Here are a few good things to know, especially if your health care coverage is moving toward a high-deductible health plan or if you just haven’t needed to use your plan in several months. Even if you are currently on a more traditional plan, but are headed toward a high-deductible plan, inform your health care providers. Remember, this shift in health care coverage is not news to medical professionals. Nearly one-quarter of all Americans have some form of high-deductible coverage and this number continues to increase. No matter what type of health plan you have, staying informed of your options will result in your best care.
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Start all your appointments by identifying the fact that you have a high-deductible health care benefits plan. Tell the receptionist, the nurse, the doctor, any support staff. Be upfront and let them know. This information will help all those caring for you to understand your perspective as well as work out lower cost options. High-deductible plans are becoming more and more commonplace. Let your doctor and his staff work with you.
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Check your plan before your visit. Keep cheat sheets or lists of covered prescriptions and average procedure costs handy. On most plans, many preventive medications are fully covered. How are they covered on your plan? Help your doctor help you. Knowing what is an out-of-pocket cost may help focus your medication choices.
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Double-check your HSA or HRA balance before scheduling an appointment to ensure you are able to cover the out-of-pocket costs for any visits.
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Be specific about the reason for your visit when scheduling an appointment. If you are scheduling a physical, use the word “physical.” (On most plans, a preventive appointment like an annual physical is completely covered.) If you start to ask about your sore ankle, the visit may be billed differently and no longer covered as a “preventive appointment.”
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Know your options for treatment. Depending on your medical need, you may want to try a less expensive option such as a virtual doctor’s visit by phone or video. For some issues, an urgent care facility may be another less expensive option.
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In the end, the costs are yours to manage. Ask your doctor’s office what the visit will cost you or be prepared to follow up with your health plan administrator to fully understand the direct cost implications to you. The costs are specific to your plan benefits and may differ from other group or individual plans.
Your doctor will appreciate your involvement in your own health. Many studies show that the more knowledgeable and involved we are with our care, the better the outcome. Your physicians want you to comply with their recommendations. It hurts everyone when we don’t fill our prescriptions or make needed doctor visits. They want to create do-able solutions for you. So don’t be afraid to ask about options. By asking about costs, treatments and frequency of visits you always know more than when you started. Good health to you.
What is an HSA anyway?
I have an HSA with company contributions. Now what?
Understanding the Basic Terms