Costs Keep Climbing! Make It Stop!

This is scary: out-of-pocket medical costs have increased 45% over the past five years.  This includes your premium dollars and co-pays.  And that’s just for those of us with employer-provided group health plans.  It’s even worse for us with individual health insurance policies.

Obviously, the temptation is to do without regular checkups.  To let the prescriptions lapse.  To drown our sorrows in Twinkies.  Take heart!  There are a few things we can do to trim some costs and still maintain health (and sanity, too!).

First order of business:  understand the rules and requirements of your health insurance plan.   All plans vary.  Take the time to go over your particular coverage options and rules.  To save any money and still get the treatments you need, pay attention to how things work.  For example, suppose your doctor writes you a prescription just before you leave the hospital after a procedure.  When you fill that prescription, lo and behold! your plan won’t pay for it because it was written in the hospital.  Had it been written in the doctor’s office, it would have been covered.  These are things you need to know – in advance.

Make sure you have a primary care doctor.  Total medical care costs are lower when you receive most of your care from your primary care doctor, as opposed from going from one specialist to another.

Use an emergency department only for emergencies.  If you have severe shortness of breath, chest pain, sudden weakness or uncontrolled bleeding, of course head for the ER.  Otherwise, for a tetanus shot or some stitches or other minor health problems, see your primary care doctor.  It will save you time and money – and aggravation, too.  And here are some other suggestions to help you avoid an emergency department visit:

  • Consider using an urgent care clinic:  These clinics are open evenings and weekends, times when your regular doctor’s office is likely closed.  They handle many issues, including urinary tract infections and strep throat.
  • Have a plan in place: Work with your doctor to have a plan to deal with any new complications if you are suffering from a condition that could suddenly get worse – migraines, heart disease, kidney stones, asthma.   Ask if you could keep medications at home for usual complications.
  • Ask a nurse support: Many insurers offer access to 24-hour nurse lines.  Here you can talk to a nurse to help direct you to the right medical care for your complaint.  Your doctor may have a 24-hour emergency number as well.
Reduce your risks, and do not cut corners on prevention.  You know the drill, here.  Get your flu shot.  Eat your veggies.  Exercise regularly and include plenty of fiber in your diet.  Drive carefully.  Do not text and drive. Stop smoking.  Cook and store food properly.  Enjoy your friends.  

Shop for medical and health care services when you can.  You already know to avoid unnecessary procedures and tests.  Should something be recommended, ask  your doctor why such a test is necessary.  Still not sure?  Get a second opinion.  If you do indeed need it, ask your doctor to recommend several facilities for that procedure.  And check with your insurance company, too.  They may be able to help you compare costs on common tests, scans and so forth.

Check all invoices carefully before paying them.  We have gone over this before.  Review all medical bills and EOB‘s (explanations of benefits), along with any other paperwork from your insurer.  Make sure it all matches up, that you actually received the treatment you are paying for, that there are no duplications, typos, or other errors.

Be smart about your Rx refills.  Generics can cost 30% to 80% less than brand-name drugs, and are just as effective and safe.  Ask your doctor if you can use one or if there are any other less expensive options.  And believe it or not, where you fill that Rx may make a difference.  There are discount plans, savings cards, mail-order pharmacies, and patient assistance programs to help with your medication expenses.  You just might find all sorts of savings out there.


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