MEMPHIS, Tenn. — ‘Tis the season for open enrollment. Whether you’re shopping on the Marketplace or getting coverage through an employer, consumers all across the country will be choosing health insurance plans for 2015.
Besides the confusing language and hard-to-understand charts, folks will also be navigating their way though the dollar figures and paying close attention to what their plans will cost.
Whether it’s the price of prescriptions or skyrocketing premiums, it’s safe to say everyone is sick of the rising costs of healthcare.
However, the On Your Side Investigators found there are some ways to save. While much of that depends on the plan a consumer selects, there are also ways to lower costs throughout the year.
High Deductible Plans
The concept is simple, but the rest can be tricky. Basically, a high deductible plan means you’ll pay less out of pocket for insurance every month. However, in order to get visits, prescriptions, procedures, etc., covered (in full or at whatever percentage your plan allows), you have to reach a certain dollar limit first.
So, if your deductible is $2,500, you’ll come out of pocket for essentially everything until you reach that amount, then your insurer kicks in its portion.
We spoke with Dr. Scott Morris, CEO of the Church Health Center. He says while such plans are a great costs savings for young, healthy people, it’s not a good option for older adults with medical issues.
He specifically referenced high deductible plans available through the Marketplace.
“Effectively, what you’re covering yourself for is a catastrophe. I’m in a car wreck, I have something terrible happen to me, that’s unforeseen, but if you have a cold or sore throat, or even pneumonia, you’re going to be paying out of your pocket for that,” Dr. Morris said.
On the day we visited the Church Health Center, we met one of Dr. Morris’ patients, Ms. Willie James Allen.
“I wasn’t able to buy no medicine, I wasn’t able to pay no doctor,” Ms. Allen, who has beaten cancer twice, said.
She represents one of the thousands of the working poor who visit the Church Health Center every day.
However, even people who have insurance through their employer want to cut their out-of-pocket costs.
3 Quick Ways to Save
#1 – Get a PCP
Once consumers have their plan for the year, there are some strategic ways to slash expenses. Dr. Morris says the first step to saving should be using a primary care physician.
“That doesn’t mean, in my opinion, the minute clinic, or go as quickly as you can, it certainly doesn’t mean the Emergency Room, that’s the most expensive ineffective way of providing care,” he said.
Dr. Morris says building a good relationship with your PCP leads to a better understanding of what you really need.
Which takes us to the next savings step…
#2 – Avoid unnecessary tests
Dr. Morris told WREG, “You don’t want to go and tell the provider, ‘Do this test.’ You’re effectively saying, ‘I want to pay for that.'”
In fact, Dr. Morris says patients often have the misconception that just because something costs more, or includes technology, it will lead to a better outcome.
He added, “Ninety percent of what any doctor does and learns about you comes from conversation, not even from putting hands on you, and it certainly doesn’t come from doing tests.”
By the way, labs and tests are cheaper at stand-alone facilities – you’ll pay more if you go to a place owned by a hospital.
#3 – Get healthy
It may seem simple, but it’s true. The healthier someone is, the fewer trips they make to the doctor’s office.
Dr. Morris says people should ask themselves, “What can I do to live the healthy life, am I eating right, am I exercising, am I smoking?”
Other Ways to Save
Check out comparison websites – Sites like Healthcare Bluebook allow users to compare prices of tests and procedures by zip code. Many insurance companies also have sections on their websites for finding in network providers. Keep in mind, comparison shopping in healthcare won’t get you apples to apples. Providers charge different prices, even for the same procedure/test.
Talk to your doctor – It may feel uncomfortable, but talk to your physician about why he/she is ordering a specific test or procedure, and ask how much it will cost.
“Any good provider is never going to be threatened by a question of why we are doing this, how much is it going to cost,” Dr. Morris said.
Find a friend in billing and/or coding – In healthcare, coding determines reimbursement for physicians, which also affects your costs.
Let’s say you visit your doctor for something your insurance company pays at 100 percent, but you weren’t feeling well on that day, or you end up discussing a healthcare problem that turns that visit into something other than routine.
Well, your 100 percent-covered, preventative-care visit may have to be coded as a sick visit, which means the out of pocket costs change for you. It’s important to get an understanding of how this works from both your insurer and the doctor’s office. An employee in billing/coding can often offer the best explanation.
Ask for a discount – Consumers haggle for everything else, why not healthcare? Patients can always at least try to negotiate the costs. That may not work, but another idea is to ask to pay in installments if you run into a costly procedure.
