Even with insurance, out-of-pocket medical costs and prescription drugs can run up a hefty tab. Keep costs under control with these tips.
Health insurance helps make medical care more affordable — or at least prevents a serious health problem from bankrupting us — but it doesn’t make medical bills magically disappear. Most of us — whether on employer-sponsored plans or insurance coverage purchased through the Affordable Care Act insurance exchanges — still have plenty to pay out-of-pocket. If anything, the costs we pay on our own are climbing.
Fortunately, there are ways to fight the high cost of medical bills and prescription medicines and keep your out-of-pocket expenses to a minimum.
First, we would be remiss if we did not say the best way to save on your medical bills is to stay healthy. You know this, but for the record: Load up on fruits and vegetables, get outside and walk (or run or bike) every day, and say “No, thank you” to seconds at the buffet table. Being sedentary and overweight is hazardous to both your health and wallet. Prevention is worth a lot.
Beyond that, here are ways to save on out-of-pocket costs, emergencies and prescription drugs — expenses that can crop up no matter how hard we try to maintain good habits:
1. Shop around
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You wouldn’t buy a car or a plane ticket without shopping around, so why aren’t you also looking for the best deal for your medical care?
When you need routine care or a nonemergency procedure or scan, you have time to check prices.
Websites like Healthcare Bluebook can help you determine fair prices for procedures and services. But ultimately, you’ll need to pick up the phone and start calling to learn what’s being charged in your area.
Of course, you won’t be asking about prices in an emergency situation, and if you’re having a complex operation, expertise will trump cost.
2. Take advantage of health insurance perks
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Under the federal health care law, also known as Obamacare, your insurance provides free preventive care. Use it. Weed out small problems before they turn into huge health crises.
If you get your insurance through an employer, watch for your chance to save money on premiums during your company’s open-enrollment period.
Some employers pitch in a greater percentage of your premiums or contribute toward your deductible if you participate in health screenings or programs such as smoking-cessation classes.
Even if your employer doesn’t offer premium discounts, your health insurance policy may come with all sorts of bonus offers, ranging from discounts at the gym to coupon codes at partner websites.
For some pointers on shopping for an insurance plan, check out: “10 Common Mistakes to Avoid When Shopping for Health Insurance.”
3. Stay in your network
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While checking prices, make sure to stay within your insurance company’s network of providers. Going “out of network” can mean significantly higher co-payments. In some cases, insurers may refuse to pay anything on out-of-network services.
You likely can search for in-network providers on your health insurance company’s website. In addition, check with the medical provider’s office when calling for prices or an appointment to confirm the doctor or facility participates with your insurer.
4. Skip the ER
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The emergency room should always be your last resort. Not only do you get less personal service, but you also are likely to get hit with an outrageous co-payment. Under my insurance plan, it costs $150 to visit the ER compared with $20 for an office visit.
If you can’t wait to see your regular doctor, head to an urgent care center instead. The waits are usually shorter than what you’ll find at the ER, and care typically costs less.
5. Double-check bills
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Medical bills aren’t always accurate. Medical Billing Advocates of America estimates that billing errors occur in favor of the health care provider 80 percent of the time.
Common errors include charges for medications never administered and services never rendered. Sometimes patients are double-billed or charged for room items that should have been included as part of a stay.
Always request an itemized statement, and check it carefully. If you find a mistake, call your provider’s billing department to dispute it.
6.Get dental attention
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Are you taking care of your teeth? It’s important to your overall health.
According to the Mayo Clinic, dental disease may be linked to a host of health issues including cardiovascular disease, diabetes, endocarditis (infection of the inner lining of the heart), osteoporosis and even Alzheimer’s disease.
But many of us — about 108 million people in the United States — do not have dental insurance, according to the U.S. Department of Health and Human Services.
If you are among them, and find the cost of dental care daunting, find out whether you have a dental school in your area takes in patients for free or cheap. It’s one of the many suggestions we offer in this article: “How to Slash Dental Bills (and Keep Your Teeth).”
7. Consider medical tourism
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Traveling to another country for medical care might seem extreme, but it’s an increasingly popular option.
Medical tourism organization Patients Beyond Borders says consumers can save anywhere from 20 percent to 90 percent by traveling to destinations such as Costa Rica, Malaysia and India, Mexico and Taiwan.
The most popular procedures include those that U.S. health insurance plans typically don’t cover, such as cosmetic surgery, weight-loss procedures and fertility treatments.
Of course, foreign physicians and clinics are subject to different laws and standards than those in the United States. Carefully research those standards to be sure you are comfortable with the level of care you’ll be receiving in another country.
8. Inquire about over-the-counter medications
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A few types of prescription medications have over-the-counter competitors. It’s worth asking your doctor or pharmacist if your prescriptions have such alternatives. These drugs are often cheaper, and they might save you a doctor’s appointment.
For example, Consumer Reports recently reported that certain over-the-counter antihistamines are generally “equally effective at relieving symptoms” as prescription antihistamines.
9. Try generics
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Generics are one of the best ways to save money on medications.
Plus, there’s virtually no reason not to at least try a generic drug these days. The U.S. Food and Drug Administration’s “Drugs@FDA” database makes it easy to determine whether a generic is therapeutically equivalent to its brand-name version.
The FDA explains:
Drug products classified as therapeutically equivalent can be substituted with the full expectation that the substituted product will produce the same clinical effect and safety profile as the prescribed product. Drug products are considered to be therapeutically equivalent only if they … are pharmaceutical equivalents (contain the same active ingredient[s]; dosage form and route of administration; and strength.)…
Medications in the database have received a therapeutic equivalence code from the FDA and are divided into two main categories based on that code.
Drugs that have a code starting with an “A” are considered “therapeutically equivalent to other pharmaceutically equivalent products,” according to the FDA website. Drugs with a code that starts with a “B” are considered “NOT to be therapeutically equivalent.”
10. Consider paying out of pocket
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If your copay is more than $4, you might be overpaying.
For example, big-box stores like Target and Walmart and grocery stores like Kroger and Winn-Dixie offer a 30-day supply of hundreds of generic medications for as little as $4, and a 90-day supply for $10.
11. Check online prices
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Prices on the internet are often lower than those of brick-and-mortar pharmacies. Many reputable online pharmacies also offer free shipping.
Some stores with brick-and-mortar pharmacies have mail-order programs with free shipping. Costco is one example — and you don’t have to be a Costco member to use its mail-order online.
12. Use reputable online pharmacies
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In the United States, the Verified Internet Pharmacy Practice Sites program offers online pharmacies a chance to establish their legitimacy. To tell these pharmacies apart from others, look for the VIPPS symbol on pharmacy websites.
Also, use the National Association of Boards of Pharmacy verification website to look up an online pharmacy’s certification by entering its website address.
13. Check strength prices
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Sometimes the per-milligram cost of a medicine varies depending on the strength.
For example, HealthWarehouse.com currently sells a 30-day supply of all strengths of the common cholesterol drug Crestor for $243.90.
So, the per-milligram cost is as follows:
- 10-milligram strength: about 95 cents per milligram
- 20-milligram strength: about 47 cents per milligram
- 40-milligram strength: about 24 cents per milligram
If you take a 20-milligram dose, for example, you would save around 51 percent — about $145 per month — by getting 40-milligram pills and splitting them in half.
If you would save significantly by splitting pills, ask your doctor whether your prescriptions can be split safely.
14. Ask for a larger quantity
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At many pharmacies, purchasing a 90-day supply will get you a discount.
If this is true of your medications, nicely ask your doctor to write your prescriptions for larger quantities. Explain how it would save you money.
15. Don’t wait till the last minute
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If you wait till you’re down to the last pill to ask your pharmacy to refill the prescription, you’re limited to brick-and-mortar pharmacies unless you pay extra for expedited shipping.
The free shipping option offered by online pharmacies generally takes at least a couple of days.
16. Save your receipts
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Prescription drugs that you purchase for yourself, spouse or dependents are considered federal income tax deductions in certain cases, according to the IRS website.
Your total deductible medical expenses must exceed 10 percent of your adjusted gross income, or 7.5 percent of your AGI if you or your spouse is 65 or older. (The latter percentage is only available through December 2016, however.)
How do you save on medical costs? Share with us in comments below or on our Facebook page. And share this story with family and friends who are looking for ways to reduce their medical expenses.
Maryalene LaPonsie and Karla Bowsher contributed to this post.