Health Care Practicalities: Tip-of-the-Day #191


Still on the subject of health care...I've compiled 18 tips to help you maximize your health insurance plan and ensure you're spending your money wisely.

1. Know the “rules.” Always double-check whether the benefits, services or providers you need are covered under your plan before you receive treatment. If you don't follow the plan rules for receiving health care, your insurer may deny your claim or pay only a portion of the bill.

2. Plan ahead for emergencies. While you can't always be fully prepared for an emergency, you should know which nearby hospitals belong to your health plan's network of providers.

3. Take advantage of tax breaks. Flexible spending accounts (FSAs), health reimbursement arrangements (HRAs) and medical savings accounts (MSAs) — known collectively as health care savings accounts — are becoming more popular. One of the most popular is the FSA, an employer-sponsored account that offers you a way to pay for certain out-of-pocket health care or dependent care costs on a pre-tax basis. Also, dental and vision care count as reimbursable medical expenses under FSA arrangements, so don't forget to save your receipts for these services.

4. Stay healthy. If you’re buying a private-market plan, you'll be charged based on your health, such as weight, cholesterol, blood pressure and other health conditions. Didja know that a recent study revealed that being obese adds $395 each year to the average $1,500-per-year health care cost? That's more than smoking (an addition of $230), aging 20 years ($225) and problem drinking ($150).

5. Stop smoking. If you apply for life insurance as a smoker, you'll pay a hard-to-swallow smoker rate. You'll need to be a nonsmoker for at least one year to qualify for nonsmoker life insurance rates. Health insurers may pay for nicotine-replacement programs but at renewal time, having quit can amount to substantial savings. Quitting can immediately save you $175 a month if you are a one-pack-a-day smoker!

6. Increase your deductible. Whether you are enrolled in a group or individual plan, the more you pay out of pocket, the less you will have to pay in premiums.

7. Seek out free or low-cost screenings. Does your HMO offer free blood pressure checks? Low-cost flu shots, or dieting and physical fitness classes? Take advantage of these lifestyle programs to help you stay healthy and reduce your doctor visits and medications.

8. Change your co-insurance ration. A common ratio is 80/20. This means that after you pay your deductible toward health care expenses, your insurer pays 80 percent of the bill and you pay 20 percent. Changing this ratio so you pay more will mean a lower health insurance premium.

9. Consider a catastrophic health plan. These plans offer limited insurance coverage with a high deductible, typically $1,000 for an individual and $2,000 for a family. Premiums are low because the insurance is intended for medical emergencies and doesn’t cover regular doctor visits.

10. Avoid extremes. Abandon dangerous hobbies and recreational activities such as skydiving, mountain climbing or NASCAR. Anything that poses a significant injury risk will super-charge your insurance premiums.

11. Go for an HMO. If the doctor you like is already in-network and the lab she/he works with is also in-network, an HMO can be as adequate as a PPO and offer lower premiums.

12. Trade up group insurance plans. If both you and your spouse have group health insurance plans available through work, calculate which one will cover both your needs at the lowest cost.

13. Regularly reassess your needs. You may be missing out on savings simply because you've stuck with the same plan year after year while your situation has changed. Do you have children that go to the doctor often? Do you take a lot of prescription drugs? Are tax breaks important to you? Are you willing to assume the cost of routine health in exchange for much lower premiums? Rethink these things periodically.

14. Adjust group plans. If you buy a group health plan through work, you may think you're stuck with whatever is offered every year. But employees can take charge of their coverage options and if you and your co-workers agree that some coverages are unnecessary (for instance, infertility treatment, mental health treatment and even dental), ask your employer to drop them at renewal time.

15. Inflate your credit score. Having a good credit history may help lower your health insurance rates if you are purchasing an individual plan, depending on the company. It’s not common but it is out there.

16. Haggle with your doc! Ask your doctor for a discount on medical treatments. There's a long history of patients negotiating with their providers for lower prices on elective procedures, such as laser vision surgery or psychotherapy. Establish the price you believe is reasonable and go for it.

17. Investigate your State Children's Health Insurance Program. The State Children's Health Insurance Program (SCHIP) is a federally funded program designed to provide health and dental coverage for children whose parents can't afford private health insurance. For little or no cost, SCHIP pays for doctor visits, immunizations, hospitalizations and emergency room visits.

18. Exercise more. It's harder to quantify what you'll save in health care costs by exercising more, since this number is also linked to losing weight through dieting. But generally speaking, exercising not only improves your health, it also saves you money when you purchase life insurance because healthy people live longer, and longer life expectancies mean better life insurance rates. Many studies show it's never too late to start exercising and that even small improvements in your fitness level can improve your health and longevity.

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