Healthcare can be very expensive, and the insurance process can be unclear and overwhelming. The part I struggle with the most is the unknown when it comes to healthcare costs. It feels like I never know exactly what it’s going to cost me either the day of the office visit or weeks later through a bill in the mail. At a minimum this can make it tough for families to budget, but ultimately it might keep people from getting the care they need.
I am not claiming to have all (or any!) of the answers when it comes to healthcare. However, I do have an excellent guest post today by Rebecca Berens, MD with five tips on how anyone, regardless of their insurance situation, can make their money go further when it comes to healthcare. I learned a few tips from Rebecca’s post below, and I hope you do too!
Know your healthcare insurance plan
Insurance plans can be difficult to understand. There are a lot of specific terms that we do not use in everyday life, and research shows that more than half of adults don’t fully understand what they mean. This website has a good summary of the most commonly confused terms: Taking the time to read your plan carefully and understand what your financial responsibility will be for in-network vs. out-of-network care is crucial to avoiding a surprise bill later. I recommend double checking with the doctor’s office before your appointment that they are in network because sometimes the listing on your insurance company’s website is outdated.
Pro Tip: I also recommend that if you think blood work will need to be done, check with the doctor beforehand which lab they use and make sure the lab is in network also. If their lab is out of network, they can give you orders to bring to an in network lab.
Shop around to lower prescription costs
Apps such as GoodRx can allow you to search for your medication and find out the cash price at various pharmacies. You may find that you can save a lot of money by using a grocery store pharmacy instead of the one on the corner or vice versa. Sometimes the cash price for the medication is even less than your insurance co-pay!
Save the ER for true emergencies
If you are not having a true emergency, going to the emergency room is not the best place to get care, and it will cost you a lot more money! If you have symptoms of a minor illness such as a UTI, a cold, a sinus infection, or even a cut that might need stitches, call your primary care doctor’s office first. Most offices will have an after hours line where they can give advice over the phone and may be able to get you in for an appointment the same or next day to take care of the problem. There are several telemedicine companies that offer a similar service if your primary care doctor does not.
If you do need to go to an urgent care, it is a good idea to know ahead of time which ones are in network. I recommend asking your insurance company for a list or checking their website as soon as your get your new card so you won’t have to search for this information in the moment! Many urgent cares are not in network with insurance companies, and even if the facility is, the doctors may not be.
If you are having a true emergency such as chest pain, difficulty breathing, severe abdominal pain, or a major injury please seek care immediately at the nearest emergency room.
Use your FSA/HSA
A flex-spending account (FSA) allows you to reserve pre-tax money that can be used only for medical, dental, and vision care expenses. It does not roll over so make sure you use it by the end of the year!
A health savings account (HSA) allows you to reserve pre-tax money for these expenses as well, but it does roll over and can be invested. This allows you to save money for medical expenses in the long term without being taxed on this money. Some employers will provide matching funds into these accounts as well. Currently you are only eligible for an HSA if you have a high-deductible health plan. Switching to a high deductible plan may make sense for you if you are likely to spend less than your deductible for the year. This will provide you with lower premiums and the ability to save for these expenses. Check healthcare.gov for more information about these accounts and eligible expenses.
Consider joining a Direct Primary Care practice
Direct Primary Care (DPC) is a relatively new model of accessing primary care that many people are not familiar with. These practices provide access to virtually unlimited services for a flat monthly fee instead of charging fees for each visit.
These practices have smaller patient panels per doctor which allows longer appointment times as well as almost guaranteed same or next day appointment availability. They are usually smaller independent practices so you will build a relationship with your doctor at each visit instead of seeing a different doctor or practitioner every time.
Many of these practices also include virtual visits such as phone and video chat visits as well as text messaging. Discounts on lab work and imaging and in some states even office-dispensed medications are also available.
Patients often confuse DPC with “concierge medicine,” however most concierge practices charge a much higher annual retainer fee than the on average less than $100/month cost for DPC membership. Many concierge practices bill insurance and charge co-pays in addition to the retainer. Consumer reports called DPC one of their top 5 Smart Money Moves for 2019. You can find a DPC practice near you on this map.
Interested in reading more on the topic of health and hospitals? You can read my birth stories for both Adeline and Jacob, my breastfeeding journey, and my recommendations on what to bring to the hospital when you have a baby!