From the editors of Goodhousekeeping.com
These days, we're all feeling squeezed when it comes to health costs and we're all looking for ways to save. Certainly, it's an imperative for the 47 million who have no health insurance at all. But it's also the case for the millions of self-employed people who buy their own health insurance, as well as for the 159 million Americans who are covered through their employer.
This year, the average employee on her company's group plan will still pay $3,597 in health-care costs, $331 more than in 2007, reports Hewitt Associates, a human resources company. Just over half of that $1,859 will go to her share of insurance premiums, with the rest covering deductibles and co-pays for doctor visits, lab tests, and X-rays, as well as prescription drugs and services that are not included in the health plan, such as dental care and eyeglasses.
Here are 15 cost-cutters that can put a big chunk of that money back in your wallet:
1. Ask for a freebie. If you're starting a new drug regimen, see if your doctor can give you a sample or a starter kit. That way, you can check whether the medication works for you and doesn't cause severe side effects before you invest in a month's supply.
2. Don't bypass your doc. Now that many health plans don't require a referral to see a specialist, it's tempting to skip the primary-care physician and go right to the dermatologist for a rash or to the orthopedist for a sprained ankle. But you may not need the specialist or his/her higher co-pay. "Insurers may charge as much as double ($30 versus $15 for a co-pay) to see a specialist," says Mila Kofman, superintendent of insurance for Maine.
3. Focus on the Web. A recent eBay search turned up 2,950 pairs of eyeglass frames, including Dolce & Gabbana ($79.99; retail, $125) and Gucci ($79; retail, $305). Try on frames at an optician's first, then look for the same or similar ones online. Ordering contacts from an Internet retailer like AC Lens (aclens.com ) can save you up to 30 percent on popular brands. A box of Bausch & Lomb's Softlens 38, which retails for $20.95, goes for $14.95 in an online four-box order.
4. Check out a discount card. Enroll in one of these plans and you get a hefty chunk off from participating dentists, doctors, and even hospitals. For example, Vital Savings, a plan from Aetna, offers savings of 50 percent on eye exams and 15 to 50 percent on dental care for a onetime sign-up charge of $15 and a monthly fee of $10.50 for a family. Be careful: The discount-health-card industry has attracted scam artists. Before signing up, try to check out the plan with your state insurance commission. And if you're especially attached to your doctors, ask whether they participate in any discount plans.
5. Stay covered. If you leave a job, you have the right, by law, to continue participating in your company's group health plan for up to 18 months. The program (COBRA) is expensive up to 102 percent of the cost of the policy, all of which you'll pay yourself. But it's cheaper than taking out a comparable private policy or than getting sick without insurance. Also, if you stay insured, your next employer can't deny you coverage because of a preexisting condition, explains Randy Boyle of the National Health Law Program. (Some states limit what employers can do, so check first.)
6. Take advantage of kid programs. Even if you can't swing insurance right now, every state provides health coverage and medical care to infants, children, and teens whose family income falls under certain levels. For information, call 877-543-7669 or visit insurekidsnow.gov.
7. Shape up. The simplest way to save money on health care is to stay well. Women who are extremely overweight have annual medical costs that are nearly 70 percent higher than normal-weight women, a study in the American Journal of Health Promotion found. Not fazed? Some employers, including Kellogg and Clarian Health, reward fit employees with reduced insurance premiums or deductibles (or other bonuses). At the Bank of Geneva in Indiana, for example, employees who choose to participate in the plan can earn up to $2,000 a year in supplemental insurance reimbursements.
8. Get a pro in your corner. When you've just been through a major illness, you may not have the strength to take on the medical establishment by yourself; a medical billing advocate can do it for you, getting you coverage when your insurer says no or reducing an exorbitant doctor or hospital fee. "We know the medical coding and billing guidelines and will intercede on your behalf," explains Nora Johnson, vice president of education and compliance for Medical Billing Advocates of America, a trade organization. These services charge by the hour ($25 to $75, depending on their location) or take a percentage of what they collect for you, usually between 20 and 35 percent.
9. Go to dental school. Most have low-cost clinics for the public. Relax (and open wide) the people wielding the drill are third- and fourth-year students, and they're supervised. Savings can be considerable: At the Ohio State University College of Dentistry, for example, a cleaning might be $53 to $65, compared to $75 to $90 for a Columbus-area dentist. A typical crown ranges from $450 to $700 at the clinic versus $800 to $1,110 in a private practice. To see if there's a dental school near you, check with the American Dental Association.
10. Say bye-bye to brand names. Sure, choosing a generic drug over a brand name can save you lots of money depending on what you take, you could enjoy a 52 percent cut in the daily cost of your medications, reports the FDA. But now there's another reason to go generic: Fill your Rx at one of the big-box retailers like Wal-Mart, Target, or Kmart, and you can get a month's supply for as little as $4 or a 90-day supply for $10 to $15. Costco doesn't have a monthly plan but does offer major savings. Or join the Walgreens prescription savings club: For a $35 annual fee, families can save significantly on more than 5,000 medications, including many generics available in three-month supplies for $12.
11. Sign on for wellness. You may be able to cut health-care premium costs sometimes by hundreds of dollars by participating in wellness programs at your job. Almost half of large companies now offer or plan to offer cash rewards or credits toward premiums to employees who meet certain healthy criteria for body mass index, take steps to lower blood pressure and cholesterol, or work out regularly.
12. Cut your co-pays on drugs. For prescription medications that you take regularly, ask doctors if they can write an Rx for a three-month supply. You'll make only one co-pay instead of three. And if you don't have drug coverage, consider ordering a 90-day supply of meds online. Drugstore.com advertises savings up to 75 percent over average retail drugstore prices; on a 90-day supply of Ortho Tri-Cyclen Lo, for example, you'll save about $20.
13. Get the best insurance deal. When it comes time to renew their health coverage, some 60 percent of employees just take the company's default plan or check the "same as last year" box, reports Hewitt Associates. That can be a costly mistake. If you and your husband are both eligible for health insurance through work, for example, it may be cheaper for one of you to take an individual policy and put the rest of the family on the other company's plan. Too much math? Your employer may have a Web-based tool to help you figure it out or you can speak to the staff in human resources.
14. Visit your drugstore's clinic. If you'd have to pay full freight for a doctor's appointment, or it's a weekend and using an ER would set you back a chunk per your insurance plan, in-store health centers can be a bargain. Located in many branches of CVS, Target, Wal-Mart, and other retailers, these clinics treat insect bites, minor wounds, ear and sinus infections, and other routine problems. They also administer vaccinations. Fees run about $40 to $65, depending on location and treatment (flu shots are often much less).
15. Pay up front. Some doctors are willing to provide a discount to patients who can fork over the whole fee at the time of treatment, research from Georgetown University's Health Policy Institute found. This was particularly true in cases where patients had seen the physician previously and now didn't have insurance, says Mila Kofman, formerly an associate research professor at the institute. Even hospitals may negotiate a lower rate for uninsured patients who pay right away. The downside, of course, is that you have to cover the entire bill; you can't go on a payment plan. (This practice may be referred to as "paying in cash," but it doesn't literally have to be cash; you can write a check or possibly use a credit card.)
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