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Health-Smart Insurance Strategies
Reduce expensive medical costs with healthy, cost-efficient methods.
When it comes to cutting corners with health insurance, one must not go too far. It’s synonymous with compromising one’s well-being. While medical expenses grow and health insurance is a necessity, how can costs be curtailed? Reducing medical and health costs starts with learning what is covered.
Generally, health insurance plans are devised of two categories. One type of health plan is an indemnity, also referred to as a reimbursement plan. It allows the insured to select their own doctor. It pays for the medical expenses--entirely, partially, or up to a specific amount per day for a specified number of days. Managed care plans also known as health maintenance organizations (HMOs), preferred provider organizations (PPOs), and point of service (POS) plans usually offer broader coverage, but there is interaction and involvement between the insurer and a selected network of health-care providers (doctors, hospitals, etc.). For instance, an HMO requires a primary care physician (PCP) to make all of the medical care arrangements for referrals to specialists in the network.
A worthwhile health insurance policy is made up of several components. It covers the following expenses for:
- visits to a physician's office or a doctor's hospital visit
- hospitalization room, board, and incidental services
- surgeons' fees and related costs
Other out-of-pocket expenses may be required in addition to the monthly premium costs. For instance, if any family member covered in the plan makes frequent physician visits, the expenses can be exorbitant. Prior to making a health insurance decision, verify if the plan requires any or all of the following:
- Coinsurance: a certain percentage of the medical cost after the deductible is reached.
- Co-payment: a fixed amount for each visit to the doctor or medical provider (commonly used with HMOs).
- Deductible: the amount to pay toward medical expenses (usually annually) before the insurance company begins to pay claims (commonly used in indemnity plans).
Next, prioritize what is important to your personal health insurance needs. In general, an ideal health insurance plan is one that offers the greatest flexibility with the best benefits for the lowest price. In reality, a standard health insurance plan is nonexistent. While shopping around for an optimal quote, consider the following before choosing a plan:
- Does the health insurance plan cover the medical services that you and your family necessitate
- Is there freedom to select a medical provider
- Does the plan include the providers you currently use?
- Are there any coinsurance, deductible, or co-pay requirements?
- Does the health plan have exclusions or pre-existing conditions? If so, what is the waiting period? (On average, the waiting periods range between three months to one year.)
- What is the reputation of the insurer and is the positive rating from a major ratings organization? (The information can be confirmed by contacting your state's department of insurance.)
Six Ways to Trim Health and Medical Expenses
Intelligently, cost compare health insurance. For affordable good coverage, shop around. Although the spectrum of premiums vary, money can be saved with quotes from several insurance companies. Weigh and balance each plan's coverage, features, limitations, and exclusions. Determine whether out-of-pocket expenses are cost efficient to the premiums.
Additionally, review the other benefits offered by the prospective health insurance plan. For example, insurance companies often provide extras to maintain good health (i.e. discounts on vitamins, alternative medicines, health club memberships, or bike helmets). Review all plan materials to learn which products and services are available through the health plan.
Practice safe health and take advantage of free health screenings. Research local free health screenings and low cost vaccinations. Clinics and hospitals often provide a range of screenings; like, blood pressure, cholesterol, and mammograms.
Maintaining a healthy lifestyle is the most effective way to lower medical expenses. Try the following health tactics:
- Exercise on a regular basis
- Ditch poor health habits (excessive alcohol use and smoking)
- Use wellness programs
- Have regular checkups
Maintain a healthy weight
Reduce prescription drug costs. If you use prescriptions drugs on a regular basis, drugs can inflate a budget. To trim costs, try ordering prescriptions via online drugstores. If you are a member of prescription drug plan, you might obtain a three-month supply of your prescription drug through the mail for the same price it would cost for a one-month supply.
For prescriptions, most health plans have a three-tier co-payment system. The top tier features the very expensive brand name drugs. The middle tier is includes medications that the insurer considers cost effective. Usually, the lowest tier is the least expensive and includes generic pills. Drug costs can be saved by $10 to $40 per prescription by asking a physician for medications that are in the last two tiers. Moreover, when deemed medically appropriate by your doctor, pills can be split in half to cut prescriptions costs. For instance, if a drug comes in 25 mg and 50 mg, request that your doctor prescribe the 50 mg pills so that they can be split. To save other prescription costs, request generic drugs.
Log and track medical bills. Certain medical expenses are tax deductible; therefore, keep an itemized log. If the total medical expenses exceed 7.5 percent of the adjusted gross income, the bills are potentially a write-off. Authorized medical expenses include anything from healthcare services to medical aids such as contact lenses, hearing aids, eyeglasses, etc.
Negotiate health and medical discounts. Negotiating lower medical bills is a possibility with certain physicians, or hospitals if -- they are willing to reduce the price. Ask for a lower price if you pay in cash, upfront.
Critically, cutting corners with health insurance, one must not go too far. It’s synonymous with compromising one’s well-being. While medical expenses grow and health insurance is a necessity, how can costs be curtailed? Reducing medical and health costs starts with learning what is covered.
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