How to Make the Most of That New Health Plan You Just Bought

Health Insurance

August 20, 2019

How to Make the Most of That New Health Plan You Just Bought 

In your quest for affordable coverage, you may have selected a different health plan for this year than the type that you’re used to having. This may mean that you went with a short term plan instead of major medical insurance, or it could mean that you opted for a high deductible insurance plan. Whatever the case may be, you’ll get the most out of that new plan if you learn to maximize the affordable health coverage. 

Get to Know Your Network

Seeing an out-of-network provider when an in-network provider would do is like throwing money away. Most insurance companies pay for a much lower portion of your care when you receive it from an out-of-network provider. In fact, some don’t cover a single cent of an out-of-network bill.

Before any test or treatment, it’s smart to double-check whether the provider is included in your insurance plan’s network. Even if you’re receiving care at an in-network hospital, it’s possible that not all of the providers are covered by your plan. Check into each one before you receive care if possible, and ask for a different provider if necessary.

Even though many short term plans don’t restrict you to a particular local network, they often pay more for care received from preferred providers. Try to use those preferred providers whenever possible. 

Visit the Right Facility

Your new insurance plan might cover visits to both your primary care physician and the emergency room, but it probably doesn’t cover them to the same extent. You’re likely to face an unnecessarily large bill if you go to the ER for a problem that could have been taken care of with an office visit or a trip to an urgent care center.

If your short term health plan covers emergency care but not regular doctor visits, you might be tempted to stop in at the ER to have your scratchy throat examined. That’s a bad strategy unless you’re also experiencing life-threatening symptoms, like unexplained stomach pain or the worst headache of your life. It’s usually cheaper to pay the full bill for an office visit than it is to pay the deductible and coinsurance for services received in a hospital setting. 

If it’s after hours or your doctor can’t fit you in, try a retail pharmacy clinic or an urgent care center. These places will still cost much less than the ER, and your health plan likely covers them both to a certain degree.

Compare Prices for Procedures

Plans with broad provider networks give you the freedom to choose where you receive care. That can help you save money on health plan costs. Charges for the same procedure can vary widely from one provider to the next, so shop around for the best price if you’ve got the time. A planned surgery, for instance, gives you time to seek out a second opinion or find a surgeon who charges less. Price doesn’t always have anything to do with quality, either. Just because a surgeon charges less doesn’t mean she’s a subpar surgeon. Healthcare pricing is, honestly, a complete mystery sometimes.

This tip for how to cut medical costs is especially useful if you have an expensive procedure coming up. A 10 percent savings on a $100 office visit is nice but not essential, whereas a 10 percent price difference on a $20,000 knee replacement will keep thousands of dollars in your pocket. 

Get Smart About Prescriptions

Just as you should compare healthcare providers’ prices, you should also compare prices among pharmacies. The same prescriptions may be quite a bit higher at one pharmacy than at another place just down the street. Some grocery and chain pharmacies offer common generics for just a few dollars. In those instances, it may be best to pay the cash rate instead of your insurance plan’s drug copay. 

Walmart sells a variety of 30-day generic prescriptions for just $4 – drugs for everything from asthma and allergies to thyroid function and high cholesterol. Grocery chain Publix even has a list of select generic medications that don’t cost anything and don’t require a paid subscription membership.

To save on drug costs, you can also join a prescription discount program through a pharmacy or an independent company. Members of these programs show their membership cards or coupons to receive lower prices on many medications.

Finally, look into the option of getting a 90-day supply of your regular medications. Although it seems like a 90-day supply should cost you three times as much as a 30-day supply, that’s not always the case. You may save money buying in bulk, especially at places like Sam’s Club or Costco. These warehouse chains require a paid annual subscription, but you may find that the cost savings outweigh the membership fees.

Find Out What’s Free

Insurance companies aren’t always completely forthcoming about how to use your health insurance to its full potential. If you spend some time exploring your plan’s benefits, you might learn that there are a number of services that you can get for free or cheap, even if you haven’t yet met your high deductible.

For example, all health plans that meet the standards of the Affordable Care Act, even high deductible ones, must cover preventive services, such as screenings and vaccinations, without any copays or cost sharing. Although that’s not the case with short term health insurance plans, some do allow you to see your primary care physician a few times for only the cost of a copay.

Your plan may offer other options for affordable healthcare as well. For example, you may have access to a 24/7 nurse line that you can call with medical questions instead of having to pay for an office visit. Your health plan may also include health-management programs, discounts on fitness memberships or incentives for being active. These benefits will save you money in the short term and could help you mitigate future medical costs, since the healthier you are, the lower your risks for complicated medical problems as you get older.

Don’t Put Off Treatment

When you’re wondering how to save money on medical costs, it can be tempting to avoid incurring any doctor bills. It might seem that not using medical services is the best way to keep your costs in check. 

Unfortunately, this plan can really backfire on you. It’s smart to get preventive care and to seek treatment while problems are still mild. If you wait until your medical issues have escalated or symptoms become unbearable, you’re much more likely to need expensive care, such as hospitalizations or surgeries, in order to get the problems taken care of. When that happens, you’ll wish you had spent $200 on an office visit instead of $2,000 or more on a pricey procedure. 

Ask Your Doctor for Tips

Doctors don’t typically discuss costs with patients, especially when it comes to prescriptions. They usually have office staff who can answer questions about cost. But when it comes to specific procedures or a medical course of treatment, speak up with your doctor if cost is a concern.

If your doctor orders an expensive test, for example, don’t be afraid to ask if there’s a cheaper option available or a less invasive (i.e., less expensive) procedure that could help with the diagnosis he’s considering. Instead of exploratory surgery or a needle biopsy, comprehensive lab work could give your doctor all the information he needs. There is the potential that this approach might lead to more costs – abnormal blood work could call for even more expensive testing – but it might be worth the risk to avoid additional costs depending on your situation.

When your doctor writes you a prescription for a new or name-brand drug, you can ask whether there’s a similar drug that would be cheaper but just as effective for your condition. Your provider’s office may even have samples on hand to give you. 

Double-check Before You Pay

Billing mistakes are more common than you might think. Always review a medical bill before you send in a payment. For one thing, your bill might include treatments you didn’t receive. For another, coding errors can cause insurance companies to deny payments for procedures that should be covered.

If you have any questions about your bills, contact the medical provider or the insurance company to straighten out the situation. Even if you find out that the billing was accurate, while you’re on the phone, you may be able to request a discount or a payment plan from the biller. Some providers have hardship or charity programs for patients with limited income, so don’t be shy about asking for help if you need it. Providers want to get paid. They’ll work with you to recover what you owe.

Having affordable coverage shouldn’t mean that you have to skimp on taking care of yourself. Instead, learn how to use your health insurance wisely, and you’ll find that you can save money on medical costs while still prioritizing your health and wellbeing.