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Nine ways to find money in your health plan

Smart spending can keep your health care from costing an arm and a leg.

Feeling the pinch? With costs rising on everything from food to gas, every penny counts. It pays to shop smart — especially when it comes to health care. Your best asset? A clear understanding of your medical coverage and how the system works.

You can take control of your health care costs. Here are a few strategies to help cure your budget’s medical bill blues:

Understand your medical coverage

  • Know your network. Doctors can opt out of provider networks without warning. Always verify that your doctor’s still in the network by asking when you make the appointment. If you’re given a referral, double-check they’re in-network. Same goes for labs, hospitals and urgent care centers.
  • Practice prevention. Fully 75% of all medical bills are the result of preventable or lifestyle-related disease. Regular checkups can help catch disease early and lower your risk of facing high medical bills in the future. Most health plans cover preventive care as a copay, which makes the visits relatively inexpensive.
  • Get empowered with your EOB. After you file a claim, your provider will send you an Explanation of Benefits, or EOB. This outlines how your insurance covered your claim and shows you what amount you may be billed for. If you suspect a mistake, contact your insurance provider. Many mistakes can be easily corrected — and that can save you some money.

Pow-wow with your physician and pharmacist

  • Don’t forget your formulary. Bring a list of your plan’s covered prescription medications (the “formulary”) to your doctor visit. Most plans price covered medications at different “tiers,” and the price difference can be substantial. Giving your doctor the list can help him or her choose the right medication — at the right price — for you.
  • Go generic. Sometimes doctors prescribe the same medications out of routine — without an understanding of how much they cost. Always ask your doctor if there’s a generic alternative or cheaper drug that can treat you just as effectively.
  • Reconfigure your dose. If you take a regular medication twice a day, see if there’s a higher strength version available. Ask your doctor if you can safely take the higher dose once a day. Sometimes these higher-dose medications require the same copay as their lower-dose counterparts. This could mean less hassle — and less money!

Be a savvy shopper

  • Price-compare your prescriptions. Need to fill a prescription at a retail pharmacy? Shop around. Even if you pay copays, you could save money by looking for the lowest price. You’ll generally pay the lesser of the cost of the prescription or your copay. If you take a regular prescription, consider a 90-day supply through mail order. You could save money on copays and conveniently review lower-cost alternatives, order refills, and research side effects and drug interactions online.
  • Find the right fit. Choosing the right health plan is the first step toward saving money on your medical expenses. You’ll need a balance of cost and benefits—you don’t want to pay for more coverage than you regularly use, or scrimp on premiums only to pay a bundle at the point of service. Estimate your expenses for the coming year, then select the plan that makes the most sense. It’ll help you maximize your health care dollars.
  • Explore extras. Most health plans come with discount programs that can save you money on health-related products and services. Many providers also have 24-hour hotlines with nurses and health advocates. They can help you decide whether your child’s fever warrants a doctor visit, give you wellness support or help you through a diagnosis or treatment decision.

Becoming an empowered health care consumer helps you save money, time and effort. It can also help control long-term health care costs. And that helps keep everyone feeling good.

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