Guest post from Rachel who blogs at RachelWojo.com
As mother to a child with a long-term, life-threatening illness, innovative methods of securing medical supplies have been crucial to our family’s financial sustainability. Obviously the following list is not comprehensive, but perhaps you will get a fresh idea or two that can practically assist you during high-demanding medical crises.
1. Use your private health insurance for every doctor’s visit, prescription, and therapy.
This point may seem like a no-brainer, but often consumers will forget to provide current information, especially at the beginning of a calendar year, or insurance plan year.
2. Take advantage of Flex Spending Plans.
If your employer has a medical flexible spending plan available, be sure you take advantage of this avenue to save from paying taxes on your necessary medical supplies. There are guidelines and restrictions as to the covered items, so be sure to identify the items and coverage you need from the flexible spending plan before you commit to it.
3. Determine if the prescription or therapy is truly medically necessary.
Often something as simple as the location of therapy changes the cost dramatically (such home versus facility). Get a second opinion if you are not confident.
4. Use a medical supply mail-order company for long term prescriptions.
Purchasing a 90-day supply over a 30-day supply will usually save money in the long run. Many companies have free shipping and you save time and money on pickup and gas.
5. Ask for samples.
When looking at medical supplies, weigh both quantity and quality. Ask for samples and test them before committing to a box of 500.
6. Use generic.
Ask the doctor for a generic brand prescription instead of the brand name.Whether the item is medication or testing supplies or whatever, often the generic will serve the same purpose while saving money.
7. Be proactive in asking others about their medical/financial strategies.
Social workers, clinical workers, nurses, fellow parents…you never know who has information about a program or benefit of which you are unaware.
8. Don’t be afraid to ask for a payment plan.
If you owe a medical bill you cannot immediately pay in full, make payments. Most medical billing companies try to prevent turning the bills over to collections as long as the consumer is faithfully making payments, regardless of the size.
Many people encounter serious financial difficulty due to unexpected medical issues and it can be discouraging. My hope is that this list will promote new ideas that evolve into long-term solutions for you or your loved one’s continual medical care.
How do you save on medical bills?
Rachel Wojnarowski is originally a small town country girl who converted to a suburban mother of seven by way of life happening. She and her husband, Matt, enjoy caring for their busy family, whose ages span 9 months to 21 years and include a special needs daughter. She loves to inspire others through her blog by sharing faith, family, and fun.
We have a high deductible plan and my sons ADHD meds are about $300 out of pocket until we hit the deductible. We found using GoodRx.com or Medfisher.com to compare prices between pharmacies and to obtain a savings voucher saves us $200 a month. I only pay $99 a month now for the same meds. I thought it was a scam, but no. It is totally legit and saves us a ton of cash.
For those underinsured/uninsured, for help with prescriptions… Check out FamilyWize.org. A lot of United Way distribute the cards, or you can print them for free. Their cards can reduce the cost of prescriptions when used at the pharmacy, it doesn’t cover all of it, but can help a lot! The average savings is 42%… My husband used it once on a prescription that cost $350 (which we wouldn’t have been able to afford monthly!) and it reduced it down to $35!! It’s worth a shot to check out.
Another thing about the Walgreens Prescriptions Savings Club (or W card) is that you can include pets as family members and get their meds much cheaper than at the vet (of course it has to be human meds that are approved for use in animals, they do not carry pet meds). The W card is $20 per year for one person, or $35 per year for a family, regardless of family size.
I recently had a medical emergency while we were between insurance plans. When the doctor ordered an x-ray, I told him I was paying for the visit out of pocket and asked if the x-ray was strictly necessary. It turns out, the x-ray wasn’t. The lesson I learned is that doctors sometimes take for granted that the insurance company will foot the bill when ordering pricey tests and treatments. If you’re paying out of pocket, be sure to ask what is really necessary.
After dealing with medical issues as my mom fights cancer, it is absolutely necessary that you ask for all your paperwork. If you have it all, you can discuss your results with the doctor and he/she won’t have to run extra tests, etc.
With that said, I believe it’s extremely important to be knowledgable of your disease. I think that the more you know the smarter you can be about the services you need.
A lot of these suggestions are great! I wanted to add one suggestion for non-emergency medical care, which is to consider getting it done abroad. Lots of countries in Asia and Europe have hospitals known for great medical and dental care at WAY lower rates than in the US. We saved $3,000 on dental work alone in Thailand last year, and sometimes you can save way more than the cost of the trip.
In addition, buying prescriptions (or getting them prescribed) while you are traveling can save you tons of money. I have one prescription that costs $32/month in the US… and 80 cents for a year’s supply in Thailand. plus I don’t need a prescription there. Traveling friends and family can sometimes bring things home for you.
It was already mentioned to price check medications at different pharmacies. Even different pharmacies within the same chain may have different generics for the same drug, which can be a difference in price (each pharmacy has someone different ordering the generic meds). Don’t forget to price check your local pharmacies (vs the chains) When I was giving my dog subcutaneous fluids at home, I went from paying $12 for one bag ($144 for 12 bags) at the vet, to $54 for 12 bags mail order to $25 for 12 bags at our local family run pharmacy. I had to ask the vet for a prescription–they did not offer the option.
I forgot to mention. 1) You can ask the pharmacy if they know of any discount programs for the medications you use. My pharmacy told me about a discount card, did the paperwork for me, & it’s saving me $82,50 per year. You can always call ahead & ask to speak with the pharmacy manager, who will know more than some of the part time employees. 2) Some local pharmacies will do the 3 month pricing that mail order does (obtain 3 month supply for 2 1/2 month cost). HyVee does here.
In regards to xrays, as a poster mentioned earlier, you can get significantly lower cost xrays at a small office. My husband is chiropractor and he takes xrays the same way a hospital does and charges hundreds less. It has to do with insurance reimbursement. Anyway, a small office, like a chiropractor, has xray equipment and can take pictures, determine if there is a break or whatever and hand the xrays to you or put them on disk and you can head to the hospital for a cast, or head home because there isn’t a problem. The chiropractor will bill your insurance and you will be shocked at home much less it is—hundreds! You can even call ahead and find out how much a leg, ankle, shoulder xray would be. Obviously if you or your child is cringing in pain you may just head to the hospital. But if you are unsure, it is a good place to start.
Some commenters have noted that you can get a discount paying your bill in full immediately. This is also true if you have a bill you have been paying on for some time-I recently found this out when speaking to our hospital about a bill for my daughter. After a year of paying on it, it was down to approximately $400 and they called to let us know that if we paid it off within two months we could save 20%. Although it wasn’t an option for us to pay off the bill immediately, by this time we could afford it and saved a big chunk of cash. So don’t be afraid to go back and renegotiate!
Great point!
If you are a member, Costco has a Costco Member Prescription Program for folks without prescription insurance. It is free and easy to sign up. http://www.costco.com/Browse/ProductSet.aspx?Prodid=11486621
So many great ideas here! The thing that has helped me the most is a prescription discount card. I use the Swagbucks Health Advantage Card. I have saved so much money on my medications! The web address is:
http://www.swagbucks.com/p/health-advantage
It is free
They even have a tool that allows you to enter your med, amount you need, dosage, and zipcode; and it lists the prices for that med at local pharmacies that accept the card, and distance from your zipcode! This card has often made the difference between being able to get a med, and not. I have a Walgreens W card, I pay the yearly membership fee, and that saves me a lot; but sometimes the price on the swagbucks card is even cheaper!
If you’re taking a brand name medication that hasn’t gone generic yet, or you can’t take the generic for some reason, look for manufacturer coupons. Big drug companies sometimes offer them, and many have more than one use.
Also, if you don’t have the lump sum to pay for a medication right away, see if you can ask your pharmacy to short fill it for you and only pay for two weeks worth. That way you don’t go without, and you can hold over til your paycheck you comes in.
And be careful with the mail order! In theory, yes, it should be cheaper, but it isn’t always. Make a few phone calls and compare prices.
–A pharmacy customer service rep. 🙂
I have been a nurse for 18yrs. I have seen so much. It breaks my heart when I see patients all the time that come to the hospital time after time b/c that can not afford their medications. I very much agree that your doctor needs to always be aware of what your needs are and that you can not afford mess if they are too expensive. I have a $2500 deductible for my family of 3 and then 80/20 max of $6500. None of my meds are discounted until I have paid the $2500. I have one med premarin that costs me &169.00/3mos. Right now I am taking it every other day as I do not have enough money in my HSA acct to pay for it. I am sonvery blessed to have health insurance,but so many people do not.
I also want to add if you have an HSA like I do, SHOP around for the cheapest pharmacy. SAMS club is the cheapest. Walgreens,CVS,Target and most of our local grocery stores are very expensive!!!! If you have a co-pay you might not care.
Laurie
I always ask if there is a discount for paying cash at time of service. I saved 20% on xrays on my knees, and I payed only 600.00 for an MRI for my husbands herniated disk, and saved 400.00!
And don’t be afraid to ask the doctor about the meds they prescribe! Thankfully, I’m not chronically ill, but I had a sinus infection and the doc prescribed an antibiotic. When I went to pick it up, the price was almost $200. AFTER insurance. I said, “Um, no thank you,” and called my doctors office to ask for something cheaper.
Now, if I had NEEDED that medicine, I would have paid for it. But plain old amoxycillan worked just fine. And it only cost me $10, plus the headache of calling back.
In AZ, anyone can apply for the Copper RX discount card, but not everyone knows about it: http://azgovernor.gov/coppercard/ Also, try talking with your pharmacist. Often times, they know of programs to enroll you or your family members to help cut prescription costs.
Pay attention to your prescriptions and ask questions. Sometimes doctors write scripts for over the counter medications (like Ranitidine, which is a prescription generic for over the counter Zantac). Believe me, once I asked questions, I switched and saved! (with my doctor’s blessing of course).
As for needing medical aid, your best resource is your doctor. Sometimes you don’t even need to schedule an appointment, you can simply explain your insurance situation over the phone and the receptionist can give you the name of the local government office or program that may be able to help. Usually, your doctor can get the paperwork started for you (especially if you end up in the ER).
I would add – don’t pull out your credit card thinking you have to pay a medical bill right now! (Unless you can pay it all off that month.) I have heard too many stories of people carrying medical debt on a double digit interest credit card. Never do that. At a hospital they can direct you to applications for financial assistance if needed, and they can cerainly set up a payment plan for you. Doctors offices are not as flexible, but most are willing to work with you.
My son was diagnosed with Hydrocephalus in September 2011, and since we live almost two hours away from Children’s Hospital Colorado, I’ve found that scheduling all of his appointments on the same day helps with travel expenses and taking time off work. We’re on a payment plan, and should have it paid off by October.
The best thing to do is contact your health insurance company and ask specific questions about your deductible, coinsurance, copays, coverage, etc. The doctor’s office and/or hospital can help you make sense of it all, too.
Also, I’m currently on hormone therapy for Endometriosis and have to get monthly shots that cost over $750 per shot for six months, plus a daily pill. Thankfully my insurance covers most of it, though the remainder counts toward my annual deductible and coinsurance. My doctor gave me a discount card that covers the last $250 after insurance. So far I haven’t had to pay at all.
I know something else we did to save $ on an elective medical procedure. My husband wanted Lasix. He was on my insurance at the time, but we knew that would be changing shortly. My insurance gave a huge discount on it, so we wanted to do it while he was still on mine. The office offered a payment plan where you could make payments. If you paid it off in a year, you didn’t have to pay any interest. We did it in Nov. and paid it off when we got our tax return. We had done the math and figured out we could afford the $200 – $300/month to pay it off in a year’s time, and made the $200something dollar a month payment until we got the tax return (just in case we didn’t get as much back as we usually do). I know it would be better to save and pay cash up front, but if we did that, we would have spent way more on his insurance. Now we don’t pay for glasses or contacts (going on 6 years!)! Lasix is not for everyone, but my husband was a great candidate for it.
Publix offers many antibiotics for free. I only pay about a $10 copay with insurance, but still that’s $10 saved. Our pediatrician is the one that first told us about it and now I always ask, “Is that one that Publix gives for free?” They always know if it is or not so I don’t have to go there if it is one I have to pay for — CVS is closer to the house, but Publix is not far and Publix is by the doctor’s office. If the sick child is not absolutely miserable and/or deathly contagious (we had a history of ear infections with our oldest, finally got tubes in Dec.), sometimes I grocery shop while we wait–which takes making the list the night before, but with the ear infections, I pretty much knew the drill, knew what was wrong, and knew we’d be getting antibiotics the next day (none since Dec.–keeping fingers crossed).
We also use an FSA. We have a grace period until mid March to use up funds. Some years we use up, some we have $500 left! I renew all my 90 day allergy meds in the beginning of March (I only use nasal spray and eye drops when needed so they last me more than 90 days, but I stock up if we have extra in the FSA). I used to buy OTC products, but they are not covered anymore. Sometimes we forget to pay with the FSA card, or it won’t scan for whatever reason–we save the receipts but don’t immediately file for reimbursement (unless it is a huge expense). If it is a year we run out, oh, well. If we have a few hundred left at the beginning of March, we submit for reimbursement. I never feel that the money was wasted — $75 for eye drops, $75 for nasal spray, $100 reimbursement for receipts, of course someone was sick in Jan. or Feb. –there went the other $200–deductible not met yet–LOL! It always seems to work out.
Another thing to mention is to try to have procedures done before the end of the year if you’ve already met your deductible. We came to the determination that my son needed ear tubes in mid. Dec. The ENT said, “I can get you in on the 29th.” Since we’d already met our deductible on him for the year, we did it rather than wait until Jan or later. Since this wasn’t a life-or-death situation, there was really no hurry other than that.
OK, this isn’t about medication – but therapy. My daughter has a speech disorder that requires a very specific type of intensive therapy – 5 times a week. I was lucky enough to find a speech therapist that specializes in her disorder. I sit in on her therapy, taking notes and the therapist sends home whatever materials we use in the session. We go 2 times a week & I duplicate the sessions at home. At $50 a session, we save $150 a week by doing this. We spent a year in OT (occupational therapy) and although the clinic did not typically have parents in the room, they did allow me to go with her when I asked (you have to be respectful of them saying no if it’s a group session as there are privacy issues with the other patients). Instead of going the 2x’s per week they recommended, we only did 1 time a week plus I was able to give her 3-4 more sessions per week at home.
Also, check out your out-of-network providers for long-term therapies like this. Our speech therapist does not take any insurance (I file for out-of-network benefits). It is a very small office, so her overhead is very LOW. After our reimbursement, we actually pay less than if we were going to a large clinic (w/higher overhead) that is in-network. Nuts, I know.
Also I asked my Dr if it was ok to split my Rx pills in half- but please check if it is ok- he prescribes a higher dose and I use a pill splitter- one Rx goes twice as far- some pills can’t be split though.
Try your local public health department for lower cost vaccines, lab tests, etc. also your public health nurse can help point you in the right direction if you have kids with health problems.
I used to work in a doctor’s office, and though some are very strick about supplies, often a little pull of the heartstring will help in getting a few from the office. I often sent patients home with enough dressing supplies to last them a week when they’d come back if they need more I often gave it to them.
These are great ideas! Two others come to mind –
Carefully read all the bills you receive and make sure that all insurance has been billed and the charges are correct. I saved over $1700 last week calling to make sure that the billing process was done correctly. In the same vein, make sure it is an actual bill. I have called about bills, only to find out that what we received was a notification and that payment from insurance was still pending.
We have to travel several hours for much of my daughter’s care. I asked if travel assistance was available, but none of the folks I asked knew. After I few trips I called both of her insurers and found that medicaid covers travel and food expenses when we are not at home. It makes a tremendous difference to have all of my food paid for during a 32 day hospital stay. If you need medical care away from home, don’t forget to see if there is a Ronald McDonald House in the city where you will receive treatment.
YES! Ronald McDonald Houses are such a blessing. Thanks for mentioning them!
Walmart now has huge sections in several areas in health and beauty of 88 cent heath items. From bandaids to tylenol generic. Lots of 88 cent choices.
Look into Medicaid Waiver programs in your state. Eligibility varies by state, a hospital social worker should be able to help you out.
Also, check into research studies. You may find that the med a doc has prescribed may be in use in a study. Usually, there are frequent clinic visits as well, that are covered as part of the study. And sometimes, there are even financial incentives for participating in a study.
Our local Children’s Hospital also offers acetaminophen for $1 in the pharmacy. If you show that you’ve been there for a visit, then you can get a couple of boxes!
Some stores like Meijer offer free meds. It’s worth checking out!
Ask if there’s a cheaper (perhaps not as new) medication that works as well. When I had strep throat, I requested a SMALLER pill to take than the horsepills that I have received in the past. So, she prescribed an “older” medication. Not only was it easier to swallow, instead of it being $60+ it was only $20. It worked perfectly fine.
I have a family high-deductible insurance which we rarely ever meet. I have found that I do better if I just ask for a cash discount at the dr’s office. I get a receipt and then I can send into the insurance later if needed. Check your records to see about what your office visits cost (after insurance) and how it compares to what the office will give you for cash discount. Ask about “self-pay” discounts.
Unless I have a gut feeling or symptoms of something other than viral…we wait it out a good 7-10 days. During that time if the sick person starts to get better and then gets sick again, that is a symptom of a secondary infection and needs to be seen. I have found that most will run to the dr too quickly for viral symptoms only to be told to wait a few more days and then if not better to come back.
We avoid the ER (if it’s an emergency yes we do go) even if it means going to the dr just to be sure (before the weekend comes up). Once we had an X-ray at dr’s office was $70. Same x-ray a day later at ER was $700 plus reading fees. One time we opted for an Urgent Care/after hours facility on the weekend when we felt one of our children needed to be seen sooner rather than waiting until Monday versus going to the ER.
A fever is your body’s first line of defense of fighting whatever you have. I don’t treat fevers. I will give medicine for comfort though. It’s not very often that my children “need” acetaminophen or ibuprofen for comfort even though they are running a fever.
Paying cash can create discounts. Google and find out about patient assistance programs and know when enough is enough.
My husband is well into his 70’s and he went from zero meds to 18 new meds in one weeks time. I did google research on several of the meds and talked with the doctor about what was truly a need and what the doctor thought might help we cut the meds by 7 meds!
We also cut some of the meds that he does take in half to make the RX last longer (hubby gets what he needs and is feeling better than when he was on all 18 meds. and isn’t that what life is about when your 70 something is feeling your best!)
Also sometimes a change of diet can equal taking less medication.
A complete list of everything you take is important when going to a doctor include vitamins, and over the counter meds and any other herb supplement you take also note if you eat a lot of a certain item.
Sugar subs are bad for you and if your doing more than your fair share you need to share this information with your doctor.
Above all know when to stick up for your family member.
Many hospitals offer a sustantial discount if you pay the bill in full. We have called when the bill arrived and recieved a 20% discount on our part of the bill if we paid with a credit card over the phone. We then paid the credit card bill in full when it arrived to avoid the interest charges.
We have a limited indemnity medical plan through my husband’s work which does cover things fairly well with no co-pays or deductibles. The only kicker is that the number of services and visits are limited and it will only cover a certain amount- everything else we pay oop.
Our son is enrolled in the state sponsored low-cost health insurance program. We pay a monthly premium and have a set co-pay for him for all appointments and medications. This has helped us save a lot of money since he has Autism and requires additional therapies.
It does help to be completely honest with your doctor about not being able to afford certain meds. I have done this and have walked out with less costly prescriptions. Also, take advantage of lower income clinics within your locale if you qualify. Yes, they have a negative stigma and a long wait time, but it is one way to be treated without breaking your bank account.
If you are on medications for a chronic illness, Google the manufacturer and see if they offer any patient assistance plans. Two of our girls are on chronic meds and we only pay a $10 copay out-of-pocket. We should be paying over $100/month, but the manufacturers have copay cards that cover part of the cost of the copay. Some of these types of plans are only good for a year, but even saving $1200 over the span of a year is totally worth it. That’s $1200 we can invest somewhere else!
I have to second Courtney’s comments. My son has been diagnosed with a rare illness which would require medication with the retail value of $3,000 – $6,000 a month. Thankfully we have insurance that should cover everything but a $50 copay every month, however, since there are no generics for his condition, and it isn’t widely covered by insurance companies, almost all of the manufacturer’s have assistance programs to either help with copay assistance or month coverage of medication. It is definitely worth a check with the manufacturer to see if you can qualify for any type of assistance.
If you have medical insurance, know your policy very well. If you don’t, take the time to call your insurance company and ask a lot of questions. I have been able to get some medical supplies, e.g. a breast pump, compression stockings during pregnancy, etc. covered by my insurance , when I had assumed it wouldn’t be covered–but I called ahead and asked many questions–where to buy, what models are covered, do I need a prescription… Also, some policies do not have a co-pay or have a reduced co-pay at “retail clinics”, such as CVS, Target clinics, etc. I have saved SO much money by not making assumptions and calling my provider BEFORE medical services to clarify coverage.
When you get a bill in the mail call the billing office and ask what kind of discount they will offer if you pay it in cash today often this is 10-20% off! This tip has saved my family several hundred dollars! It never hurts to ask.
Another note about claiming medical expenses on your tax return: you can only do this if your medical expenses add up to 10% or more of your income. I’m not sure what they count as medical expenses, but I don’t think it includes optical/dental/etc.
Target has a pharmacy rewards program where you get a 5% all-day shopping pass with every 5 prescriptions (that you can stack on top of store coupons, manufacturer coupons, and the 5% off for a Target Red Card if you have one).
Definitely check your flex spending plan rules very carefully: we were once able to use it for everything from co-pays to Tylenol. This year, we can only use it to directly pay medical providers, but it’s still a good deal.
We haven’t used it, but our township has its own prescription savings plan. (The county might, too.) Also, even if you don’t have optical or dental coverage, there might be some sort of discount plan attached to your medical coverage that could save you money on eyeglasses.
Finally, there are issues with teeth and eyes that fall under the “medical” category. My son had dental surgery for extra baby teeth (!), and it was partially covered; I was able to see my opthalmologist for an eye infection/irritation, as long as they didn’t do any readings for glasses or contacts. You may have to fight with your insurer (we battled it out over the oral surgery for a year), and it’s always a good idea to check with your insurer beforehand on every possible detail: surgery location, anesthesiologist, followup care, diagnostics, etc.
Actually, on your taxes, you can deduct the amount of medical expenses you pay out of pocket which exceed 7.5% (not 10%) of your income for that tax year. You CAN include dental and vision plus any healthcare premiums.
We claimed a medical deduction for the first time this tax year (2011) as my husband had an ER visit and my daughter had eye surgery. It made a difference of $800 on our tax refund. Keep and file your receipts!
Ahh, that’s what it was. Thanks! I just remember our tax guy running the numbers during our worst medical year ever (lots out of pocket) and it wasn’t enough to meet the threshold. Then again, our income is a lot lower now so it would be easier to meet. 🙂
nope it’s now 10% not 7.5%
oops I mean for 2012
Stephanie is right. We were able to claim it last year. My daughter has the same illness as the author and the expenses add up quickly.
Also you can look into pharmacy programs. Walgreens works out great for me I pay $20 annual fee. Even though I pay the initial $20, I pay $12 for a 90 supply vs the $20 under my insurance for my thyroid meds and pay $36 for.a 90 day supply of my birth control vs the $108 id pay (my ins doesn’t cover that brand)…..this may not work for everyone…..I advise people to ask the pharmacist if they will save $ based on the medicines you take.
This worked for us too. My husband was taking a generic med that was $30/month, but through Walgreen’s $20 program he now only pays $10/month.
If you don’t have insurance, many offices will offer cash discounts on bills paid in full at the time of service. My brother received a 10% discount on his root canal because the bill was paid in cash when he had it done. Don’t be afraid to ask.
Totally agree with this one. If you’re able to pay the bill in full, even after it going through insurance, call and ask before paying. You can often get a 10-20% discount for paying the total amount at that time.
We live in a more rural area and our local doctor’s office and physical therapist’s office won’t discount. But both of the nearby hospitals and several in the nearest large city will give 10% if I call and ask. I do mention that I’m willing to pay off the whole bill. It has already been discounted by the insurance because they are “in-network” and my insurance has paid 80%. I even called an out-of-state hospital where my son had to visit the emergency room. Our deductible had already been met and after insurance we only owed $150. But they were still willing to give us 10% just for asking.
My husband and I have a medical plan with a very high deductible. In most cases, it’s not even worth our doctors billing the insurance company. Instead, we negotiate an upfront cash payment that’s a little less than what we would owe after the insurance in-network discount. That way we save a few dollars and the doctor’s office saves time and hassle dealing with another insurance company.
We have also negotiated bulk visits with our chiropractor. We pay a large sum up front for the year’s adjustments, and it works out to only $16/adjustment instead of the usual $30.
I’ve been thinking about doing this since our deductible is $10,000 now and we usually have about $2,000 or so in medical over the year. The only reason I don’t is because if we were to have an expensive event, the amount we routinely pay anyway won’t have been applied to the deductible. (I hope I’m making sense) Do you just consider it the risk of getting the discount?
Yes, I know what you mean. In our case, our deductible is $1500/person. We never get anywhere near meeting that, especially since I see a naturopath twice a year who is outside insurance. Both my husband and I are young, and we’re in good health except for my thyroid/adrenal issues, so we don’t find facing a $1500-$3000 deductible very daunting if something major was to happen. Our insurance only covers 3 chiropractic visits per year, anyway, so it’s not like we’re missing out on much towards our deductible for those visits. The only doctors we see are our chiropractor, my naturopath, the dentist for routine cleanings, the eye doctor every 2 years, and my husband’s PCP for an annual check-up. Since we use doctors so infrequently, our insurance card is more for a discount than anything actually being covered.
Good point about asking to make payments.
I will add to that. They cannot charge you interest on medical payment charges. It will not go on your credit report as long as you make monthly payments, even very small payments, just make something.
Make sure it is a payment that you can reasonably afford. If they are ask you to make $500 payments and you can only afford $200 nicely but firmly stick to the amount you can afford.
Talk to your CPA before setting up a Flex spending plan. My CPA told me you can have the same before tax payments benefit on your taxes if provide medical receipts on your taxes. This allows you to use your money without allowing the flex-spending provider to earn interest on your funds.
As far as the tax thing goes, this may be true, but only if you itemize. My family just takes the standard deduction, so a flex would work better for us than a family that itemizes. The other cool thing about flex is that, say you have a $5000 flex account for the year, you can use it all towards the beginning of the year even though you haven’t actually contributed that much yet.
Flex spending accounts are changing next year; IIRC the new limit is around $2,000.
And to deduct medical costs, you must have costs that are greater than 7.5% of you income. Flex spending accounts are deducted from income before taxes are computed lowering your taxable income and taxes.
I lost my health insurance about 18 months ago and have a rare serious condition. My doctors worked with me to try to switch me to Walmart’s $10 for 3 months worth for most of the meds. For three of the medications-my doctors were able to help me get patient financial assistance with each drug company so I was able to get my meds for free. One of the meds cost $600 a month, one costs $400 a month and the other one is $2000 a month.It depends on your income.
I would recommend talking to your doctors and see if they have a cash price -both of mine give me a substantial break since I don’t have insurance.
There are several great tips both in the post and comments, so I will not repeat any of those. I do want to recommend finding a doctor who is willing to talk to you (or have a nurse talk to you) over the phone when practical. I have a friend who has to choose to either bring her child in or not every.single.time. Our pediatrician, allows us to call and explain what is going on. The triage nurse will tell us what to keep an eye on, basic treatment, or that we absolutely should see the doctor or go the ER. Sometimes, the doctor herself will call us back to discuss what is happening and then let us know that it is ok for us to continue treating at home with over the counter remedies/medications, or have us make an appointment. In any situation, if either myself or my husband feels the child really should be seen, they will see us without an issue. What it all boils down to is that we save on office co-pays because we avoid unnecessary visits and yet still have the comfort of knowing that nothing is seriously wrong.
I forgot another tip. Depending on your state, your pharmacist is also a wealth of information, especially regarding over the counter medications/remedies. If you have something going on that is not life threatening, it doesn’t hurt to stop by and ask your pharmacist for their advice. They may be limited by law as to how much advice they can give (NY strictly limits them), but they can often help you save a trip to the doctor for a simple problem. In Florida, I credit a pharmacist with saving my daughter’s life, or at the very least my sanity. We had just moved there and my daughter woke up on day 2 with a bug bite. We were heading to the grocery store to stock up our new home and she seemed okay when we left. By the time we got to the store, she was cold, listless, and pale. We had no idea where to take her as we had not had a chance to find a doctor yet and had no idea where the hospitals were. We put her in a shopping cart and went into the store, hoping to ask a manager for directions to a hospital. The store greeter suggested we talk to the pharmacist first and we gave it a shot. The pharmacist looked at the bug bite and told us what changes to keep an eye out for and then she walked over and picked up a generic bottle of Benadryl, opened it, gave me the box so I could pay for it and had us administer it to her right there. Within minutes, my daughter was back to her old self and we were only out the cost of the medication, which we should have on hand anyway. I do not suggest going to a pharmacist over a doctor or ER for serious or life threatening problems, but for more simple things, it could save a trip and a co-pay.
This is all good advice! I would like to add one thing. Almost always, if you have a procedure or office visit that is not covered by your insurance, the office or hospital will be willing to reduce the actual bill. I had to get a bite guard this past winter for TMJ and our dental plan didn’t cover it. I asked if the bill could be reduced to what most insurance companies pay for the appliance and it saved us $150!
Also, I worked at a dr’s office for several years before our girls were born and we had a patient that paid one dollar every month on their account. Because they were faithful in making payments, no matter how small, we never even thought about sending them to collections.
I would also add that a lot of prescription medicine has coupons online. Always check for a coupon first, especially for a newer medicine that does not have a generic equivalent yet. If there is no coupon available, ask your doctor about a savings card. I have several prescriptions that have savings cards and I save about $50 a month using them.
Where do you find these coupons?
Check online through the medication’s company website (a lot of prescriptions have patient-friendly websites, which also feature message boards, etc). I get my savings cards for two of my brand name meds from my medical team (I’m a transplant recipient). Another thing, don’t be afraid to ask the pharmacist if they know of any saving cards available…speciality pharmacies can be really helpful because they know the importance of the meds.
Excellent suggestions! Many times the doctor’s office will have coupons as well.
Just google the drug name and “coupon”, like “Veramyst coupon” or try the drug’s website, such as http://www.veramyst.com. I also ask at my pharmacist (I use CVS) and they usually know if there is a coupon out there. When I get a new drug at a doctor’s office, I always ask for savings cards or a sample. The drug website should also tell you if there is a savings card out there.
Generic isn’t always the same thing… it’s true that it’s cheaper, but fully investigate the differences before going with generic. Some times the differences can be even life threatening.
Totally agree. I never realized this until my daughter had a series of seizures and was put on a twice daily medication. The pediatric neurologist was VERY clear that we had to use the exact medication he prescribed. The concentration can vary slightly for generic-for example her medication says “100 MG/ML”. He educated us that this concentration can vary slightly either way, which is not really an issue with an adult. However, when you are dealing with a one year old, who is already getting dosed according to her weight, that slight difference can mean that she is either getting over or under medicated.
I am allergic to generic Zofran (third dose involved a rash and hives) and while I have never had a reaction to the real thing they won’t give it to me anymore. Darn it.
I had hyperemesis gravidarum with my first child, and terrible (but not as severe) morning sickness with my second, and my insurance would only cover generic Zofran. The generic made me SO much sicker, that we ended up paying out of pocket for the brand name. Over $1000 per month! But, it kept me out of the hospital for dehydration and other side effects of the hyperemesis, so it was worth the cost. I have also had allergic reactions to generic medications, so I don’t believe people who claim they are completely the same.
Most medically trained people would never say generic meds are the same as name brand. Per the FDA, the ACTIVE ingredient must be the same, but the other ingredients can be completely different. Some patients I’ve had are allergic to generic brand X medication, but can take the same medication if it’s made by generic brand Y. The side effects can be different or more exaggerated in certain brands. So they’re not allergic to the medication itself, but the additional ingredients.
I have worked at several medical facilities and they usually do an inventory of supplies once a year. Any supplies nearing the expiration date have to be removed, although it may still be good for a few more months. Ask you medical office or local hospital if they are giving away any medical supplies.
In terms of medications, write to the company directly and explain your situation. Many name-brand companies want your business, so they may send you discount cards or even pay for your medication for a set period of time. You probably already do something similar to get coupons from food companies, it is the same thing.
If it is medical care you need, call local medical schools, therapy schols, dentists, etc. Students need to practice assessing patients and demonstrate competency performing certain techniques. They sometimes have free clinic days throughout the year that you may be able to participate in. All students are supervised by a licsenced medical professional in the same field and the students are motivated to do a thorough and excellent job because they are being graded.
Another way to save is to try to find doctors, therapists, etc that are close to your home (if you can find good ones). I was originally referred to a PT 25 minutes from my house for twice weekly visits. I asked for an in-town referral and found one within 5 minutes of my home. I saved so much time and money over those 2 months.
Two things that save us money: 1) Ask if your doctor can write your prescription for a double dose and split the pills. For example, if your dosage is 20 mg daily, your doctor may be able to prescibe 40 mg pills which you split. You’ll get two months of medication for the cost of one. 2) If you will be using a medication short term, ask for samples instead of a prescription. My daughter needed certain eye drops to be used for a few weeks. Our copay was $50! I called the doctor’s office to see if there was a cheaper alternative. They said I could pick up two boxes of samples at their office. She only used one bottle and I saved $50!
Good ideas Lori, thanks for those tips.
Way to go!
When I decided to use Accutane for my acne, my dermatologist generously gave me all of his samples without me asking – it was enough to cover half of my treatment, and the other half I got from Canada at 50% off, so I essentially saved 75% or about $1800 on meds.
One thing to do is make sure that the pills can be split. Some cannot safely be split.
I agree with K*. The molecules of medicine are not necessarily evenly distributed throughout the pill, making it unsafe to split.
Just a word of caution- be careful about asking your doctor to write an script for a higher dose and split it as this is technically insurance fraud.
I agree with Kay…my aunt was a pharmacy tech for years, and I remember her saying that a lot of medications, including heart/blood pressure medications cannot be safely split.
I also agree with Joanne, as this is a topic in my healthcare law class.
Does anyone have more information on how to get government aid for children’s medical expenses? We reside in Missouri. Thank you for your help! 🙂
I would say your first step would be to google for info. Just search “Missouri medical assistance” or “Missouri medicaid”. I know that here in Michigan you can apply for Medicaid online, so there might be other programs you could research or apply for online. You could also go into/call your local Department of Social Services or Department of Human Services, whichever it’s called there. They would be able to direct you to government assistance.
We have secondary coverage for my daughter’s cancer treatment through BCMH (Bureau for Children with Medical Handicap). The hospital social worker gave us the initial paperwork, but it was also available through the Health Department of our county. I don’t know if that process was just an Ohio thing.
Does that program just cover cancer? We are currently paying out of pocket for my son’s prescriptions. There’s not a local pedi or family or Md that will see him, which would save us $300 a doctor visit, but we really cant afford $1000 of meds and doctors visits…which cost gas driving to specialist and work money waiting to be seen.
BCMH covers all kinds of medical issues. From the comments it sounds like each state may have their own names for things.
Good luck. Taking care of a sick kid is difficult enough; paying for (or even looking over each bill to check if it is billed correctly) adds stress to it all.
Find your local SHIP office. Every state has a network of State Health Insurance Assistance Program counselors. SHIP can help provide unbiased information regarding public (Medicare/Medicaid) and private insurance as well as local clinics, assistance programs, pharmaceutical company discount programs, etc. They can also often help with billing disputes or suspected fraud.
http://www.hapnetwork.org/ship-locator/
Here is a link to Missouri’s HealthNet for Kids: http://www.dss.mo.gov/mhk/ It looks like you can even apply online.
Excellent work! Thanks for helping her!
go straight you your local hospital’s finacial dept. They will try to help you with help on your bills when you provide your pay stubs or W-2 forms.
Molina is the Missouri health care plan. They take very good care of children in Missouri.
This is a helpful article, thank you. Since my husband just unexpectedly lost his job we are scrambling a bit to get all of our medications and such taken care of before we lose our insurance. We simply cannot afford the Cobra plan, which is 2/3 the price of our monthly net pay.
So far I am finding that Walmart is a help with their $10/for 3 months prescription plan. Not all of our medications fall within this (especially my husband’s asthma meds), but it is still a help. Unless the medication is a controlled substance, you can fill as many months at a time as you wish (beyond 3 months) – if your doctor for example writes a script for a year’s worth.
I’m glad you found it helpful!!
I would suggest that you shop around for cash deals. I am a physician and married to a physician. In our area there are a number of employers that are going to extremely high deductible plans giving their employees money in flex accounts ticker the difference. As a result, there are entities operating on cash only. Many times these rates can be lower than what your insurance would pay to their doctors. (there are lots of games with coding so I say sometimes) these doctors make money because they are not employing an army of staff to deal wih insurance related issues. They are also getting their money up front instead of later or maybe never depending on the payor source. There are several radiology facilities doing MRI with and without contrast and including the radiologist read for less than $500. My plan charges me $1500 for this service once I hit my deductible. Things like this are not always te case- be informed. Know which pharmacies are sky high, and which ones are reasonable. Sometimes cash pay is cheaper than your co-pay. If you need a branded medication, check the drug’s websites-lots of coupons to be found.
Also, don’t brag to your doctor how great your insurance is and how you don’t pay for anything. We pay and pay for things you don’t pay for, and we aren’t happy about it. We aren’t angry at you, but it certainly doesn’t put us in a great mood. We are getting less and less of each healthcare dollar as be our our nurses.
Thank you for the insight Lori.
Hi Lyn,
My son and I use asthma medications, and I’ve had luck searching and finding coupons from the manufacturers for discounted meds. Sometimes it’s a one-time only discount, and other times they are good for monthly discounts for a certain length of time. I also check every few months to see if there are new ones out. Most times, you have to get on their mailing list, but then you can print out what you need and take it to your pharmacy. I’ve been able to find discounts for Singulair, Symbicort, and Nasonex. I’m sure there are lots of other medications out there that manufacturers discount.