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4 Tips For Savvy Health Care Shopping

Your employer and President Barack Obama[1] are imploring you to become a better health care consumer. They want everyone to take a more active role in his or her care because it’s vital to help slow the seemingly perpetual rise of health care expenses.

A growing number of companies offer high-deductible health plans that make their employees pay more for care out of pocket.

Some workers also are finding that the cost of their coverage now is tied to the quality of their health or whether they smoke.

President Obama’s health care overhaul promises to provide insurance coverage to millions of Americans. But the uninsured first have to figure out which plan suits them best.

Becoming a better health care consumer shouldn’t require prodding because it can put more money in your pocket and keep big medical bills at bay. Here are four key principles to keep in mind.

Numbers matter

Many companies now provide biometric screening to their employees, and it’s not a bad idea to take them up on the offer. This involves measuring variables such as body weight, cholesterol and blood pressure that can tell you whether you’re at risk for developing heart disease or other problems.

Companies do this in part because they want their workers to nip health problems before they become full-blown and costly medical emergencies such as a heart attack or diabetes. That means finding the right cholesterol drug or figuring out an exercise plan that helps you drop a few pounds and leave the cardiac risk zone.

Businesses frequently hire outside firms to coordinate these tests, so your boss won’t know your individual test results, but the company may get data showing the averages for those covered under their plans.

Knowledge pays

Knowledge is power, and in this instance, that power can help you avoid debt. Do some research before buying coverage.

You need to get an idea for what type of coverage fits best. For instance, if you don’t have significant medical expenses, consider a high-deductible plan. It will cost less than more traditional plans, but the catch is you will have to pay more out of pocket when you use the medical system.

That $20 co-payment at the doctor’s office may be replaced by a $90 bill.

Before committing to a plan, understand what kind of bill you may receive for surgery or a hospital stay. Then you can think about how easy or hard it would be to come up with that money. Do you have $5,000 stashed in a savings account to put toward an unexpected and expensive medical bill?

Look for a plan benefits summary that lays out key variables, such as the annual deductible, which is what you pay before most coverage starts. Also look for the co-insurance, which is the percentage of a bill from a big medical expense such as surgery that the plan pays, generally after you pay your deductible.

A plan may offer 90 percent co-insurance, which would leave you with only 10 percent of the bill. That sounds great, but 10 percent of a $9,000 surgery is $900.

Not priced equally

Many patients with prescription drug coverage are enrolled in a plan that offers three or more payment levels. Savings can found by sorting through these tiers.

First-tier prescription drugs come with average co-payments of $10, the second tier averages $29 and the third averages $52, according to a recently released study of employer-sponsored health insurance from the Kaiser Family Foundation[2].

If you have tiered coverage, ask your doctor if your prescription has a lower-tiered equivalent. Pharmacists also can check with doctors and adjust prescriptions from brand name to generic, if a good option is available, said Carolyn Castel[3], a spokeswoman for CVS Caremark[4] Corp., the nation’s second-largest drugstore chain.

Shop around

The doctor’s office has been the traditional destination for patients with the flu, bronchitis or a nasty case of poison ivy. But those visits can be pricey for patients with high-deductible insurance.

Walk-in clinics have been added to many drugstores and grocery stores over the past decade, and they may offer a better deal. Care at these places typically is handled by a physician’s assistant or nurse practitioner.

Consider shopping around for surgery or care that isn’t urgent, such as a shoulder scope or an MRI exam. There may be a wide variation of prices charged among providers in your network, and that means you could find big savings for the portion of the bill you have to pay.

Unfortunately, shopping around doesn’t often mean making three phone calls to get three prices. Hospital pricing is extremely murky and can depend on a patient’s coverage. Plus a patient may receive more than one bill for a procedure.

Check to see if your health insurer has any tools to help you estimate your out-of-pocket expenses. They might be able to give you a reasonable idea since the insurer will know coverage details like which doctor is in your plan’s network.

The nation’s largest insurer, UnitedHealth Group Inc.[5], offers an online cost estimator that give customers approximations of their costs tailored to their insurance coverage and factors such as whether they have met their annual deductible.

It can find some wide variations, depending on the provider. For instance, the bill for a knee MRI done in Seattle can range from $92 to $494 for a patient who has paid his deductible and is responsible for a 20 percent co-insurance payment.

References

  1. ^ Barack Obama (www.mysanantonio.com)
  2. ^ Kaiser Family Foundation (www.mysanantonio.com)
  3. ^ Carolyn Castel (www.mysanantonio.com)
  4. ^ CVS Caremark (www.mysanantonio.com)
  5. ^ UnitedHealth Group Inc. (www.mysanantonio.com)

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Comments

  1. Reply

    Health Tips And Vitamins I Should Take Being A Growing Teen? Anyone recommend any daily vitamins i should take? please provide the store i can get em at and the price. what it does and all the details please. also any random health tips would be appreciated. thanks.

    View Comment
      • HealthNut
      • September 12, 2013
      Reply

      A multi vitamin suh as centrum is good. Flaxseed oil capsules are great as well.

      View Comment
    • Hg
    • September 12, 2013
    Reply

    Do These Health Tips Actually Work? 1 apple / day – no doctor
    1 lemon / day – no fat
    1 cup of milk / day – no bone problems
    3 ltrs water / day – no diseases…

    Also what are some losing weight health tips?

    View Comment
      • HealthNut
      • September 12, 2013
      Reply

      No, these health ‘tips’ are actually myths. It’s all very healthy to do that, but no.

      To lose weight, all you can really do is exercise more and eat healthy and try to keep your calories at around 1600 a day. It’s good to drink homemade lemonade that tastes pretty sour and not sweetened very much- it’s good for your metabolism. Tea is good, fruits and vegetables are good. It’s a great time to get active because it’s summer and you’ll sweat more, which is awesome for your body to flush out toxins and such. I like making fruit smoothies and adding spinach or kale (you can’t taste it and it’s so good for your body- not to mention filling). When you snack during the day, only snack on ‘raw’ foods like fruits and vegetables, or maybe a few almonds.

      Good luck!

      View Comment
    • David
    • September 12, 2013
    Reply

    What Are Some Basic Tips To Give To Kids About Staying Healthy? I’m trying to teach my 6 year old nephew how to stay healthy. I need tips from eating right, to being active and maintaining hygiene. Any health tips you expect a 6 yr old kid to understand.

    View Comment
      • HealthNut
      • September 12, 2013
      Reply

      You should tell them to eat lots of smaller meals and to eat slowly so that their bodies are more able to recognize when they are full. Also its important to drink lots of water and fruit juice rather than soda. Try and encourage him to stay away from junk food and eat fruit or something healthy when he wants a snack. Also teach him to be active, that playing sports and running around is good for you as well as fun. Also teach him the basics of hygiene like showering daily and brushing his teeth 3 times a day. Try and make it all fun for him though, as kids respond more to things that they find enjoyable.

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  2. Reply

    Anyone Have Some Good Tips For A College Student Who Wants To Lose About 35 Pounds? Basically Im pretty lethargic due to the studying….I do a fair bit of walking and I dont eat fast food more than a coupla times a month, but I seem to keep gaining weight. Basically I need some health tips or some way of beginning to get rid of the buddha belly.

    View Comment
      • HealthNut
      • September 12, 2013
      Reply

      As a fellow student, I understand your struggle. My butt feels constantly glued to a seat and I don’t have the time or attention for planning healthy meals. It’s tough but I manage to control my weight and even lose weight every now and then with some pretty easy tactics. Since you want to lose it, you’ll have to get serious. I would highly recommend cardio workouts. Depending on your fitness level and personal tastes you could try at home workouts like Tae Bo or you can hit the gym (in which case walking or jogging on the tredmill mixed with weights would be effective). Basically, make yourself workout even when you feel tired from studying or a long day. Next thing you know, you’ll look forward to the stress relief. Remember to watch what you eat and consider counting calories…you may be surprised how much you eat daily! Get sleep. Lack of sleep stresses the bod out and you may compensate with food. And you definitely will have less energy for workouts. GOOD LUCK!

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