical needs. Someone with a chronic condition, however, could save more with a plan that has higher premiums and lower deductibles, copays and coinsurance, as he or she will be going to the doctor more often.
Consider your medical needs for the coming year, and use them to estimate how much you’d spend with a few different plans.
2. Visit only in-network providers.
Insurance plans contract with groups of doctors and facilities to form a network that offers lower rates for members. When you use providers within that network, your care is covered at a higher rate. If you venture outside, you’ll have to pay more.
For example, one visit to an in-network family doctor for acute illness could result in a $35 copay, with your insurance picking up the remainder. A visit to an out-of-network doctor for that same illness could cost about $150, or the entire billable cost.
Always check your insurer’s website and search for doctors under your specific plan’s network.
3. Take advantage of FSA and HSA offerings.
Flexible spending accounts (FSAs) and Health Savings Accounts (HSAs) can help you budget for medical expenses while providing tax benefits. If your employer offers one, sign up. When deciding how much to contribute, estimate your medical expenses for the year and go from there. If you have a deductible, set aside at least that much.
A few important points:
● FSAs are— with few exceptions— “use it or lose it” accounts, so estimate your contribution carefully because if there are funds left at the end of the year, you may lose that money.
● HSAs are only available for people with qualifying high-deductible health plans. If you have such a plan, but your employer doesn’t offer an HSA, you can open one yourself through an outside financial institution.
● Unlike FSAs, an HSA is your account and the balance can be carried over from year to year, and even follow you as you change jobs.
4. Know what’s covered under free preventive care.
Under the Affordable Care Act (ACA), insured Americans are allowed certain free preventive services and screenings. These include immunizations and screenings for some types of cancer. Take advantage of this care because it can help you stay healthy and save you money.
5. Save on prescription drug costs.
Prescription drugs can be a major expense, particularly if you need recurring prescriptions.
Save on your medication costs by:
● Choosing generics over brand names whenever possible.
● Asking about a therapeutic alternative when your doctor recommends a brand name with no generic available.
● Asking your doctor for samples.
● Visiting the drug maker’s website for coupons or patient assistance programs.
● Getting your medicine in larger doses and splitting the pills.
● Refilling multiple months at a time.
A money-saving example: A one-month supply of the cholesterol drug Crestor could carry a $65 copay under some plans if a generic is not available. A one-month supply of Zocor— a different brand-name drug that treats the same condition— would cost $215, as insurance wouldn’t cover the brand name because there is a generic available. The cost of a one-month supply of simvastatin, the generic version of Zocor: $15 copay.
6. Negotiate high medical bills.
When you receive a medical bill, don’t automatically accept the balance as the final amount due. Contact the provider’s billing office to ask if they can reduce the cost. If the person on the phone won’t offer to lower the bill, ask to speak with a supervisor. Also, ask if a monthly payment plan is possible to make the bill more manageable.
7. Carry lessons into the next year.
You may find the plan you chose for this year wasn’t the best for your situation. Make sure you learn from your experience and choose a more suitable plan during your next open enrollment period.