Cutting Your Health Care Costs

Health care spending continues to rise at the fastest rate in our history, from 7 to 14 percent a year, depending on the study.

Fortunately, knowing how to work the system and, most important, knowing your coverage inside and out can offer some protection against rising costs.

The American health care system—a complex union of insurance companies, doctors, hospitals, and drug manufacturers—doesn’t provide consumers with many price breaks. But learning a few tricks can help you, in some cases, get something for nothing.

Importance of screenings

Sign up for free health screenings that are appropriate for your age and any chronic health conditions you may have. Early detection of most conditions, including cancer, high blood pressure, heart disease, and diabetes, translates into fewer complications and lower medical bills. Because screening tests can be expensive, any you can get for free from local hospitals or at community health fairs can save you hundreds of dollars.

Use the phone

Depending on where you live and your health plan, the minimum cost of a doctor’s visit can be anywhere from $50 to $80. If you have an important question regarding a treatment or diagnosis, call your doctor or the nurse and leave a message for one of them to call you. It is unlikely your provider can take time during office hours to return calls that are not emergencies, so expect a call after office hours.

Keep it short

Minimize hospital stays, if possible. Surgery is expensive no matter where you go. In most cases, however, having surgery as an outpatient, either at a hospital or an ambulatory surgery center, can cut your costs. Ask your doctor if either of these is an option.

Emergencies only

Use the emergency room only when it's truly necessary. ERs are expensive places to get health care and should be used only in true life-, limb-, or health-threatening emergencies. If you’re dealing with something other than a clear-cut emergency, call your doctor or the ER first and describe the situation. More than half of all emergency room visits are unnecessary, according to the National Center for Health Statistics.

Track costs

If you itemize your taxes and your total medical expenses exceed 7.5 percent of your adjusted gross income, you’re entitled to a deduction. Keeping track of all your medical costs can help you or your accountant figure this one out.

Your results

Medical tests are time-consuming, inconvenient, and expensive, even if you’re only paying part of the cost. For example, 20 percent of an MRI can be $500. To avoid repeat tests, keep track of your imaging and blood test results in case you have to see a specialist.

Recognize that there are risks and limits to the medical care and the human fallibility of any health care professional. Don’t ask for unnecessary tests or visits to your provider to try to change an established diagnosis or treatment plan. A second opinion by another provider on a diagnosis or treatment plan should be sufficient to confirm either.

Your benefits

People don’t want to spend an evening reading updates to their insurance plans, but knowing exactly what your health insurance does and doesn’t cover is an important part of managing your costs.

Your insurer, for example, may have added coverage for acupuncture, chiropractic care, massage therapy, and other alternative therapies. Other plans cover flu shots, and still others offer discounts to nonsmokers or people who maintain a healthy weight. You’ll never know if you don’t read your benefits manual.

Learning if you have to use in-network doctors, labs, providers, or hospitals, or a particular mail-order pharmacy to receive covered services or medications is the best way to reduce your costs and get the most from your policy.

Alternative coverage

If you lose your job or quit, or have your hours reduced so you are no longer eligible for health benefits, look into COBRA. It is a way to continue health plan coverage for limited periods of time, but you have to pay more.

If you are separated or divorced, the Health Insurance Portability and Accountability Act (HIPAA) offers special enrollment rights, generally allowing employees and dependents who were covered under a spouse’s plan to obtain coverage under the employee’s plan.

For more information on health benefits, visit the U.S.Department of Labor Web site athttp://www.dol.gov/ebsa/Publications/10working4you.html.