“That’s what you have insurance for...”
“Don’t worry, my insurance will pay for it...”
How often have we heard or even used one of these statements? But, do you realize that the costs of health care impact you even if your insurance covers it? All the costs paid for medical claims are paid from the premiums that employers and members pay. When costs rise, premiums rise. It’s that simple. And, when costs go up, employee contributions towards premiums usually increase too. Even if the employer pays increases in premiums, that leaves less money on the table during negotiations for wage increases. No matter how you look at it, medical costs impact you. In addition to the out-of -pocket costs you pay, the amounts paid by your insurance still impact your paycheck. Thus, it’s important to be a smart health care consumer to keep costs down.
WAYS TO REDUCE YOUR OUT-OF-POCKET MEDICAL COSTS:
Save on medications – purchase generic, mail order, and formulary
Talk to your doctor about your benefit plan to make sure services are in-network
Use in-network doctors and facilities
Grab the phone before the car keys: Can you be seen by your primary care provider for this health care need? Is a Specialist warranted, or is Urgent Care or Emergency Room needed?
Go to the most appropriate and cost-effective place for your condition (log onto www.anthem.com for cost comparisons and quality rankings of providers/facilities)
Save money on prescriptions by visiting Medtipsterfree.com. This site will help you find generic drugs for a lower co-pay or even zero co-pay.
Read your medical bill and explanation of benefit forms (EOBs)
REVIEW YOUR HEALTH CARE BILLS
By reviewing your health care bills, you will know what health care actually costs and could prevent your insurance plan from paying more than is necessary. Billing of health care services is very complex. For example, today, there are more than 14,000 procedure codes for physician services. Not to mention the numerous health conditions that could be diagnosed. Providers are human and billing errors do happen. Here are some things you should look for when you receive a bill or Explanation of Benefit (EOB) from your insurance company.
Did you receive all of the services listed on the bill?
Are they in the correct amounts or dosages?
Even though you might only be responsible for a copayment or small percentage, note the total cost of care and how much your insurance paid.
Avoid duplication and actively participate in your care; know what services you received and why they were done
For some services you may receive bills from providers whom you never see face to face – such as radiologists
When your doctor orders blood work, ask to have the test results shared with all of your doctors (any specialists you regularly see) to avoid double testing. You should also keep a copy of your lab results for yourself so you have the information in case you see a new doctor or need to go to a walk in medical center.
Anytime you see a discrepancy or a questionable charge, contact the United Welfare Fund at 718-658-4848
AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE
Consumers need to play a key role in all aspects of health care delivery. Remember that money you save the Fund in unnecessary charges will help hold down health care costs – including costs you pay in the form of premiums, deductibles, and copayments. Learning how to use health care services helps to maximize your benefits. Leading a healthy lifestyle reduces your risk for the leading causes of preventable death. Being a wise health care consumer is an important choice in leading a long and healthy life.