Patchwork health care coverage is probably this country's biggest emotional flashpoint. Ever-increasing premiums and expensive medication co-pays are just a few of the daily aggravations consumers face.
Added to these headaches are the sobering facts that over 59 million Americans are without health care coverage; 20% of U.S. adults reported problems paying their medical bills; and 31% of U.S. adults admitted spending too much time on insurance paperwork, disputes and coverage denial.
Make the Most of Low Cost Coverage Options
1) Health Savings Accounts. If you're stuck in a high-deductible company health insurance plan, consider investing in a health savings account that allows you to direct pre-tax toward medical expenses up to and beyond their annual deductibles. Plus, any remaining balance rolls over and continues accruing interest, tax-free.
2) Low/No Cost Health Care. It's still possible to get decent medical care even without health insurance coverage. Find A Health Center, a service of the U.S. Department of Health, provides listings of federally funded healthcare centers available in most cities and rural areas. These centers charge on a sliding-scale basis.
Artists can take advantage of several low-cost options. The Artist Trust in Seattle, Washington, offers low-cost health care options as part of their membership package, while the Austin, Texas-based SIMS Foundation offers mental health and addiction recovery services to local musicians. Brooklyn's Woodhull Hospital offers the Artist Access Program, an opportunity to trade talents for medical checkups, while The Hour Exchange in Portland, Maine, is a similar bartering program open to anyone.
3) Small Business Relief. Prior to October 2010, self-employed Washington state freelancers and consultants were forced to seek coverage in the expensive individual marketplace. State law now defines a group as one person or more, which means Schedule C entrepreneurs can take advantage of lower premiums and discounts formerly reserved for bigger corporations.
While The Group of One option is restricted to Washington state, the Small Business Jobs Act is not. The White House estimates this bill will provide over $1.9 billion in tax relief for the nation's entrepreneurial backbone, allowing millions of self-employed business owners to deduct the cost of health insurance on their 2010 taxes.
4) Research Procedure Costs. Good doctors urge patients to get second opinions, so why should price comparisons be any different? The National Institute of Health offers medical procedure comparisons for 19 states, plus links to other helpful medical pricing sites. The Health Care Blue Book prices medical services and products specifically for cash-paying patients. Health consumers living in New Hampshire can access the state's Health Cost website, which provides medical care prices by insurance plan and by procedure, plus estimated pricing for the uninsured.
5) Negotiate. Many doctors willingly reduce their bills if the patient pays immediately. Depending on the method of payment (credit card versus check), the discount may reach as high as 30%. Those seeking further cost reductions can contact Medical Cost Advocates, a medical-negotiating business designed to help uninsured consumers get the same kind of discounts typically offered large insurance carriers. The company charges a 35% fee against the amount reduced, but only if the bill is successfully trimmed. Incidentally, MCA has an A+ rating from the BBB.
6) Itemize. If the total amount of medical expenses is greater than 7.5% of your adjusted gross income (AGI), the amount can be deducted from 2010 federal taxes. Not sure what procedures can be included? IRS Publication 502 offers a handy list.
#-ad_banner_2-#7) Question the Billing Codes. Incorrect billing codes can unnecessarily increase a patient's bill. Consumer Reports recommends getting itemized invoices to see whether services and medications charged were actually received. Be aware of upcoding (when a simple cold is charged as pneumonia) or upselling (a doctor requests generic drugs but the hospital provides the more expensive brand-name) issues.
Inexplicable charges can be investigated by calling the provider and requesting a correction. Be sure to keep track of the date, time and name of the person you spoke with, in addition to the recommended solution. To better understand coding's arcane language, check out the comprehensive list of medical codes on the National Institute of Health website.
A Penny Saved...
8) Go Generic. Generic drugs are often far cheaper than brand-name prescriptions, while providing the same effect. Better yet, join a discount club. Places such as Walmart and Target offer discount pharmacies, while Walgreens offers a discount club for patients who don't qualify for Medicaid or Medicare.
9) Pharmaceutical Coupons. Recognizing that not all generics work the same as their more expensive brand-name counterparts, pharmaceutical companies are introducing their own coupons. Pfizer offers discounts on Lipitor; Medicis has its Medicis MedisSAVE Program; while Amgen offers discounts on Xgeva, a drug reducing bone fractures from cancer. Coupons can be found either at the company's website or at an aggregator site such as InternetDrugCoupons.com.
10) Online Pharmacies. Rural-based patients can take advantage of online pharmacies, but before placing that purchase, the National Association of Boards of Pharmacy (NABP) warns that only 4% of the almost 7,000 online pharmacy sites are considered legitimate. Consumers unsure about a potential site can query LegitScript.com. The association also recommends Pharmahelper.com, a site offering online pharmacy site comparison shopping from NABP-verified U.S. pharmacies.
11) Medical Discount Plans. Medical discount plans are another helpful option, but should not be confused with actual health care coverage. Instead, plan members receive a list of caregivers and pharmacies offering discounts to card holders. Available programs include SimpleCare, Total Care and Health Plan Plus, which offer discounts on doctor visits, dental exams, hospital stays and prescription drugs. The Federal Trade , however, reminds patients that not all discount plans are legitimate and offers several ways to determine whether a plan is valid or fraudulent.
Finding the optimal mix of reduced-cost and medication options are just a few ways Americans can lower their medical costs. For more information, see these features on Simple Ways to Lower Health Insurance Premiums and Understanding Health Care Changes That Impact You Now.