30 Ways to Cut Health Care Costs
How to Pay the Lowest Price Without Sacrificing Quality
Kiplinger Personal Finance
If you're like most Americans, you're shouldering a larger portion of your health care costs. But as more insurers raise deductibles and switch from fixed-dollar co-payments to coinsurance -- which bases out-of-pocket expenses on a percentage of the total costs -- you have an incentive to take more control over how much you spend.
Therein lies a problem, however: Most people have no idea how much medical care actually costs. "If a gas station tried to charge you
Take our advice on how to find the least expensive care without sacrificing quality and you could save hundreds, even thousands of dollars.
PICK THE RIGHT PROVIDER
1. Make sure everyone you see is in-network.
Most people don't realize how much they actually save by staying within the insurer's network: An imaging center in
If you're referred by your doctor to a specialist, check to see that he or she is in-network. And make sure that everyone involved in a procedure is in-network, too. For example, if you're having surgery, check on the facility, the doctor and the anesthesiologist.
2. Ask about alternate facilities.
Doctors often work at outpatient surgery centers as well as hospitals, and what they charge can vary widely by location. Rice, who has a high-deductible policy, shopped hard when his son had surgery on his heel last fall. He carefully picked the doctor, then called the hospital to ask how much the surgery would cost. At first, he was quoted a price of
"Then I asked my son's surgeon if there was any other place he could do the procedure, and he gave me the name of an outpatient center," says Rice. The fees for the doctor and the anesthesiologist were the same, but the outpatient center charged only
3. Find lower-cost after-hours care.
The average in-network cost of an emergency-room visit is about
Sometimes you need high-level emergency-room care, but not always -- and it's best to know your options before an emergency. "Find out whether the urgent-care center in your neighborhood is in-network," says
4. Save big at independent facilities.
Different facilities charge vastly different prices for x-rays and tests. For example, the average in-network cost of an MRI at a hospital is
If you haven't met your policy's annual deductible, you could save
"When doctors order a lab test or an x-ray, they write a requisition form," says Kang. "But as with a prescription, you're free to fill it at any facility. People don't understand that."
5. Ask about any extra discounts.
Some plans offer additional discounts as an incentive to use certain providers. Aetna, for example, identifies "Choose and Save" hospitals, and "Aexcel" doctors, which meet certain standards for quality and efficiency. Some employer plans lower the coinsurance rate as much as 10 percent to 15 percent if you use these providers.
SAVE ON PRESCRIPTIONS
6. Switch to generic drugs.
The savings can be huge. Someone who takes Glucophage, Prilosec and Zocor can save more than
Not only is the list price lower, but the coinsurance rates are usually lower, too -- often 15 percent for generics, 25 percent for preferred brand-name drugs and 35 percent for nonpreferred brand-name drugs.
You may get an even better deal on your own. Some chain stores, such as
7. Find therapeutic alternatives.
Some brand-name drugs don't have a generic equivalent yet, but they may have a therapeutic equivalent, which is in the same class of drugs but is chemically a little different, says Kang. For example, Mavik, an ACE inhibitor used to lower blood pressure, has a retail price of price of about
8. Get your drugs through the mail.
Mail-order pharmacies often provide a three-month supply of drugs for the same price as a one-month supply at a local pharmacy. This strategy could save you more than
9. Split your pills.
Ask your doctor if you can save money by cutting any of your pills. For example, the 30-day cost for 20-milligram tablets of Lipitor can be about the same as the 30-day cost for 40-mg tablets. You may be able to order the larger Lipitor tablet and split it in half, saving you about
10. Double up.
If you're taking a 20-mg pill twice a day, ask your doctor whether it would be safe to switch to a 40-mg pill once a day. "A doctor may put a patient on 10 mg of medication twice a day, when it may be equally effective to take a 20-mg pill once a day and save significant money," says
GET NO-FEE PREVENTIVE CARE
11. Schedule a screening.
Many insurance plans must now provide certain preventive-care screenings without charging deductibles or co-payments. Depending on your age, this rule may apply to blood-pressure, diabetes and cholesterol tests, mammograms and colonoscopies, flu shots, routine vaccines, well-baby and well-child visits, and other preventive services (see the preventive-care page at www.healthcare.gov for details).
12. Sign up for
13. Cash in on wellness benefits.
More than 40 percent of large employers surveyed by the
14. Sign up for special programs. Many employers offer cash if you participate in a healthy-living program -- for example, 22 percent of the employers surveyed by the
15. Get help for chronic conditions.
If you have a chronic condition, such as diabetes, your insurer may provide incentives for you to take your medications, visit your doctor and have regular tests. "They're offering anything from discounted premiums to gift cards to cash to days off from work," says Berger.
USE TAX BREAKS
16. Contribute to a flexible spending account.
Money in a flexible spending account escapes both federal and
17. Exploit the grace period.
If your employer offers a grace period until
18. Get triple tax breaks from a health savings account.
If your health insurance has a deductible of at least
19. Use HSA money in retirement.
You can't contribute to an HSA after you sign up for
20. Get a prescription for OTC drugs.
Starting this year, you can no longer use FSA or HSA money for nonprescription drugs (except insulin). But you can use the money for over-the-counter drugs if you get a prescription. Ask your doctor for a prescription for any medications you use regularly, such as pain relievers, allergy medications, anti-fungals and cough-and-cold medicines, says
KNOW THE RULES
21. Get credit for everything.
If you have a high-deductible policy, make sure you're getting the insurer's negotiated rate rather than the much higher list price, even if you haven't hit your deductible yet and are covering the cost yourself. And make sure all of your care is counted toward the deductible. "Every time you go to the doctor, even if you pay out-of-pocket because of the deductible, you should receive an explanation of benefits from the insurer," says Mostafaie.
22. Watch out for common errors.
Always get an itemized bill when you have a hospital stay or major procedure -- and question unexpected charges. Then match your bill with your explanation of benefits. Coverage may be denied just because the procedure wasn't coded properly, says
23. Ask for a cash discount.
If you're in your deductible period and paying for a test or procedure yourself, get some leverage by paying cash. Some providers will cut your bill by 20 percent if you give them cash, says
24. Negotiate a lower payment.
After getting the bill, ask the provider or hospital for a break if you pay a lump sum right away. "Tell them this is the amount of money you have," says Pane. "I usually start by offering 50 percent."
25. Play by the rules.
Annually review your insurer's rules regarding emergency care and whom to call for approval. That way, you'll have a plan in place before an emergency, and you won't get stuck with extra charges because you didn't know the drill.
DO SOME HOMEWORK
26. Use tools at your insurer's Web site.
Many insurers offer personalized tools to help members shop for care. Aetna, for example, makes it easy for members to look up specific fees for 450 physician-based services and more than 40 facility-based services. The tool shows the retail price for the procedure, the Aetna negotiated rate with each in-network provider and facility within a certain distance, and exactly how much you'll pay based on your plan's coinsurance rates and whether you've met your deductible yet. You can also check quality ratings for doctors and hospitals.
27. Sign up for your employer's tools.
28. Find fair prices at Healthcare Blue Book.
At www.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.
29. Compare drug costs at DestinationRx.com.
This site shows generic equivalents and therapeutic alternatives to your medications and how much you can save through mail order or pill splitting. You may be able to access personalized information through your employer's pharmacy plan.
30. Use money-saving apps.
Your insurer or employer may offer cost-saving apps for your iPhone or Android phone.
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Personal Finance - 30 Ways to Cut Health Care Costs
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