A new year is here, and with it new opportunities to rein in
a major slice of the household budget: health care. It’s complex but being
proactive can pay off, experts say. Some of the best strategies for maximizing
health care at the lowest out-of-pocket cost include:
Plan for worst-case
scenarios during enrollment. Try to buy or sign up for as much coverage as
you can comfortably afford. The enrollment deadline for 2015 plans under the
Affordable Care Act is Feb. 15.
Karen Pollitz, senior fellow at the Kaiser Family Foundation,
advises asking yourself how much money you could come up with on short notice
without tapping retirement accounts or credit cards. If you don’t have your
plan’s out-of-pocket maximum in the bank, “you’re probably not overinsured."
Socking away extra money for emergencies helps. The average
deductible for individual coverage in job-based plans was more than $1,200 in
2014, according to the Kaiser Family Foundation. Remember that you could get
caught in end-of-the-year deductible double jeopardy, in which a medical event
that spans two calendar years, such as a pregnancy or cancer treatment, causes
you to owe two plan-years’ deductibles in rapid succession. Health plans reset
at the beginning of each plan year, typically Jan. 1.
Use cost estimate and
comparison tools. FAIR Health, a nonprofit data analysis group,
provides free tools to estimate medical and dental costs in your area and help
you determine what your insurance will cover if you go out of network. You also
can get free cost benchmarks by using Healthcare Bluebook. Some employers
contract with health-care software provider Castlight Health for similar
options.
Shop for cheaper
drugs. If you’re paying more than a few bucks for generic drugs, you
could be missing out. Discount programs at grocery, pharmacy and big-box chain
stores offer 30- and 90-day supplies of generic drugs for as low as $4 and $10,
respectively. Some programs charge an annual fee; others are free. Check for
restrictions.
Open your bills and
explanations of benefits right away. If they’re confusing, call your
insurer and straighten out any problems before bills go to collections, which
can hurt or ruin your credit. Remember that you can appeal a claim with your
insurer. If you can’t pay your share, call the provider and request a reduction
or extra time to pay it off in installments. Nonprofit hospitals are required
to offer some kind of help.
Don’t waste money on
unproven preventive strategies. That often means ditching vitamin
supplements, which studies say work only for a small subset of people. Spend
money on proven strategies such as exercise, maintaining a healthy weight and
eating right. Consume more fruits and vegetables and stay away from processed
food and simple sugars.
Avoid costly and
sometimes harmful overtreatment. Make it a habit to ask your doctor
what your options are and the risks and benefits of each. Do you really need
that EKG during a routine office visit, or a preoperative chest X-ray? The
American Board of Internal Medicine Foundation’s Choosing Wisely campaign can
help you start the conversation.
Find a doctor who’s a
good fit for you. A solid working relationship is crucial for people
with chronic conditions. Your doctor should care about you, understand your
life and act as a steward to help guard your pocketbook from excessive medical
expenses.
Know when to call an advocate. If you’re not getting
anywhere with a billing problem or a care question, a health-care advocate may
be a wise next step. Contact the National Association of Healthcare Advocacy
Consultants.
Use retail clinics
and urgent-care centers. Used appropriately for non-life-threatening
health needs, these are cheaper than hospital emergency departments.
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