Americans still spend thousands of dollars annually on their health care, even though employers pay a significant portion of the cost. According to the Kaiser Family Foundation, workers who have employer-sponsored health insurance pay $1,243 per year for single coverage and $5,588 per year for family coverage. For single coverage, the average annual deductible is $1644, while family coverage can have an overall deductible of less than $2,000. The annual out-of-pocket limit can run into the thousands. These 20 money-saving tips can help you to reduce the stress of high healthcare costs.
Stay in Your Health Insurer’s Network
You’ll be charged more if you go to a provider outside your plan’s network. You may be eligible for some coverage for care outside of your network if you have a preferred providers organization (PPO). You’ll most likely have to pay the entire cost if you have a health maintenance organisation (HMO). You can search online for providers within your insurance network using the tools provided by your insurer.
Federal law requires that insurers cover “surprise” medical costs at in-network rates starting in 2022. This is when patients are unknowingly treated by out-of-network providers in an emergency. If you visit an innetwork facility but see a provider (e.g., an anesthesiologist or physician) that is not in your network, you may be charged a surprise fee. You can appeal any unexpected bills you receive to your insurance. Many states also have laws that offer some protection from unexpected medical bills.
Take advantage of preventive-care services
Even if your deductible is not met, most health insurance plans will cover preventive services. These include immunizations, blood-pressure screenings, cholesterol and diabetes screenings. www.healthcare.gov/coverage/preventive–care-benefits has a complete list. Some treatments for chronic conditions such as diabetes or heart disease may be covered by high-deductible plans. However, this is before policyholders reach the deductible.
Telehealth – Tune in
During the pandemic, video chat and phone consultations with clinicians have grown exponentially. Anne Brunson, benefits administrator Maestro Health, said that it is possible to save money by having your insurance company partner with a vendor such as Teledoc. Virtually visiting your regular care provider will cost you the same as an in-office visit, but some insurers may lower or waive your co-payments.
Make an appointment after you have met your Deductible
You can squeeze in appointments that are necessary to meet your insurance deductible before the plan year ends. You could be responsible for the entire cost of your insurance deductible next year.
Employer Perks: Don’t miss out
Your employer could make contributions to your flexible spending account or health savings account. Some employers will match your contribution, while others may require that you participate in a program for wellness to be eligible to receive funds. You may also be eligible for free access to weight-management or smoking cessation programs. You may also be eligible for incentives such as a reduced monthly premium by participating in these programs.
Contribute to the Health Savings Account
For 2021, if your high-deductible plan qualifies, you can contribute up to $3,000. If you have self-only coverage, or $7.200 if family coverage, plus $1,000 in catch-up contribution for people 55 years and older. The account is pretaxed or tax-deductible money. It grows tax-deferred and can be withdrawn tax-free for eligible medical costs.
Stash Money in a Flexible Savings account
You may be eligible to contribute up to $2,750 to your employer-sponsored FSA for health care. The money can also be used tax-free to pay for qualified medical expenses. Employers may permit employees to transfer a small amount of unutilized funds to the next plan year or offer a grace period of up to two and a quarter months to use funds from the previous year. Employers may allow employees to rollover unlimited amounts between the 2020 plan year and 2021. Employers can also extend the grace period for 2020 plans and 2021 plans up to 12 months.
Get more FSA-eligible expenses for HSA and FSA members
HSA and FSA money can be withdrawn tax-free to cover deductibles, co-payments, or coinsurance. You also have the option of using it for eyeglasses, medical monitoring, testing devices, orthodontia. You can use funds without a prescription for over-the counter drugs, such as pain relievers and cough suppressants, as well feminine-hygiene products.
Your HSA can help you save for retirement
HSA funds are non-expirable, which makes them a great way to stash money for future medical expenses. HSA eligible premiums are available for Medicare Parts B and D, Medicare Advantage plans, but not supplemental policies. Long-term-care insurance premiums are also eligible (up to certain limits), as well as expenses for home improvements that accommodate medical conditions, such as widening doors or adding support bars.
Deduct medical expenses
You can deduct qualified medical or dental expenses if you itemize deductions on a tax return. These include prescription drug costs, payments to doctors and other medical expenses that exceed 7.5% of your adjusted income. For more information, see IRS Publication 502. Medical and Dental Expenses.
Switch to generic or alternative drugs
Ask your doctor to prescribe generic versions of your medication if they are available. Or ask your pharmacist to change to generic drugs at the counter. Generics can cost up to 85% less than the brand-name medications. Ask your doctor if there are any generic drugs that might be available for you. Also, check with your insurance to see if they are covered at a lower rate.
Get 90-day drug refills
You can save money on maintenance medications you take frequently by ordering 90-day supplies instead of 30-day refills. Walmart charges $4 for 30 days of certain generic medicines without insurance and $10 for 90 day supplies. Mail-order medication, which are often available in 90-day supplies, can help you save money.
Compare Drug Prices to Get Discounts
Sites such as GoodRx.com or SingleCare.com allow you to enter the name and zip code of your medication. This will give you a list of nearby pharmacies and coupons. Sometimes, the cash price for a coupon is lower than what you would pay with insurance. Some pharmacies offer discounts through their own programs. Walgreens Prescription Savings Club ($20 per year for individuals, $35 for families) offers discounts up to 80% on cash drugs prices. NeedyMeds.org has information about drug discounts and assistance programs.
Coupons and discount programs are often not allowed to be used in conjunction with insurance. A drug purchase that includes a coupon or discount program will not count towards your deductible unless your insurer permits you to submit the purchase later. The pharmacies might not be able monitor dangerous interactions between drugs if you switch pharmacies or bypass your insurance.
Compare Care Costs
Comparing the prices of procedures at different facilities can help you save big. Healthcare Bluebook’s Michael O’Neil says that outpatient services, such as x-rays or MRIs, are typically more expensive than those performed at hospitals. Healthcare Bluebook collects data on pricing for health care. O’Neil estimated that he saved approximately $10,000 by asking his doctor to order scans and have the procedure performed at a clinic not affiliated with his local hospital. An urgent-care center is often less expensive than going to the emergency room.
www.healthcarebluebook.com offers a free tool to estimate fair prices for a variety of procedures. The tool was unavailable recently while it was being redesigned, but should be back online by July. www.fairhealthconsumer.org allows you to see both uninsured and in-network pricing estimates for the procedures you are interested in. New federal regulations require hospitals to publish pricing information on their websites.
Recover your Health Insurance Plan
Review your options during each open enrollment period. You may find that a plan offering a lower deductible, premium or network, or a drug formulary, is more cost-effective, especially if you have changed in your family’s health. You have an opportunity to switch or enroll in the HealthCare.gov plan if you are a member of the exchange.
Medicare beneficiaries should also reevaluate their plans. Boomer Benefits’ Danielle Roberts says that Part D drug plans are subject to revision by insurance companies. This means that each year their benefits, premiums, and co-pays change. You may decide to switch to a Medicare Advantage plan that includes all the benefits. To shop for Part D or Advantage plans, visit www.medicare.gov/plans-compare
Get help choosing a plan
An agent or broker who is knowledgeable can help you navigate the various plan options without additional charge. If you are looking for an agent/broker to help you purchase a plan in the individual marketplace, visit https://localhelp.healthcare.gov. www.shiptacenter.org Medicare beneficiaries can get local assistance and counseling by selecting their state.
Check if you are eligible for financial assistance
You may be eligible to receive financial assistance to cover medical expenses if your income falls below certain levels. Medicare.gov provides information about Medicare’s programs. Extra Help helps to pay prescription drug expenses for people with limited incomes and resources. The Medicare Rights Center’s Casey Schwarz says that some programs have higher income thresholds. New York’s Elderly Pharmaceutical insurance Coverage program offers assistance to married Medicare beneficiaries who have incomes up to $100,000 (or $75,000 if you are single).
Ask about Cash Pricing
O’Neil suggests that you ask your provider to quote the lowest price for patients who are not insured. If you have a large deductible you don’t anticipate meeting before the year ends, it may be less than the insured rate. Sidestepping insurance might be worth it.
Examine Bills and Insurance Explanations for Benefits.
You should verify that your insurance covers medical expenses properly and that you have received all the medications and services listed on your bills. Request an itemized bill detailing each fee for complex procedures or hospital visits. Ask for a correction if you find a problem. Brunson of Maestro Health noticed once that she was charged with intravenous fluids she had never received in an emergency room visit.
Increase Medicare Premiums
If your modified adjusted gross income from your tax returns from the past two years exceeds certain levels, you will be charged an “income-related month adjustment amount” (IRMAA). This is added to your Medicare Part B or Part D premiums. An additional charge will apply for 2021 if your 2019 income exceeds $88,000 on an individual or $176,000 jointly. You can request an adjustment of your IRMAA if your income has dropped due to a major life-changing event by submitting Form SSA-4 to the Social Security Administration.
