23 Ways to Save Money on Health Care
Find the best plan
1. Bargain-shop for the right plan.
When selecting a health plan, don't just choose the one with the lowest monthly premium or the one you used before. Benefits can change significantly every year-as can your family's health needs. The best way to bargain-shop: Jot down your family's average number of doctor visits per year, routine prescriptions, dental cleanings, and other services. Compare what you'd pay over an entire year for these items on each plan. Don't forget to include monthly premiums and deductibles.
If your employer offers health insurance, make sure you look through all the options available and choose a plan based on what you really need. "The language can be complex, and plans can look the same," Maria Goy, co-founder of Spot, a company that offers low-cost injury insurance, tells Parents. "Be sure to understand what your deductibles cover, including medications. If they offer someone to talk to about health plan options, consider taking them up on the conversation."
2. Consider an HD plan.
If your family is healthy and doesn't visit the doctor too often, a high-deductible (HD) health plan can save you hundreds of dollars per month in lower premiums.
Another benefit: Most HD plans qualify you to open a health savings account (HSA), where you can sock away (on a pretax basis) money to pay your insurance premiums and out-of-pocket health expenses. Better yet, unused HSA money continues to grow tax-deferred, year after year. An HD plan might not be right for you, though. "You need to make sure you understand that you are responsible for all costs until your deductible is met-which can be a lot," says Goy. If family members have chronic (and costly) health conditions, you're not disciplined about saving money in your HSA, or if having such a high deductible makes you uneasy, then an HD plan might not b the best move. Make sure you know what your HD plan covers, as some plans may not cover certain types of accidents.
3. Join the farm bureau.
Believe it or not, you don't need to be a farmer to join your state's farm bureau. Simply by paying an annual membership fee (usually less than $50) you're eligible for all sorts of benefits-including discounted group health insurance in some states. If you or your spouse are self-employed, this might work for you. For more information, look up your state's farm bureau to see what benefits are available to you.
4. See if you have any subsidies available.
Depending on your income level, the government may be able to pay a portion of your health insurance coverage under the Affordable Care Act. The ACA Health Insurance Marketplace that re-opened in February allows those who qualify to enroll until August 15, 2021. If you qualify, you may be eligible for premium tax credit or cost-sharing subsidies-if you're eligible, the tax credit can cover the premiums for your health insurance, if purchased through the Health Insurance Marketplace. Find out if you qualify for a subsidy at Healthcare.gov.
Maximize your coverage
5. Take advantage of extras.
Your health plan may offer valuable services you don't hear much about, so poke around its website to learn what's available. Some carriers, for example, have nurses on call 24/7. They can tell you how to safely remove a splinter or whether or not your child's cold symptoms warrant an immediate doctor visit (and another co-pay, ka-ching!). Some plans also offer discounts on acupuncture, gym memberships, massage treatments, and weight-loss programs.
6. Look for special services.
Many health plans have programs for patients with ongoing conditions, such as asthma or allergies, including discounts on preventive care, helpful newsletters, and more. Springfield, Ohio mom Jaimee Starr has a son with asthma who gets chronic bronchitis in the winter months. After talking with her health-plan representatives, Starr learned she could buy a home nebulizer from them for just $55 instead of renting one from her pharmacy for $180. Health plan reps also steered her to a drugstore that offered lower prices on her son's asthma medication. See if your own insurer offers advocate programs, like United Healthcare's Advocate4Me, to help you navigate your health insurance and get the treatment you need at a lower cost.
7. Flex your spending.
If your employer offers a flexible spending account (FSA), you'd be nuts not to use it. FSAs are tax-sheltered accounts that you can use to pay for out-of-pocket medical costs such as office and prescription co-pays. Reader Lisa Chavez-Melo, a human-resources professional in Albuquerque, New Mexico, suggests "guesstimating" what you'll spend on medical expenses each year and putting about 20 percent less into your account so you don't have to worry about scrambling to find last-minute ways to spend it before it disappears. (FSAs are a "use it or lose it" plan and the money must be used within the year.) Some good ways to spend that last bit of FSA money: replacement glasses or contacts, and dental cleanings.
8. Read bills carefully.
Carefully review your medical bills. Something as simple as an incorrect billing code could prompt your insurance to pay less than expected or even reject your claim. If you don't understand a charge, ask for clarification. "Understand your Explanation of Benefits (EOB), which is essentially a receipt from your insurance company explaining what they paid for," says Goy. "Be sure to confirm the EOB matches your bills." Other common errors: mistakes in an account number, claims with incomplete information-even claims sent to the wrong insurance-company address by a doctor. Read your benefits booklet carefully to make sure your plan is paying all it should. If you catch an error, send a certified letter to your insurer. Follow up in a few weeks to make sure the mistake is corrected.
9. Don't accept "no."
If your insurance company won't pay for a service you think you deserve, don't just give up. Appeal the decision. If you're denied again, contact your state insurance commission. That agency can mediate a dispute between you and your insurance company. If you win, you could save yourself hundreds, or even thousands, of dollars.
10. Remember to network.
When making an appointment, always double-check that the doctor is still in your insurance plan's network. (Many come and go.) And ask to see in-network providers when you go to the hospital or an urgent-care center. Just because a facility participates in your plan doesn't mean every professional (the nurse-practitioner or radiologist, for instance) does. Also, if you need to see a doctor when you're out of town, call your insurance provider's toll-free phone number to find out the best way to get services that will be covered.
Discuss options with your doctor
11. Have your doctor help you.
Get a copy of your insurance company's list of covered prescription medications (a "formulary") and share it with your doctor. Many insurers separate drugs into several pricing tiers, so some medicines cost you more than others. When your doctor writes you a prescription, make sure to ask for the generic version.
"Generic medications can save you a considerable amount of money," Ramzi Yacoub, chief pharmacy officer at SingleCare tells Parents. "It's always worth consulting with your doctor or pharmacist to take advantage of these cost savings opportunities." If your doctor knows what's on your insurer's list, they can select the best medication for you at the lowest price. Also, if your plan requires you to get a referral to a specialist, take your insurance plan's preferred-provider list to your primary-care appointment. Your doctor can easily pick out the best specialist who participates in your plan.
12. Be up front about finances.
Are you short on cash? Do you have a high insurance deductible? Don't be embarrassed to tell your doctor. They may be able to suggest less-costly treatment options or even agree to lower fees. "Try to negotiate the fee you pay before or at the time you make your appointment and/or offer to pay cash," suggests Ruth Linden of Tree of Life Health Advocates. "Some physicians will agree to accept a reduced rate, if you inform them you are experiencing difficult financial circumstances." In fact, according to a report on Bills.com on negotiating medical bills, 40 percent of people who ask for a discount get one.
13. Slice your pills.
Believe it or not, many high-dose prescription pills, from allergy meds to antidepressants, require exactly the same co-pay as their lower-dose counterparts. Ask your doctor whether you can safely split a higher-dosage pill in half, so you can cut your costs too (you can't do this with controlled-release medications).
14. Ask for samples.
Your doctor's cupboards are full of free drug samples, courtesy of the pharmaceutical industry. If your child is getting shots, ask for a trial-size pain reliever in case he needs it later. If you're trying a new antibiotic or rash cream, your physician may even have enough samples to cover your course of treatment. Also, check out the drug company's website, which sometimes offers coupons or free samples.
15. Look for help to lower prescription costs.
"Find out if your medication is available through a patient assistance program (PAP)," Linden says. "PAPs help lower-income patients receive free or low-cost medication-even patients who may already have prescription drug coverage. Eligibility for a PAP may depend on several factors, including your income and the amount of your copay for the drug in question, if you have prescription drug coverage."
You can also compare prices with websites like GoodRx and SingleCare; look up your prescription to get coupons or find where you can it at the lowest price. Yacoub suggests buying in bulk: "Extend your prescription fills to 90 days if possible. A 90-day refill can cost less than filling one month's supply at a time." A study published in the Journal of the American College of Cardiology found that larger refills can also increase adherence to medication, lowering the chance of hospital admission.
Take preventative measures
16. Get regular checkups.
Don't skimp on checkups! Under the Affordable Care Act, all preventative care visits with providers in your network are free, allowing you to keep tabs on your family's health and potentially head off any underlying health issues. This includes annual physical, annual OB-GYN checkups, and mammograms, and annual checkups for your kids, too. You can find more information on preventative care visits at Healthcare.gov.
17. Stay up to date on vaccinations.
Getting vaccines on time will also lower your child's risk of illness-and your risk of facing high medical bills.
18. Watch your head.
Make sure you and your kids wear helmets when you ride a bike, a scooter, or a skateboard, since most serious injuries are the result of falls.
19. Get in a lather.
Americans plunk down big bucks every year on cold remedies and flu treatments when the best preventive medicine is plain old soap and water. Teach everyone in the family to scrub their hands for about 20 seconds before eating, after playing outside, or after being in contact with someone who's already sick.
20. Steer clear of the ER.
Never use the emergency room as a substitute for your regular doctor. You'll pay much more, and you'll probably wait longer to be seen, says Parents advisor Alice Domar, PhD. If your child feels lousy on a Friday morning, make an appointment with the doctor for that day so you don't end up in the ER over the weekend. If it's not a life-threatening issue, an urgent care facility may also be able to help you at a reduced cost and wait time.
21. Skimp on supplements.
Not all supplements are effective or safe-so make sure you research and check with your doctor before spending money on a bunch of vitamins that might not help you. A 2020 blog post by Penn Medicine says that while there is evidence that some supplements do contribute to overall health with little to no risk, others aren't that effective and can sometimes be harmful if they interact negatively with other medicines you're taking.
22. Sign up for rewards.
Join ExtraCare Pharmacy & Health Rewards and get a $5 Target coupon for every 10 prescriptions you fill with CVS Pharmacy at Target. Members can earn up to $50 in rewards during each calendar year.
23. Keep an eye on discounts.
Remember that you don't have to buy glasses or contact lenses from your optometrist or ophthalmologist. Federal law requires them to give you a copy of your prescription so you can buy lenses anywhere you like. Even if you don't have vision coverage, insurance providers may offer discounts on glasses or contact lenses. If not, look elsewhere: Some Automobile Association of America policies include eyewear discounts. Warehouse clubs and online retailers also offer deals.