As employers try to cut the costs of providing health insurance to workers, they’re offering more high-deductible health plans. The premiums are lower, but you’ll pay $1,000 or more — sometimes a lot more — out-of-pocket 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? Here are 10 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.
The federal government offers a list of free procedures and screenings online.
Before you have a test or screening, check to make sure which costs are covered. Money Talks News founder Stacy Johnson found out the hard way that some of his annual physical examination was provided at no cost to him, but that 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. A few years ago, Consumer Reports found a 447 percent difference in the price when it surveyed stores for the cost of generic versions of five widely prescribed medications. Costco was the cheapest, CR said.
Also, see “10 Ways to Get Your Medications for Less.”
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 is charged. You don’t want to be quoted the so-called “chargemaster” rate normally used for people who don’t have insurance. The latter is likely much higher than the rate your insurance company has negotiated 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
With qualifying high-deductible plans, the Internal Revenue Service allows you to create a health savings account — a savings or investment account where you can deposit pretax earnings to spend on health care.
Any money and interest earned that you don’t spend remains in the account year after year. Many employers kick in some money too.
For 2016, an individual can set aside $3,350 in an HSA, while a family can set aside $6,750. Increase the number by $1,000 if you’re 55 or older.
For 2017, the numbers remain mostly the same, except individuals will be able to contribute an extra $50.
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.
That 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 not to go 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.
10. Work the system
NPR told the story of a man who met the $4,500 deductible of his plan when his appendix had to come out. After that, the insurance covered the cost of a nonemergency procedure he’d put off.
In some cases, you may still owe a copayment or coinsurance after you reach the deductible, but you’ll still pay for less.
Are you among the growing number of Americans with a high-deductible health plan? How has it worked for you? Let us know why by commenting below or on our Facebook page.