When you have insurance through your employer, you may have heard the term ‘deductible’ being thrown around but not know precisely what it is or if it applies to you. A deductible is an amount that must be paid out of pocket by the insured person before an insurance plan kicks in. Once this amount has been met, your health insurance can begin paying for benefits.
When patients meet the deductibles, they are sometimes stuck with high co-pay costs after visiting G.P.s and specialists in search of various treatments. For most people who are relatively healthy, there are certain things they can do to maximize their after-deductible family health care spending and keep costs low. Here are some tips on what actions you need to take to maximize your family medical care plan:
Review All Your Current Claims and Find Out Which Ones Are Already Covered by Your Family Medical Care Plan
You should strive to know what is covered or not covered by the family medical care plan. Before you start doing anything, it is essential that you first know what is included in the coverage of your family medical care plan and what’s not. This way, whatever actions you will need to do after meeting the deductible will be well defined and won’t cause any problem for anyone involved. It is best to ask an expert about this matter; otherwise, gather information from several reliable sources on the internet or maybe from other people who have a similar type of insurance.
Find out how much the co-insurance rates are for the healthcare services and procedures under your family medical care plan. The co-insurance rate is the percentage of your medical treatment that you need to pay for upon reaching your deductible. The more expensive your family medical care plan is, the higher the percentage of co-insurance that you will be paying for per procedure or service provided. It would be best if you could access several reliable sources of information regarding such matters to give yourself an idea of how much you need to prepare before reaching your deductible and meeting it.
After meeting the deductible, all parents need to know how much is required for each claim before proceeding with any procedure or service under the family medical care plan. This way, you can more or less prepare for any possible shortfall of funds that may arise shortly after you meet your deductible at the end of the year. You can ask an expert in your company if they are willing to help you with this matter.
Go Private
Some treatment, such as a medical imaging service, is cheap through private clinics. They offer bulk-order discounts to hospitals. Even if your insurance does not cover the cost of consultation and other fees at private clinics, you should still be able to save a lot by receiving the treatments there rather than hospital outpatient departments.
Patients can benefit from both public and private health coverage simultaneously if they use ‘alternative service providers’ like clinics and drugstores designated by personal insurers. It is advisable that you buy prescription drugs outside of the hospital pharmacy. If your kids need expensive drug therapies for chronic diseases like cancer, arthritis, or asthma, find out from your primary care physician where you can buy them at lower prices.
There is often no good reason for buying prescriptions within hospitals at an inflated sale price when pharmacies across town offer better deals on the same treatments. Hospitals tend to get heavy discounts from pharmaceutical companies anyway, because of their bulk orders.
Also, buy over-the-counter drugs outside pharmacies. Purchasing OTC drugs such as paracetamol and ibuprofen from supermarkets or convenience stores is often much cheaper than using them at hospital pharmacies after a prescription from G.P., who will charge a much higher price.
Ask For a Written Prescription When Getting Drugs
If you need to buy some medication at a hospital pharmacy, ask the doctor to write down the full name of the medicine and dosage on a piece of paper rather than telling you verbally. With this, you can easily take advantage of bulk-buying discounts from pharmacies. Some pharmacies may frequently run promotions to encourage members to sign up for their loyalty cards, which entitles them to discounted prices when purchasing specific medications.
When your pharmacist gets your medicine from shelves, they can find out the lowest price for this medicine by checking all local pharmacies. Sometimes you will be charged more if not given a detailed list of what you have been prescribed. Some pharmacists may refuse to give drug estimates orally because they want to avoid responsibility if an overcharge is reported later on.
With a written prescription, it is easy to switch to generic prescriptions when possible. Generics are the same drug as brand-name medications but generally cost much less and can be cheaper than your deductible if you’re not able to take advantage of an FSA or other payment plan that covers the total cost. Also, try to get your prescriptions filled at a local pharmacy instead of having them mailed in by mail-order. Mail-order prescriptions tend to have much higher co-pays.
Ask Doctors Whether Specific Medical Care and Tests Are Necessary
Don’t wait to see the doctor once you have made the deductible. This will make medical conditions worsen and become more expensive to treat in the long run. If you know your family history includes a predisposition for a particular condition, get checked out right away just in case any issues can be detected early with proper screening.
Be careful with how much medical care you receive on any given visit, especially when seeking urgent care services. If possible, see only one doctor during any given appointment time slot. Don’t get checked out by every person on staff once inside an emergency room if all you have is a cough. The more examinations you have on a given visit, the higher your bill will be.
Before getting your kids tested, find out whether they can be referred to specialists directly or just have the tests taken at hospitals’ laboratories first before sending the findings up for review. It may save you thousands of dollars if the specialist fee component can be waived by just having the same tests done again under the hospital’s charge, which will automatically send results to relevant departments.
Never go out of the network for medical services, as this will result in a much higher bill than if you were treated within your plan’s network. If you plan on traveling outside of the country when seeking medical care, make sure your choice of doctor and healthcare provider network is on a preferred provider organization (PPO) plan.
While PPO doesn’t directly affect whether or not the patient has reached his deductible yet, it affects his deductible. With a PPO plan, your deductible will be lower than if you were on a point-of-service (POS) plan or another type of indemnity plan.
Consider Cheaper Medical Care Options
Ask your physician about switching from one medication prescribed by them to another that may be ‘off-label’ and cheaper. Try generic prescriptions instead of brand-name prescriptions when possible since these tend to cost less. Discuss this option with the prescribing doctor before making any changes to your medication regimen. When you purchase over-the-counter medications, make sure they are bought for someone who is already sick. Your buying cold medicine when you have a stuffy nose or ibuprofen when you have an ache will count towards meeting your deductible.
For the treatment of chronic diseases such as diabetes mellitus and hypertension, there are different ‘tiers’ of medications under the same generic name but with vastly different prices from one producer to another. Also, certain medicines might work better with specific brands, so always ask doctors or pain management physicians if they have any preference when prescribing these drugs. Those who need treatment regularly may consider choosing insurance plans that cover all tiers of a particular drug.
You can get kids vaccinated privately. It is worth getting your kids vaccinated at private clinics rather than waiting for free vaccinations through public hospitals for some vaccines that are not covered by public programs. For example, the flu vaccine can be found easily on sale at many clinics but only given every January during the annual flu campaign by government clinics. If your child catches flu before they are due to get the free vaccine, that would be such a waste of time and money.
Make Use of Financial Assistance Options Available to You
Are you seeking to acquire a plastic surgery procedure after meeting your deductibles? Where can I easily get a touch-free infrared forehead thermometers? You may be able to get help paying for medicine, doctor’s visits, equipment, rehab and physical therapy services, mental health care, or other health expenses through other financial assistance programs offered by your insurer that are separate from the deductible. Check with your insurer to see what they have available.
Research Patient Assistance Programs (PAPs). Some pharmaceutical companies offer free medication through PAPs if you meet specific income requirements. These meds could be used to fill in the gap between when you hit your deductible and when you can refill a prescription at a lower cost or even get it for free through an FSA or similar program. If you need expensive medication every month, this can be an excellent help.
Pay with a pre-tax Flexible Spending Account (FSA). If you have an FSA set up for medical expenses through your employer, each dollar you spend decreases your taxable income by one dollar. That’s about 28% savings on the money you’re spending! Even if your deductible is high enough that you can’t use all of your funds in the same year, this is still money that will be available to you in future years. To learn more about FSAs, including how to set one up and which expenses qualify for payment from it, look for an FSA guide.
Getting secondary insurance if you have to meet a high deductible before your primary coverage kicks in. The secondary insurance plan covers small expenses up to an amount that fits your primary deductible. For instance, if you know all prescription medications cost less than $100, you could buy a secondary insurance plan for these costs, so you never need to worry about meeting the higher deductible from your primary insurer.
Make the Best of Every Visit to the Doctor
Go armed with a list of things you want to ask about or talk about and take notes on what you see your child doing at home. Also, make sure to take notes on any questions that come up to you, since often parents are more aware of their health problems than those their children have.
Always keep track of which medications your child is taking right now, including the dosages. If possible, test your memory by writing down just three essential medications before heading out to the doctor’s office so that it becomes automatic, which makes it easier for you to play catch-up when there.
You can easily take charge of your family’s medical environment by keeping all of the paperwork from every visit to a doctor, hospital, or clinic in one place so that it is easy to find. Make photocopies of those records and give them to family members who may be taking care of your child as well as any babysitters you use. If the information becomes too cumbersome, consider scanning documents into a computer file that can be e-mailed to everyone who needs access to this critical data.
Your family medical care plan is a preventive program provided by your employer to maintain the health and well-being of its insured. It’s a matter of fact that most employers offer such a plan for their employees, along with the other employee benefits. And it is due to this reason why you can’t deny the importance of your family medical care plan in maintaining your overall wellness.
In connection with this, you should know that you need to do a few things or actions when your deductible is reached for you to maximize the advantages of having such a family medical care plan after meeting the deductible at the end of the year.
