Reducing the Cost of Medical Care

Reducing the Cost of Medical CareMy brother has had a hard time getting medical insurance in the past because he was out of school and didn’t have a job with health coverage. He and the family have thus had to be creative to keep their medical bills from overwhelming them.

Medical expenses can be a huge burden. With basic ER visits often costing $1500 or more, one mishap or illness can burn a huge hole in your wallet. How can you keep medical expenses manageable? If you have a big medical bill, how can you fit it into your monthly budget?

Cheaper prescription medicine

As you’ve probably read and seen in the news, opting for the generic form of a prescription medication can reduce your bills tremendously. Stores like Walmart and Walgreens offer monthly supplies of certain generics for $4 or $10 for three months. Some even offer free prescriptions on select medicines.

But what happens when there are no generics available for your prescription? How can you keep from going broke?

The first step is to ask the doctor if there are any alternatives or options. Physicians can sometimes give you a free sample, or at least a coupon that you can redeem at your local pharmacy. It might not cover your full course of treatment, but this sort of thing can still save you a ton of money. Just be careful not to opt for a more costly drug simply because you can get a free trial.

You should also check with the drug manufacturer to see if they offer a patient assistance program. You may qualify to get your medication free for anywhere from six months to a year. To get started, try searching the name of the medicine or manufacturer and the phrase “patient assistance.” My brother used this strategy when he was unemployed.

See also our previous article on saving on prescription drugs.

Finding affordable health insurance

When hunting for health insurance you should consider a few things:

  • Amount of premiums: This should go without saying, but if you can’t afford the premiums, then it’s pointless to sign up for the plan. You’ll have to stay current on your payments to keep the coverage.
  • Size of the deductible: What can you afford to pay out of pocket during the year? Generally, the lower the deductible, the higher the premium. If you’re relatively healthy and you’re looking for a policy for catastrophes, then having a high deductible can be a great way to save money.
  • Co-insurance/co-pay: If you visit the doctor regularly, the amount of your co-pay – a flat fee for an office visit – is important to consider. When paid repeatedly, your co-pay can really add up. Co-insurance, on the other hand, is a percentage that you are responsible for. If you anticipate any costly medical procedures in the near future, consider this carefully.

Remember that you can’t judge insurance policies based solely on their sticker price. Different policies have different coverages. Don’t settle for a bad plan because it’s cheap, but you also should’t pay for more coverage than you need.

See also our previous article on saving on health insurance.

Tips on keeping your costs down

Once you’ve settled on a policy, you need to be proactive and keep your expenses to a minimum.

Use the ER properly. Seek an urgent care location or regular office visit whenever possible to minimize your costs. The cost to visit an ER can be significantly higher than an urgent care facility, and the wait is often much longer at the hospital.

Avoid having unnecessary duplicate tests done. If you want a second opinion on a major medical condition, having another test done may be a prudent choice. However, you should be on the lookout for duplicate tests when you seek a second opinion. Have your records transferred to the new doctor instead of paying to have the same battery of tests done a second time.

Needless to say, having a healthy lifestyle can be greatly beneficial. If you can adopt a routine of fitness and good eating habits, you will not only save money, but improve your quality of life.

Handling a huge medical bill

What if you land in the ER due to some unexpected accident? Hopefully you have an emergency fund in place to soften the blow, but what else can you do to minimize the damage?

  • Go over the charges with a fine-toothed comb. Be especially careful when viewing a long list of charges. Make sure you’re not being billed for tests and procedures that you didn’t receive. Also be sure you’re not receiving a ‘balance bill.’ These bills will charge you for everything that the insurance company doesn’t pay, even if it’s not an allowable cost. If you don’t receive one, ask for an itemized list of charges so you can review it carefully.
  • Call your insurance company. There are times when bills are coded wrong or paperwork is mixed up and you get stuck with a huge bill. As soon as you notice this, please call your insurance company to see if there are any hang-ups.
  • Apply for charitable help. You may have to swallow your pride and contact your hospital to see if you qualify for any sort of charitable care programs.
  • Offer a lump sum payment to settle your hospital bill. It doesn’t hurt to ask if they are willing to accept a smaller amount. If they accept your offer, make sure you have it in writing. You don’t want a hospital bill coming back years later when it’s incorrectly sent to a collections agency.
  • Inquire about a payment plan. If you can’t afford the full amount, ask about breaking it up and paying over time. While this doesn’t really save you any money, it can make the bill more manageable.

There are ways to manage hospital bills, but you can’t just give up and not pay. After all, you can eat an elephant… As long as you take it one bite at a time. Having options can make it a little less stressful.

If I were in that situation, I would review your itemized bill first to determine your best course of action. If you have no insurance coverage, look into settling or getting charity. If you have insurance, be polite and persistent when dealing with the customer service representatives. They may be able to help you with the claim or point you in the right direction.

Your thoughts on dealing with medical expenses

Medical bills can be both time-consuming and stress-inducing. Don’t let them get the best of you, though. If you’re willing to hustle a bit, you may catch a break.

What are your thoughts are on the matter? How have you coped with medical expenses? What success stories do you have? What setbacks have you faced? Any tips to help the rest of us?

6 Responses to “Reducing the Cost of Medical Care”

  1. Anonymous

    First, Use online mail-order for long-term prescriptions — I have saved ridiculous amounts of money using,, and They handily beat my own insurance company’s in-house mail-order drugstore, plus, I just file the prescription claims against my insurance company myself so my deductibles are tracked appropriately.

    Which leads me to:

    Second, we opted for the High Deductible with Health Savings Account insurance plan. The premiums are MUCH lower (especially for large families), which you should use those savings to _fully_ fund the HSA account. The HSA has tax-free money going in and out so you save big time there too. But spend a day to run the numbers to compare the insurance plans your company offers. I know a lot of people that choose the most expensive insurance plan, thinking it is somehow ‘better’ — when it is just ‘more expensive’. You need to have the deductible amounts ready to go, in cash, before your HSA account gets funded.

    Third, you _must_ switch to generics — or you will go broke, seriously. The generics of today, were the ‘name-brand’ meds from 10 years ago. Plus, you’ll be avoiding all of those medications you see on TV at night that have class-action lawsuits forming against them. You don’t want to be the ‘victim’ of one of these new medications (and suffer the increased medical problems caused by them) — let someone else be the guinea pig. We learned this the hard way.

    Fourth, question doctors. There are a lot of doctors (mostly young ones) that love to run a bunch of unnecessary and expensive diagnostic tests. Let them know you are paying cash (have a high deductible) to see if they can propose cheaper alternatives, etc. Of course this depends on the situation, so discuss this stuff with a doctor/nurse in your family (or who is a friend) or your insurance companies nurse-line.

    Fifth, live a healthy lifestyle!

    Sixth, avoid emergency rooms AND urgent care centers like the plague. Ugent care costs are not much cheaper than ER vists, and sometimes are more than the ER due to how the visit is billed and the fine-print in your insurance policy (find this out before an emergency). If you think you need to go to the ER (or Ugent care facility) but are not really sure: call your insurance company’s Nurse line while in route. The nurse may be able to let you know that the issue can wait till morning where you can see your normal doc (and save you $800-$1500). If the ER doc wants you to have a follow up visit: do the follow with your primary Doctor — do NOT go back to the ER!!

    Seventh, at _every_ doctors visit make sure that the facility AND ALL doctors that you see accept your insurance carrier. If a doctor walks into your room, the first question you should ask is: “Do you accept my insurance?”. This is especially true if you are in a Hospital/ER/UrgentCare setting. If you get hit with an out-of-network doctor, then expect to pay big time.

    Eighth, watch out for over-billing, double-billing, billing for procedures that weren’t done, or payments that haven’t been credited. The sheer number of medical billing mistakes I have seen (just in our family) is truly amazing — thousands of $$$.

    Ninth, don’t pay ANY bill, until it has first been processed by your insurance company. This helps you with #8, in that you wont overpay. The insurance company is going to redo the medical providers bill with the insurance companies ‘negotiated-rate’ which can be 50%-75% of the medical providers bill. If the provider wants you to ‘pay at time of service’, then you must follow up in your records to ensure that what you paid is the negotiated-rate. A medical provider will NEVER refund you unless _you_ notice the error and complain.

    That’s it from me. I’ve lived each one of my points, so I speak with some experience (though I don’t work in the medical profession).

  2. Anonymous

    My company has an FSA, which I use to cover the cost of an expensive medicine with no generic. The cost is about $80-90 per month, but using tax-free dollars to cover it helps a ton. I’m hoping they will eventually implement an HSA so I can build up some tax-free reserves. Being a diabetic in my 20s makes me think I’ll be needing more expensive care sometime in the future.

  3. Anonymous

    Health savings accounts! I just started one with chase, which charges 2.50/month in maintenance. But since it’s tax deductible, you basically get a discount of your tax rate on all your medical expenses!

  4. Anonymous

    Two other ideas for saving on prescription drugs:

    1) Compare prices. Chain drugstores don’t always have the best price. The local supermarket’s pharmacy turned out to have the lowest price for some of our non-covered meds.

    2) Many pharmacies now have discount programs for the uninsured. Walgreens, I think charges a one-time fee to join; Costco doesn’t charge for its program.

  5. Anonymous

    As a inpatient (hospital) pharmacist, who also happens to work part time in the emergency department, I must agree. Use the emergency department only when you can’t see your primary care doc or the urgent care is unavailable. It saves money, usually saves time, and saves frustration for most everyone.
    And don’t forget that these trips usually include a bill from both the hospital and the doctor. Just the nature of the beast.

  6. Anonymous

    The big tip is to do the research first. With a small child, we need to know where there is an urgent care (if there is one) that accepts our insurance, at various times/days.

    My expensive and comprehensive HMO had a nurse line that was very helpful for steering us to the cheapest and least obnoxious option for care; no (cheaper) insurance we’ve had since I switched jobs has had a useful nurse line, the answer is always “go to the emergency room.” So I did the research and it’s posted on our fridge, ever since one slow, unecessary, and incredibly expensive ($500 copay!) late Saturday night emergency room visit.

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