9 Ways to Maximize a High-Deductible Health Plan

High-deductible health insurance plans can make consumers living on a tight budget nervous.

As employers try to cut the cost of providing health insurance to workers, they’re offering more of these types of plans. The premiums are lower, but you’ll pay a lot of money out-of-pocket — typically thousands of dollars — before the insurance coverage kicks in.

High deductibles also are the rule for many plans available on the federal and state health insurance marketplaces created under the Affordable Care Act.

How do you get the best use of this kind of coverage while also keeping costs down? Here are several tips.

1. Claim your freebies

Under the Affordable Care Act, certain preventive health services are available to you at no cost, even with a high-deductible policy. Make sure the doctor’s office or hospital accurately codes any such procedure you have. That way, the insurance company will know it’s one of the free services and will cover the cost.

A list of free procedures and screenings is available online at the federal health insurance marketplace, HealthCare.gov.

Before you have a test or screening, check to make sure which costs are covered. Many years ago, Money Talks News founder Stacy Johnson found out the hard way that while some of his annual physical examination was provided at no cost to him, much of the rest was not.

2. Ask for a discount

Tell your doctor’s office or the hospital that you have a high-deductible plan and ask if there’s a discount for paying cash. You may even find that a doctor will give you a considerable discount if she knows you have to cover the entire cost out-of-pocket.

If you can’t afford to pay, ask the doctor or hospital for a low- or no-interest installment plan. Some still offer them.

Needless to say, you should ask whether a less expensive, alternative treatment is available.

3. Save on medications

Ask your doctor if a generic exists for the drug he or she wants to prescribe. If so, don’t stop there — shop around. Sometimes, you can save a huge amount of money simply by purchasing a generic drug from the right pharmacy.

For more, check out “5 Ways I Slashed My Drug Costs up to 50%.”

4. Compare prices of medical providers

Hospital prices across the country vary wildly for the same procedure. While cost shouldn’t be the sole basis for selecting a health care provider, it should be part of your process.

When you call around to compare prices, make sure you identify your insurance company so you’re quoted the rate it would be charged. Chances are good that your insurance company has negotiated lower costs with the provider.

5. Stay in your network

Even if you’re paying out-of-pocket thanks to your deductible, you’ll typically pay the lower in-network rate if you stick with the health providers in your insurance plan’s network.

6. Open a health savings account

If you are signed up for a qualifying high-deductible plan, the Internal Revenue Service allows you to create a health savings account — a savings or investment account into which you can deposit pretax earnings to spend on health care.

Any money and interest earned that you don’t spend remains in these accounts year after year. Many employers kick in some money too.

In 2020, an individual can set aside $3,550 in an HSA, while a family can set aside $7,100. Increase the number by $1,000 if you’re 55 or older.

For more on this topic, check out “3 Ways a Health Savings Account Can Improve Your Finances.”

7. Have a super-solid emergency fund

It’s asking for trouble to buy a high-deductible plan without having money at least equal to the deductible in a savings account or HSA.

Such a healthy emergency fund will keep you from racking up interest on the unpaid balance you owe to the local hospital or clinic, or prevent you from putting your bill on a high-interest credit card.

8. Keep good records

Keep copies of all your medical receipts, just in case the insurance company makes an error.

9. Do some research

It’s unwise to avoid going to the doctor when you have a problem. But you don’t need to see a professional for a simple case of the sniffles. Many insurance providers have online information and nurse advice lines that can help you understand symptoms.

Of course, if any of this feedback indicates that you require care, don’t delay. Waiting to see a doctor could end up costing you substantially more if the condition worsens.

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