Insurance tips and tricks: How to make health care affordable

SALT LAKE CITY -- It’s no secret that rising health care costs in the last decade have pushed many people to the financial limit. Even those with good employer-offered plans can still struggle to get the care they need. And certainly, comprehensive health care may be out of reach for many families. But there are some ways to better fit basic health care into your budget.

Knowledge

Often, we aren’t even sure what benefits we have until we need them or worse — until we have health costs to pay.

Just being aware of what is covered and what isn’t can do at least two things: Allows you to maximize the benefits you do have as well as avoiding a cost for something that is not covered.

A simple way to do this is to contact your HR representative if your plan is through work and/or go to your carrier’s website online. They should provide an individualized explanation of benefits for you specifically.

And always, when in doubt, call customer service to ask specific questions regarding coverage before that doctor's appointment.

Look at your options

One of the most proactive measures to minimize health care cost is to carefully choose your plan at open enrollment.

If your employer offers plan options weigh them carefully. Take into account family size, premium rate and specific individual health issues.

If you take time and do the math, you could end up making a much smarter choice for your family as well as for your wallet.

Wellness

Obviously, the most efficient way to cut down on health care costs is to avoid them in the first place. With wellness the first step is to become familiar with all areas of health care coverage you have. Many plans will offer wellness services in areas you are not even aware of.

Almost all carriers cover 100 percent of basic wellness services with even basic plans. Routine physical examinations such as mammograms and a colonoscopy are usually covered as well as common lab tests and immunizations. Most plans cover things such as flu shots at 100 percent.

Catching problems before they start, even if it’s just the flu, can really help cut down on prescription costs, lab tests and even hospitalization.

Another area of health care that might often be overlooked is the wellness information and programs offered through employers and carriers. Most carriers offer a wealth of free information on wellness and disease prevention and/or management online.

The Blue Cross Blue Shield “Walking Works” program is an example of this.Though it may sound simple, taking advantage of these great tools may be the difference between a healthy year and getting pneumonia in the winter. There are a lot of health and exercise tracking programs, for example, on both carrier websites or through resources they will often link to online.

More padded plans might offer even more extended benefits through long-term disability programs. Check and see if your LTD provides any prevention benefits such as an ergonomic assessment at work.

Employee assistance programs are another thing to look out for. They might be automatically offered along with benefits. These types of programs address personal problems that may impact health or work performance. An EAP might offer everything from limited counseling to financial planning assistance.

Flexible Spending Account

One way to get ahead of the health care spending game is to pre-emptively set up a Flexible Spending Account.

An FSA allows you to set aside funds on a pre-tax basis at the beginning of the year. This preset amount can be used for many out of pocket health costs. FSA funds can cover everything from co-payments, deductibles and co-insurance to certain over the counter medications and health supplies.

Plan your FSA wisely. The funds won’t necessarily roll over if they aren’t used.

Definitely give this method some thought. Using money you would have spent already, in a tax-free way, saves a lot of dollars in the end.

Alternatives

Of course, not everyone has access to these kinds of benefits – even the most basic kind.

One avenue employers are taking is a “Mini-Med” option.

Ron Osborne, CEO of insurance benefits brokerage firm, Western Benefit Solutions explains mini-meds:

“Many employers have opted for 'mini-meds.' These plans are not for catastrophic claims such as cancer or other high costs, but they offer a good alternative to no insurance at all. Mini-meds are limited medical plans with basic coverage for things like prescriptions and doctors office visits. This option makes these basic services affordable. Mini–meds are an in-between alternative for coverage.”

Mini-meds are usually best for employees who work part time, or who are not eligible for the full company plan for other reasons. In cases like these, mini-meds are a viable alternative.

Some other programs to check out are organizations such as an “ask– a– doc” or discount prescription program.

Call-in doctor or nurse consultations are a great option if you have access to it. They can include over the phone or Internet consultations and remote prescription writing. You can imagine how much money this could potentially save when you think about the kid who has a fever at 1 in the morning and you don’t know if it’s bad enough to go to the emergency room or not.

Western Benefit Solutions offers a prescription savings program for employers to add to company benefits. Of this Osborne says:

“A savings program like this is a great option for many employers. It is usually ideal for employees with no prescription coverage and can offer deep discounts on many drugs and even more on generic. It also generates savings for things such as lab tests and imaging services.”

In the challenging environment of health care, it might be tempting to give up, but great options and resources can be found if you know where to look.

Livi Whitaker is a freelance writer and authors the positive blog for all things lovely, www.thebrightbit.com

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