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Lowering Your Out-Of-Pocket Costs
  1. See Your Physician in the Office
    The use of urgent care, emergency rooms or hospital outpatient departments multiply the charges dramatically when compared to office visit charges.

  2. Use Primary Care Physicians (When Available)
    Specialist charges are dramatically higher than primary care physician charges. For many services, primary care physicians can provide equal care to specialist physicians.

  3. Prepare For Your Doctor Visit
    Before the visit, define your goals for the visit. Do you want a complete physical, a consultation on a specific problem, a follow-up to a previous visit, or an answer to a simple question. Perhaps a phone consultation will substitute for a visit. Organize your symptoms and your chief complaint and be prepared to describe them. Have any previous medical records from another physician if they are relevant to the visit goal and have a list of prescriptions you are taking. When your doctor describes a course of treatment, make sure you understand it and agree with it.

  4. Challenge Your Physician On The Necessity Of A Service And Ask For Less Expensive Treatment Options
    Many time physicians do not consider the cost of the services they order. By asking questions about the necessity of a service or the cost, the physician may provide alternatives that are not only less expensive, but that will be more appropriate to your personal needs. Ask if a recommended test is really needed, if the test is reliable and where the test will be processed. Find out if there are any alternatives to the test and if the test is still necessary. Ask questions to make sure the test is performed by a network laboratory to maximum the coverage of the benefit plan.

  5. Get a Second Opinion
    For any invasive procedure it is always a good idea to obtain another doctor's opinion. Do not get the referral for the second opinion physician from your doctor.

  6. If You Cannot Get In For an Office Visit, Use Urgent Care
    Anytime you feel the need for a doctors care, you should call your doctor first. But, if the doctor is not available, an urgent care center is less expensive than an emergency room. These are independent or hospital affiliated clinics that offer care on a walk-in basis, with long daily hours. Be aware of where they are located when you need them.

  7. Search For Less Expensive Prescription Drugs To Address Your Prescription Needs
    Drugs are grouped by therapeutic classes and those drugs that treat certain conditions are in the same class. Within each class, the cost of the prescription drugs varies widely. The most expensive drugs are not necessarily the most effective drugs.

    Consider generics, one time brand drugs outside the seven year protection time-frame, as excellent options for many conditions. Generics average about $10 per monthly supply. If you use brand drugs, look for the less expensive brand drugs within the therapeutic classes. The cost of brand drugs average $60 per month, but can run well over $100 per month for certain drugs.

  8. Use Mail Service For Your Maintenance Prescription Drugs
    If you have a mail service benefit for prescription drugs and you use maintenance drugs on an ongoing basis, you can obtain a 90 day supply of your prescription for a co-payment amount. This is a cost-effective approach to obtain drugs.

  9. Reconcile You Benefits
    Track your medical services and the benefit plan actions to reconcile the physician and hospital bills with Plan payments. Match every medical provider bill with every benefit plan payment to determine if any provider bills are appropriate and accurate.

  10. Take Care Of Yourself And Have Routine Physicals
    The old saying, "An ounce of prevention is worth a pound of cure", is more true today than ever. Studies show that weight control, proper diet, exercise and refrain from smoking all lead to a need for less medical treatment. Today is the first day of the rest of your life, so start today.

  11. Use Home Remedies And Over-The Counter Drugs
    There is no treatment to cure the flu and yet millions of dollars are spend each year for physician visits for the flu. Learn home remedies for cold and flu symptoms, it will save you money. Over the counter medications can be effective in relieving symptoms but ask your pharmacist before buying a drug to understand the risks of any drug and any mixture of drugs you may be taking that may lead to dangerous interactions. Store brand over-the-counter drugs can be less expensive than brand name over-the counter drugs. Buy a good first aid manual and keep it in the house for quick reference

  12. Use Your Deductible Wisely
    Many Plans have a carry-over deductible, anything spent toward the deductible in October, November or December counts toward your deductible starting in January. If you can delay services that will be applied toward your deductible to these three months, it will help ease the deductible impact in the new year. Check to see if your plan has the carryover provision and, if so, plan accordingly.

  13. Make Sure Required Pre-Certification Is Completed
    Understand the pre-certification requirements of your Plan and make sure that all services required to be pre-certified are pre-certified. Your physician will probably accomplish this for you, but should be reminded of the requirement. All plans have a hospital pre-certification requirement and many have other requirements.

  14. Certificate of Creditable Coverage
    If you are a new employee and had previous coverage, provide a Certificate of Creditable Coverage to your new plan. If the coverage is creditable, it will help reduce the impact of limits on payment for pre-existing conditions.



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