Ten Tips to Make You a Better Healthcare Consumer

You have more control over your healthcare costs than you might think. The following pointers will help you become a better consumer, save money and possibly improve your health.

 
1. Use a network provider whenever possible. To control their increasing provider costs, some insurers have been reducing their network provider lists. When your health plan renews, check its list of network providers to make sure your physician and local facilities are still included.
2. Check your plan’s drug formulary against the list of drugs you and your family members regularly take. Some plans have different tiers of coverage, which might mean you’ll pay more to use a brand-name versus a generic drug or a proven versus a newer or more experimental drug.
3. Use the appropriate provider. When one of your family members has a life-threatening condition, of course you’ll go to the emergency room or call an ambulance. But for a non-threatening condition that can’t wait until your regular doctor’s office is open, an urgent care or walk-in clinic offers care at a lower cost than an emergency room.
4. Decide if you really need healthcare services. Who wants to pay for an office visit only to hear, “Take two aspirins and call me in the morning”? If you’re not sure whether you need a doctor’s care, check whether your plan offers a free 24-hour nurse line. Trained nurses will ask you the right questions to help you decide whether you need care, and what type. They can also refer you to network providers in your area.
5. Don’t automatically agree to every test your doctor suggests. In a survey published in 2011 by researchers at Dartmouth College, nearly half of primary care physicians said their own patients got “too much” medical care. Many routinely ordered screening tests are unnecessary and pose their own health risks. If you have no symptoms, ask your doctor whether a test is really necessary, how accurate it is and what the potential consequences of skipping it or waiting would be.
6. Get informed on current recommendations for common health screenings and procedures. The American Board of Internal Medicine (ABIM) worked with nine medical specialty societies and Consumer Reports to develop lists of Five Things Physicians and Patients Should Question. The ABIM says, “These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation.” See http://choosingwisely.org/?page_id=13.
7. Maintain a healthy weight. Being overweight can affect your health insurance premiums if your plan is individually underwritten. It can also increase your out-of-pocket health costs: The U.S. Centers for Disease Control reports that persons who are obese spent $1,429 (42 percent) more for medical care in 2006 than did normal weight people. Losing even a small amount of weight can improve cardiovascular health, reduce stress on joints and improve your energy levels.
8. Avoid tobacco in all forms. Cigarette smoking accounts for nearly one in every five deaths in the U.S. Even if you don’t smoke, tobacco can adversely affect your health. Exposure to secondhand smoke causes an estimated 46,000 heart disease deaths annually among adult nonsmokers in the United States; it also increases the risk of asthma, bronchitis and sudden infant death syndrome (SIDS) among children and infants. The use of smokeless tobacco is increasing among younger people. However, smokeless does not mean harmless. Smokeless tobacco increases the risk of developing cancer of the mouth, gum disease and tooth decay. It also has negative reproductive effects.
9. Don’t neglect your mental health. Mental healthcare represents about 6 percent of overall healthcare costs, and nearly 30 percent of healthcare costs for young adults, according to the Disability Management Employer Coalition 2012 Behavioral Risk Survey. Individuals with untreated mental health conditions spend more on physical health treatments than other people.
10. Take advantage of any special savings your plan offers. Many insurers have arranged discounts for plan members with other health and wellness vendors, such as opticians, gyms and fitness centers, weight loss programs and more. Check your plan documents or your insurer’s website for more up-to-date information.

Also recommended: Understanding the Health Insurance Claims Process