10 easy ways to stop overspending on healthcare
TRANSCRIPT
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TABLE OF CONTENTS
Introduction 1: Seek preventive care 2: Enroll in a high-deductible health plan (HDHP) 3: Sign up for a health savings account (HSA) 4: Create and maintain a personal health record (PHR) 5: Read, explore, and question your diagnosis, doctor, and medical bills 6: Use an urgent care facility instead of the emergency department 7: Use generic drugs 8: Use a prescription medication price transparency tool 9: Explore employee wellness programs 10: Use a comparison shopping tool
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Learning about the healthcare industry isn't easy. It's taken me years to gather working knowledge, mostly because the healthcare industry—insurance, bills, deductibles, CPT codes—isn't interesting, or that simple.
And who has time?
Unfortunately, I learned about our stealthy healthcare industry the hard way.
10 easy ways to stop overspending on healthcare!
Want to avoid the same costly mistakes I made? Then check out these…
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THE HARD WAY
This year when I went for my physical, I told my primary care doctor I was feeling pretty tired all the time, so he decided to order a lab test to check my thyroid levels. Just like in the past, my doctor referred me to a lab facility affiliated with the primary care office and the hospital right down the road. And just like in the past, I went to the referred, affiliated facility and had my lab work done.
THAT WAS MY FIRST MISTAKE.
It turns out that whether it's a test or procedure, big or small, prices on medical care can vary up to 10x, even within the same town!
When my bill arrived 3 weeks
later, I was charged $286! For a simple test!
"Whether it's a test or
procedure, big or small,
prices on medical care
can vary up to 10x, even
within the same area!"
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Of course, out-of-pocket costs did matter to me more now that I
had a high-deductible health plan, which I had just recently enrolled in.
AND LET ME TELL YOU, IT'S REALLY MESSED UP.
So now, with more skin in the game, I needed a way to find out what my out-of-pocket costs would be before I went to have a test or procedure done, so I could be financially prepared for future medical bills.
Comparison shopping is so easy in every other industry.
I researched, talked to friends, and consulted family members about what I could do to save on out-of-pocket costs. I had the best luck researching online.
When you're responsible for more out of pocket, you start thinking like a consumer.
It was this type of health plan that gave me the wakeup call I needed about how pricing in the healthcare industry really works.
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AND WHAT I FOUND WAS UNBELIEVABLE.
First, I came across a few articles talking about how prices vary from medical facility to medical facility.
My online research brought me to some medical pricing
sites. Here's the kind of information they provided:
Average pricing for a few dozen common procedures (although not my common lab test)
Pricing for different urban areas, but not for rural areas
No quality data
I thought with all the tech we have today, there had to be a way to compare pricing for different facilities without calling each facility separately.
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Then I tried a few more sites and finally found what I was looking for. This site had all the information I needed! It had:
SO WHAT WAS THE NAME OF THIS SITE?
Cost information for virtually every medical test and procedure
Quality information
Cost and quality information for facilities everywhere—all I had to do was enter my zip code
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Now that I had finally found a comparison shopping tool with all the information I needed, I searched for how much a thyroid lab test would cost at facilities in my area.
So how much could I have paid for that test instead?
I could've saved $176 on a simple test!
Don't believe me? See for yourself!
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When I searched for prices on other common tests and procedures, here's what I found for price ranges within a 30-mile radius of my house:
These are just a few examples of how much prices can vary.
THEN IT ALL CAME TOGETHER.
I finally realized the "dirty little secret" about the healthcare industry. The one they prefer us not to know.
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THERE'S MORE THAN ONE WAY TO SAVE ON HEALTHCARE.
As soon as I became privy to this "dirty little secret" about the healthcare industry, I felt empowered, and my curiosity grew. I wanted to know more. What other "secrets" about the industry were out there? So instead of learning the hard way, I decided to educate myself even more on the industry, and that's where I got…
Healthcare costs can vary greatly for the same test and procedure, in the same town, and have the same quality ratings.
10 easy ways to stop overspending
on healthcare!
Want pricing information on virtually every medical test and procedure so you never have to overpay for healthcare again?
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kay, this seems like an obvious tip,
but many people skip it. Seeking preventive care can benefit both your physical and financial health. Preventive care, such as annual physicals, tests, and screenings, may uncover a serious medical condition in its early stages and save you on larger medical expenses in the future. Also, most preventive exams and screenings are covered by your health insurance without any out-of-pocket costs.
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1 SEEK PREVENTIVE CARE
Tip:
If your health insurance policy began on or after September 23, 2010, then your carrier must cover certain preventive services without charging you any copayments, coinsurance, or requiring you to meet your deductible. Check out the preventive health services section of the healthcare.gov website to see what preventive services are covered for men, women, and children.
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hese guys have a bad rap, but they aren't actually that scary.
See, the insurance industry wants you to be afraid of high-deductible plans, because these plans have lower premiums (which means less money for them!), but they still provide the same quality of coverage once your deductible is met. Healthy people benefit from HDHPs because they save money they would have otherwise wasted on insurance premiums. HDHPs, like all health plans under the Affordable Care Act, HDHPs cover preventive care at no additional cost, so you don’t pay out-of-pocket for annual physical exams and certain screenings.
When you have an HDHP, we recommend you enroll in a health savings account (HSA) to help pay for qualified medical expenses and limit your out-of-pocket exposure. That way you can enjoy low premiums and low out-of-pocket expenses.
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Here are the 2015 deductible levels for HDHPs:
Family deductible levels $2,600-12,900
Individual deductible levels
$1,300-6,450
ENROLL IN A HIGH-DEDUCTIBLE HEALTH PLAN (HDHP)
Tip:
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ealth savings accounts (HSAs) are pretty much the
greatest thing since sliced bread.
It's a savings account to help you pay for out-of-pocket medical expenses. In order to sign up for a health savings account, you must be enrolled in an HDHP.
Here's what makes them so great:
Both you and your employer can make pre-tax contributions
You can make tax-free withdrawals from your HSA at any time to pay for virtually any out-of-pocket medical expense
Unlike other medical savings accounts, the remaining
balance in your HSA will roll over at the end of the year, so you can keep building on your savings
When you turn 55, you can contribute an extra $1000 per
year to your account
When you turn 65, you can make tax-deferred withdrawals, just like a 401(k)—it's essentially another retirement account!
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3 SIGN UP FOR A HEALTH SAVINGS ACCOUNT (HSA)
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Overall, opening an HSA is a great investment in your healthcare; and if you’re healthy, it’s another great investment vehicle for your retirement.
If you currently have a health reimbursement arrangement (HRA) or flex spending account (FSA) and want to know the difference between HSAs, HRAs, and FSAs, check out the table above.
Tip:
HSA, HRA, and FSA Comparison Chart
Info: MMS Analytics, Inc.
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ersonal health records allow patients to keep a comprehensive record on file
of their medical history. A PHR is different from an Electronic Medical Record (EMR) because it is owned by the patient—not the medical facility, so you'll always have access to all your information whenever you want. Some additional benefits of establishing a PHR for patients include the ability to:
Access or transfer information anytime
Prepare for doctor’s visits Track health goals, appointments, and vaccinations
Look at notes, instructions, or insurance claims from your
doctor Become a better advocate for your healthcare by preventing
doctors from ordering unnecessary tests or procedures (that you may have had in the past)
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4 CREATE AND MAINTAIN A PERSONAL HEALTH RECORD (PHR)
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Want to start creating your PHR right now? We've provided the first of four steps in the process for you below, courtesy of Activ Doctors Online.
Step 1: Assemble personal and medical information you already have. This includes but is not limited to:
Personal information—name, birth date, social security number, birth certificate
Emergency contacts—next of kin and emergency contacts
Health provider information—names, addresses, phone numbers of physicians, dentist, and specialists
Health insurance information—carrier, identification or policy number(s)
Current medications and dosages
Immunizations with dates Allergies Recent physical examination Important test results Living wills, advance directives Organ donor authorization Dated list of siginficant illnesses/surgeries Specialist opinions Vision records Dental records Correspondence with provider(s) Authorization forms for release of information, surgeries and
medical procedures
Tip: Want all four complete steps for creating a PHR? Check out the rest of this great guide on activdoctors.com
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Diagnosis
hen you receive a diagnosis
from your doctor, doing some research on your understanding of treatment options available and required may save you money in the long run. By educating yourself, you can be better prepared for future doctor’s visits and be a self-advocate when it comes to discussing the cost and necessity of any testing or procedures.
While researching, it’s probably best to avoid web forums and threads on discussing any diagnoses, because they tend to have a lot of inaccurate, non-expert information floating around. A good place to start is the Effective Health Care Program website, which is a service provided by the U.S. Department of Health and Human Services.
Next: Talking to your doctor
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5 READ, EXPLORE, AND QUESTION YOUR DIAGNOSIS, DOCTOR, AND MEDICAL BILLS
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Doctor
ommunication is the key to any successful relationship, and the one between you and your doctor is no different. In fact,
since this relationship has a direct impact on your physical well-being, it may be one of the most important! The experts at Baylor College of Medicine created a workshop called “The ABCs: How to Talk to Your Doctor.” The mnemonic device that this workshop revolves around aims to enhance the patient-
doctor relationship, all to ensure an optimal healthcare experience. So what does the acronym stand for?
• Ask questions
• Be prepared
• Communicate desires and concerns
By taking these steps to strengthen the relationship between you and your doctor, you can become a stronger advocate for your healthcare. And when you’re an empowered advocate, you improve the quality of your care, as well as your health.
Next: Questioning your medical bills
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Medical bills
our medical bill has finally arrived! You open your bill, take a quick glance at a list of charges and wonder what they mean. Great question! Oftentimes, when you get a test or
procedure (simple or complex), there are associated costs, like professional fees that you are billed for. These are charges that you will be billed for in addition to the test or procedure that was performed.
Then you take another glance and see you were billed twice for a test or service. This mistake happens often, which is why it is important to always check over your medical bills. Once you find a
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mistake you can call your provider, make them aware of their billing mistake, and save yourself some money.
Here are some things to look out for and questions to ask when it comes to your medical bills: Make sure there are no duplicate charges for any tests or
procedures.
Make sure you are not being charged for a test or procedure that wasn't performed.
If your bill arrives and only shows the total you owe, without a
breakdown of services you are being charged for, you are entitled to an itemized bill and can request one (you may find a mistake and save yourself a lot of money!)
Check your bill against your explanation of benefits (EOB)* to
make sure you were not charged incorrectly for any medical test or procedure, that your insurance is covering every service they should be, and that the procedure/test and total payment amounts match.
Tip: *An explanation of benefits (EOB), is a statement mailed or emailed to you shortly after a medical claim has been processed. It includes: date of service(s), medical bill charges, what your insurance will cover, how much of the service counts towards your deductible and copay, and how much you will be expected to pay.
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sing an urgent care facility when appropriate will not
only save you money, it will save you time, because these facilities oftentimes have shorter wait times than emergency departments.
Walk-in facilities are also equipped to handle medical emergencies like broken bones, kidney infections, and other non-life threatening problems, so you can think of them as an alternative to running to the ER.
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Tip:
6 USE AN URGENT CARE FACILITY INSTEAD OF THE EMERGENCY DEPARTMENT
Sign up for MyMedicalShopper today and never overpay for a test or procedure again!
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nless the medication you
are prescribed is fairly new, your medicine likely has a generic alternative available. Generic medications are great because they cost less and yield the same results.
In fact, according to the Food and Drug Administration (FDA), studies show that generics have the same quality and can cost 80-85% less than a brand name drug.
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Tip:
USE GENERIC DRUGS
Tip: The chart above shows generic alternatives and prices for common brand name medications. Check out the cost savings!
Info: selecthealth.com
Brand Name Drug Costs vs Generic Alternative Costs
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ant to save even more on prescription medicine costs? Then choose a generic brand of your
medication and use a prescription medication price transparency tool. We've checked out quite a few, and we recommend giving GoodRx a go.
If you’re not using their service, you’re probably paying too much for your prescriptions—even if you have insurance—because it turns out that medication prices vary from pharmacy to pharmacy just like medical tests and procedures differ by care provider.
GoodRx is free to download on the App Store, Google Play, and can also be accessed at GoodRx.com.
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8 USE A PRESCRIPTION MEDICATION PRICE TRANSPARENCY TOOL
P.S. GoodRx also has coupons and a discount card that you can you use at participating pharmacies, so you can't lose!
Tip:
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heck with your employer to see if they offer an employee wellness program.
These programs are designed to offer incentives to employees to maintain a healthy lifestyle.
Some common program benefits include:
Gym memberships Nutrition classes Smoking cessation classes Various support groups
Some employers even offer lower insurance premiums for employees who meet certain health goals and criteria throughout the calendar year. It’s just another way you can be rewarded for committing to a healthy lifestyle!
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EXPLORE EMPLOYEE WELLNESS PROGRAMS
Tip: If your employer doesn't offer a wellness program, check with your insurance company. Many insurers offer coverage for weight loss programs, nutrition counseling, and lifestyle coaches.
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One of the new, easy, and innovative ways for medical consumers to save money on their healthcare expenses is to use a comparison shopping tool. A comprehensive comparison shopping tool allows you to search facilities around your area that offer the procedures and tests you may need, while comparing prices and quality scores. Facilities offering the same test or procedure can charge hundreds or thousands of dollars more than another in the same town.
P.S. A facility referred by your insurance company or care provider is usually NOT the cheapest!
Tip:
USE A COMPARISON SHOPPING TOOL
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FREE access to cost and quality information for virtually every medical test and procedure!
No more… Waiting until your bill arrives to find out how much
you'll pay
Wasting time calling your insurance carrier and provider, and then getting a bill with a different price
Putting off needed care because you're scared of how
much it will cost
Take control of your healthcare! Use MyMedicalShopper!
Never Overpay for Healthcare Again