9 Ways to Get More Out of a High-Deductible Health Plan
Photo credit: Damir Khabirov
Feb 28, 2020 • 4 min read
If you are young and relatively healthy, a high-deductible health plan (HDHP) with a lower monthly premium can make sense for your budget. (Your deductible is what you pay before insurance kicks in to start covering your bills. Make sure you know these other helpful insurance terms to get the most out of your plan.) But one nagging, weird cough or bike accident can leave you with medical bills piling up in the blink of an eye.
Here, Nicole T. Rochester, MD, founder and CEO of Your GPS Doc shares how to be a savvier consumer—to protect your health and your wallet—if you’re considering or already have an HDHP.
Get a Health Savings Account (HSA).
HSAs allow you to contribute pretax dollars to be used for copays, deductibles, coinsurance and other health-related medical expenses. In many cases, your employer may also contribute to your HSA. Read the fine print, however. Not every high-deductible plan is eligible for an HSA. Find out more reasons an HSA can help you save more money in the long run.
Research your benefits.
Read your plan documents to know what services you can receive prior to meeting your deductible. Even with a high deductible, you can get preventive care (such as an annual physical exam, mammogram, or colonoscopy) free of charge. Primary care visits and even visits to an urgent care center may be covered with just a small copay.
Understand the difference between your deductible and out-of-pocket (and plan accordingly).
Your deductible is what you pay before your health insurance starts contributing to your medical costs. The out-of-pocket maximum is the cap on the total amount of money you have to pay (includes your deductible, coinsurance, and copays). After you reach this limit, your insurance plan will pay 100 percent of all covered health care costs for the rest of the year. Both figures reset at the beginning of the plan year.
If you can, map out what medical appointments you know you’ll have in a calendar year. You can’t account for emergencies, obviously, but any routine check-ups can be planned ahead of time. This will help you map out how much you’ll be paying toward a deductible for each visit as well as what it will do to your out-of-pocket tally, so can see when it makes the most sense to see specialists or other providers who may typically cost more.
Stay in network.
When possible, receive medical care from in-network providers. In-network physicians and facilities will always be less expensive than out-of-network.
Discuss treatment options with providers.
Ask about the necessity of the treatment. Can you take a wait-and-see approach? Can tests be ordered in a stepwise fashion? What happens if you try lifestyle changes (such as diet, exercise, or physical therapy) first? If a procedure or imaging study is necessary, you can save a lot of money by having it done in an ambulatory (outpatient) center instead of a hospital. Always ask your doctor if that is an option.
Negotiate prices with providers.
If you offer to pay in cash and not go through insurance, sometimes providers will be willing to lower the charges if they aren’t contractually obligated to submit charges to your insurance company. (Be aware that this amount will not count toward your deductible.)
Most doctors and hospitals will also offer payment plans if you discuss it with them ahead of time. Just keep in mind they may use a third party; in which case you may incur interest.
Research physicians or healthcare facilities, as prices can vary widely. Most insurance companies have a cost navigator. Healthcare Bluebook and FAIR Health Consumer reveal the fair market price of services in your area.
Read your bills.
Ask for itemized bills so you can see what you are being charged for. It happens more often than you would think that insurance companies and providers make mistakes, charging for services not rendered, or duplicating charges.
Look for Rx savings.
Ask your doctor for generic forms of medication whenever possible. Try these tips to cut medication costs and check to see if you can get your prescription for less by filling it through Blink Health. You can have it sent to your local pharmacy to pick up or shipped to your home for free.
This article is not medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
Blink Health is not insurance. The discount prescription drug provider is Blink Health Administration, LLC, 1407 Broadway, Suite 2100, New York, NY 10018, 1 (844) 265-6444, www.blinkhealth.com.
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