While the Affordable Care Act (ACA) has helped millions of Americans obtain medical insurance, the stark reality is that health care costs continue to rise, and consumers continue to struggle with the costs. Medical debt remains a leading cause of bankruptcy filings, and a Centers for Disease Control and Prevention (CDC) survey found that more than one in five Americans struggle to pay medical bills.
To help keep health care costs in check, review these dos and don’ts.
Do evaluate your insurance plan’s benefits
Calculate carefully for dental or vision coverage especially. Some plans cost more in premiums than you would spend in a year without insurance, making those plans a poor value. Also, make sure to check with your insurance company to identify providers within its network. Out-of-network providers always will cost more.
Do examine your bills
Billing errors are more common than you might think. Anywhere from 30 to 80 percent of medical bills contain errors. Ask for an itemized bill and read it carefully, and call the billing office with any questions or concerns. Review payments from insurance providers for accuracy, too, since providers often require patients to pay any difference between their usual charges and what the insurance company pays.
Do ask about discounts and payment plans
If you pay by cash or check, rather than filing an insurance claim, ask if the practice offers a discount for self-pay patients. Practices might have payment plan options if you cannot afford to pay all at once. Some providers will agree to charge the discounted fee that Medicare or Medicaid pays. Some may give you a break if you pay the entire bill in full. Or, it may be possible to defer payments for a few months. Another option is to ask for an interest-free payment plan that allows you to contribute a small amount toward the bill every month.
Do use an FSA or HSA
An employer-sponsored health care flexible spending account (FSA) can help you pay for eligible health care expenses that insurance does not cover. An FSA saves money because the funds are placed into your account from your paycheck before taxes are taken out. The only caveat is that you must spend all of the FSA money by the end of the year, or you lose it. If your employer does not offer an FSA or corresponding benefits, or if you are self-employed, another arrangement is a health savings account (HSA). A qualifying high-deductible insurance plan allows you to pay medical bills with pre-tax dollars.
Do consider consulting with a health care advocate
Health care advocates can help with a denied claim or billing error. They also can fight on your behalf to get a bill reduced. Although more than half of U.S. companies with more than 500 employees have a health advocate available, many employees do not know about these services. Check with your human resources department first. You also can hire a health care advocate directly. Costs vary greatly depending on your needs. For instance, an advocate may take 25 percent of the savings for helping to reduce a medical bill.
Do not automatically run to the ER
The emergency room is a “must” for life-threatening emergencies. But an urgent care facility can treat most illnesses, burns, sprains and some fractures at a lower cost. For situations like flu or strep, a retail clinic might offer fast care at a low cost. Many of these clinics accept health insurance.
Do not overlook different care options
You may be able to space out care. For instance, a dentist might give your child X-rays in one visit and a fluoride treatment in the next to keep bills more manageable. Adults might be able to have lab work done at intervals, instead of all at once. Another idea is to work with a doctor in training for certain care. In some areas, dental schools offer care that is supervised by experienced dental experts.
Do not rush to credit cards
If you face significant medical costs, one of the first things to do is tap into your emergency savings fund. If you do not have an emergency fund or the amount is insufficient, think carefully about how to tackle the debt without winding up in financial trouble. Using credit cards to pay off medical bills can lead to accrued interest on balances or fees for missed payments -- both of which can damage your credit record. If necessary, consult a reputable debt relief service to see if debt negotiation, debt consolidation or credit counseling services may provide a solution.
Do not disregard the concept of shopping for best procedure prices
If you have a procedure or treatment planned, find out the cost ahead of time. It may pay to call other medical offices to find out what they charge. With Healthcare Bluebook, you can compare what area providers charge for certain health care services. Use this information to negotiate a better price with your provider, and always consider obtaining a second opinion on both cost and care.
Do not forget to price-check for medications
Generic medications can cost up to 85 percent less than their name-brand counterparts. Some mail-order pharmacies offer lower prices for a 90-day supply of medications. Many discount stores and warehouse club pharmacies offer better prices, and some offer prescriptions for common drugs for just a few dollars a month. Organizations ranging from auto clubs to college alumni groups may offer discounts. Another idea is to ask your physician or pharmacist about purchasing larger pills (which can sometimes be more cost-effective) and then splitting them for your dose.
While there is no way to avoid the cost of health care, it is possible to be smart about your options and reap often-significant savings. If you do incur medical debt, don’t ignore it. Instead, work with creditors or a reputable debt relief business to develop a plan that fits within your budget constraints and get the bills paid.
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