15 Ways to Beat the High Cost of Medical Care

Even with insurance, out-of-pocket medical costs and prescription drugs can run up a hefty tab. Here's how to keep health expenses under control.

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. But there are ways to fight the high cost of medical bills and prescription medicines.

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 around 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 complicated operation, expertise will trump cost as a priority.

2. Take advantage of health insurance perks

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Under the 2010 federal health care law, also known as Obamacare, your insurance is required to provide free preventive care. Use it while you can. Republicans have made a few failed attempts to repeal or replace the Affordable Care Act since Donald Trump became president, and it appears technically possible for them to succeed in the near future.

If you get your insurance through an employer, watch for your chance to save money on premiums during your company’s open-enrollment period. Also, 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.

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 health care 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, when you call a medical provider’s office for prices or an appointment, confirm that the doctor or facility accepts your insurance carrier.

4. Skip the ER

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The emergency room should generally be a last resort. Not only do you get less personal service, but you stand 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, consider an urgent care center instead. The waits are often shorter than what you’ll find at the ER, and care tends to cost less.

5. Double-check bills

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Medical bills aren’t always accurate. According to the Medical Billing Advocates of America, billing errors occur in favor of the health care provider 80 percent of the time.

Errors can include charges for medications never administered and services never rendered, for example.

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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Taking care of your teeth is important to your overall health.

According to the Mayo Clinic, poor dental health may contribute to other health problems such as cardiovascular disease and endocarditis, an infection of the inner lining of the heart.

If you don’t have dental insurance, and find the cost of dental care daunting, look into whether you have a dental school in your area that takes in patients for free or cheap. It’s one of the many suggestions we offer in “How to Have Healthy Teeth and Avoid Crazy Dental Fees.”

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 on medical care by getting it in certain Latin American or Asian countries.

The most popular procedures include those that U.S. health insurance plans typically don’t cover, such as cosmetic surgery and weight-loss procedures, as well as cardiovascular and orthopedic procedures.

Of course, foreign physicians and clinics are subject to different laws and standards than those in the U.S. Carefully research those standards to be sure you are comfortable with the level of care you’d receive in another country.

8. Save your receipts

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Some medical and dental costs are considered federal income tax deductions in certain cases, according to the IRS.

These expenses must exceed 10 percent of your adjusted gross income (AGI), or 7.5 percent of your AGI if you or your spouse is 65 or older.

9. 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. You stand to save money and possibly save a doctor’s appointment.

10. Try generics

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Generics are one of the best ways to save money on medications — among many other things cheaper in generic versions.

Plus, there’s virtually no reason not to at least try a generic drug these days. The U.S. Food and Drug Administration’s [email protected] database enables you 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.”

Medications in the database have received a therapeutic equivalence code, also referred to as a “TE code,” from the FDA. Drugs that have a code starting with an “A” have been deemed therapeutically equivalent by the FDA, whereas drugs with a code that starts with a “B” are not considered therapeutically equivalent.

11. Consider paying out of pocket for drugs

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If your copay is more than $4 for a prescription, you might be overpaying.

Many pharmacies offer a 30-day supply of hundreds of generic medications for as little as $4, and a 90-day supply for $10. Ask your pharmacy for a list of the cheap generics it offers or check its website. For example, here’s a list of the $4 generics offered by Walmart.

If you find a medication you have been prescribed on one of those lists and it’s cheaper than your copay amount, pay for it out of pocket instead of using your health insurance.

12. Use reputable online pharmacies

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In the U.S., 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.

You can 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, a 50 mg pill might be more money per milligram than a 100 mg pill. So if you take a 50-mg dose of that pill each day, you could save money by taking half of a 100 mg pill each day rather than one 50 mg pill.

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 of a medication will get you a discount.

If this is true of your medications, nicely ask your doctor to write your prescriptions for larger quantities. Explain that it would save you money.

15. Don’t wait till the last minute to refill meds

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If you wait till you’re down to the last pill to ask your pharmacy to refill a 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.

How do you save on medical costs? Share with us in comments below or on our Facebook page.

Maryalene LaPonsie and Karla Bowsher contributed to this post.


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