Keeping Your Medical Costs Down: A Physician’s Perspective

Keeping Your Medical Costs Down

We all know medical care has gotten outrageously expensive, and just continues to go up. It seems that there’s no end in sight. Insurance is now more expensive and covers less than even a few years ago. In fact, the average American spends over $10,000 annually on healthcare, and it’s going up fast, without much improvement in health outcomes.

Plus, our out-of-pocket expenses (those not covered by insurance) are now over $1200 per person per year and are increasing by more than 10% per year. Those aren’t comforting trends.

We can debate all the proposals by politicians about healthcare until the end of time, but the truth is that no matter who gets elected, significant changes are likely not going to happen any time soon. Our healthcare system is just too gargantuan to transform quickly and effectively. So besides voting (or running for office), what can you do to help limit your costs?

The first answer is to be sure you have at least catastrophic healthcare coverage. Insurance may not seem like a good deal if you’re healthy, but having a hospitalization without insurance is a fast boat to financial ruin. Catastrophic plans are relatively inexpensive, and subsidies exist for most people who can’t afford full price if you buy insurance through Healthcare.gov. If you qualify for Medicaid or Medicare, these are great deals that you should sign up for as quickly as possible. Insurances of all kinds, like a car or home insurance, are designed to primarily take care of catastrophes – healthcare should be no exception.

The next simple step is to use generic medications whenever possible. Generic medications typically cost 80-85% less than brand names, which is significant, especially if you are on multiple medications. In the vast majority of cases, generic drugs are just as safe and effective as brand-name medications.

Also, when it comes to medications, shop around. The price of a medication can vary by 600% at different pharmacies on the same block! The website www.goodrx.com is a great resource for comparing prices, and also offers coupons if available.

Typically, a 90-day supply is cheaper than 30 days, and mail-order is cheaper than a retail store, but not always. And, strangely enough, your medication may be cheaper without insurance than you would pay with insurance, so be sure to ask the pharmacist about this. Finally, if you are on a brand-name medication, try calling the manufacturer, since they often have payment assistance programs. In other words, do your homework.

doctor holding a stethoscope in hand

To further keep costs down, you need to realize that hospitals, and any process affiliated with them, are going to be more expensive, so avoid them when possible. This includes emergency rooms. These are designed for emergencies, such as car accidents and heart attacks, so when you go in an urgency, such as a sprained ankle or fever, expect excessive testing and a high bill.

Try urgent care, or, even better, your primary care doctor for urgent, but not emergent, problems. If you’re not sure, or it’s after hours, virtually all primary care providers have a 24-hour on-call service that you can call to ask what the right course of action would be.

Also read: 10 Easy Ways To Keep Your Lungs Healthy

 

If you are going to have an elective procedure, such as a colonoscopy or minor surgery, try to have it at a surgical center that is not affiliated with a hospital. And call beforehand to make sure that not only is the surgeon in your network, but also the anesthesiologist and pathologist, if applicable.

You’ve probably heard about “surprise billing”, where you get a large bill even though your procedure was “covered”. You don’t want to be on the receiving end of a surprise bill, and a short phone call might save you a lot of money and headaches.

Even better than making sure you’re not overpaying for your procedure or medications are not having to need those in the first place. We have a tendency to massively over-test and over-treat almost any condition in this country, which is a big part of the reason healthcare costs are so high.

Often, providers will treat conditions aggressively because they think it will decrease their liability, make the patients happier, or (sadly) make them more money, even if it’s not the best approach.

Be sure to ask questions about any intervention, including:

  • “Is this necessary?”
  • “What are the alternatives?”
  • “What are the risks versus the benefits?”
  • “How much might this cost?”

 

If the answers are not satisfactory, you might want to get a second opinion, or politely decline.

If you get a bill that doesn’t look correct, or may not seem fair, don’t hesitate to talk to the billing office. Mistakes happen often, and it may have just been an oversight. Or it could be correct, but they are willing to accept a discount or payment plan. It doesn’t hurt to ask, and these are often (reluctantly) granted.

Also read: Nutritional Needs During Pregnancy: What To Eat And Avoid

 

My favorite way to keep your medical costs down is just good, old-fashioned preventive care. A healthy lifestyle not only makes you feel better and look better, but it also helps your bottom line. Studies show that diet and exercise alone can save you over $30,000 throughout your lifetime in direct medical costs, as well as many additional indirect savings. That’s not chump change!

Finally, be sure that any healthcare facility you visit accepts your insurance, and use your Flexible Spending Account (FSA) or Health Savings Account (HSA), if you have one, for any medical expenses. These both can result in saving thousands of dollars per year.

Medical billing can be complicated, confusing, and distressing. So take some time to do research before any non-emergent testing or procedure, and ask for help from your financial advisor, pharmacist, and physician. They should all have some suggestions to help reduce your expenses. Then, go out and spend your money on something you enjoy, rather than on medical tests.

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Dr. Kenneth Zweig, MD, is an internist at Northern Virginia Family Practice Associates (NVFP), a family medicine practice providing full-service concierge health care in the Northern Virginia area.

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