4 ways to save money on health care

From the radical to the practical, these suggestions can help you reduce your out-of-pocket expenses.

By Money Staff Nov 29, 2013 11:59AM

This post comes from Jeanne Pinder at partner site Credit.com.

Credit.com on MSN MoneyOnce upon a time, many of us had a health insurance plan that gave us most of what we needed for a $10 or $20 co-pay.

Medical doctor © CorbisThat’s no longer true: many of us now are on insurance plans with a high deductible, a high co-pay, out of network, out of pocket --- or paying a percentage of whatever costs we incur.

Come January, a couple of things will happen. First, the new health plans bought under the Affordable Care Act come into effect, covering a percentage of your costs (bronze plans cover 60 percent, silver 70 percent). That makes it important for people to know: 60 percent of what? Second, people who have never been on high-deductible plans will join the increasing number of people who have such plans, and will now learn of the new realities. A recent PwC Touchstone survey suggested that 44 percent of employers would offer only a high-deductible plan in 2014, up from 17 percent in 2013.

Prices vary, by a lot, and it’s increasingly important for you to be aware of that.

So here are four radical and not-so-radical ways to save on health care costs.

1. Don’t use your insurance (and always ask what stuff costs)

Or, better, compare the price insurance will pay with the price you would pay out of pocket if paying cash. How? Ask the provider for a cash or self-pay rate. Ask to pay in advance, or if there’s a prompt-pay discount.

Here’s an example from Gilles Frydman, a co-founder of SmartPatients.com, an online community where cancer patients and caregivers learn from each other about treatments, trials, the latest science and how it fits into their experiences. He had a nasty fall last summer; early treatment with a CT scan showed nothing serious. The pain persisted, and after a few months his provider wanted a new X-ray.

"I looked for a local X-ray place and asked on the phone how much would the X-rays be, if I paid cash," he wrote in an email. "When I went there, I was asked to sign a document stating that I would not file for any further insurance reimbursement, if I paid cash. The reason: The cash price is one-third of the regular price sent to insurance companies, which I am sure, then argue to pay one-third of the original price."

Peggy Zuckerman, who conquered kidney cancer, had a similar experience with her CT scans in early 2012. The billed price to the insurance company was $8,010, and her responsibility under her insurance plan was $4,074.85. The cash price, she learned after the fact, was $930.

2. Keep good records (and always ask what stuff costs)

This can be especially fruitful with prescription costs. Moyra Phillips of Huntsville, Ala., keeps a binder with records of what medications people in her family are taking. Many pharmacies post or print lists of prices for common drugs; she keeps a printout of current prices in that binder, and takes that with her to doctor’s appointments and pharmacy visits.

She says it’s easy that way to show a medication to a provider or pharmacist, ask the current price, and ask if there’s another medication that would serve as well. Pharmacies and insurance plans can change prices frequently, so being able to show alternatives has allowed her to save hundreds of dollars.

Insurance can be a downside here, too; she has a medication that had a $20 copay at one pharmacy, but could be bought for $8.90 cash without insurance at another pharmacy. An increasing number of pharmacies at big-box stores (Publix, Winn-Dixie) offer some free medications, while others have low-cost medications. Costco is famous for low prices, and Target, Walmart, Walgreens, Kroger and other chains have deals, too. Also, don’t overlook your local independent pharmacy.

3. Use online tools

You’re not going to be price-shopping for emergency care or big-ticket items. But for places where you can choose, there are ways to find out what things will cost. There are medication price sites like goodrx.com and needymeds.com; there are price comparison sites for procedures, too. Tools at clearhealthcosts.com give cash or self-pay rates for common procedures at a range of providers in seven U.S. metro areas, and also shopping tools including the Medicare rate for a given procedure anywhere in the U.S. You can compare these results with other price transparency sites like faircaremd.com (a bid/ask marketplace like eBay); fairhealthconsumer.org (gives ballpark prices); healthcarebluebook.com (finds what it describes as “fair prices” in your area); newchoicehealth.com (you tell them what you want and they promise to find a price for you).

4. Take charge of your health and wellness

People who are actively involved in their health care have better health, and that -- no surprise -- is very cost-effective. Understand your treatment and your costs. One good way to do that, especially if you have something complicated going on: join a reputable online community of people who are knowledgeable about your issues.

Frydman calls it the network effect, which he saw first in ACOR -- the first cooperative of online communities for cancer e-patients, which he created in 1995, when his wife was diagnosed with cancer -- and now at SmartPatients.

"These networks of smart patients, suffering from serious diseases and working together with some of the best experts in their disease have revolutionized the care and the scientific knowledge about their disease," he said.

Frydman cites examples of a group that built a centralized tissue bank for a rare cancer and led to significant scientific discovery related to immune reactions, and another group that contributed to a rapid-fire study of a large patient population on the relative danger and prevalence of a significant, unreported adverse event. That study led to a significant change in labeling information.

There’s another value of these groups -- which also include patientslikeme.com, psychcentral.com, the Society for Participatory Medicine, and others -- they provide a place for people to gather online and talk about, among other things, treatments and prices.

There’s an active conversation out there among peers about how to save money. Join in. You’ll be glad you did.

More from Credit.com:


Nov 29, 2013 6:05PM
Wow!  I can save money by not using the insurance that I'm forced to buy.  What a wonderful government I have.
Have a nice day.
Nov 29, 2013 5:38PM
Nov 29, 2013 6:55PM
The number one way to save would be to get rid of this POS they call ObamaCare. It's a freakin disaster that will bankrupt the country.
Nov 29, 2013 6:59PM
A procedure that would be billed to the insurance company at $8,010 could be gotten for $930 cash. That's what's wrong with our health care and something that couldn't occur in any country with universal care. Some medication can cost $10,000 a month and more but big Pharma sells it to other countries for less than $100 because that's all they'll pay. These examples are before the ACA kicked in and the only excuse is because insurance companies don't care. Why would an insurance company accept a bill from a Hospital charging them $8,010 for a CT scan when that same hospital would do one for $930 cash? Why would an insurance company pay $60 for a medicine and charge you a $20 co-pay when the same medicine can be bought at Wal-Mart for $4 cash? Because it's your money and they don't care they'll simply raise the price. You can rant about Obamacare all you want many complaints are valid but the ones really fukking us is the insurance companies, for profit hospitals and the medical field in general.
Nov 29, 2013 5:13PM
Of course the best way is to suck at the government teat and get someone else to pay for your medical insurance through subsidized programs like the ACA.  Thank you Obama expanding the redistribution of wealth one program at a time.
Nov 29, 2013 6:54PM
This is just one little sample of how health care costs don't really have to be so extraordinarily expensive. And it is another indicator that the ACA (Obamacare) has nothing to do with bringing down the extremely high costs of healthcare. The 1,700 page ACA law includes absolutely nothing about actually bringing the costs down. Basically it just says who is going to get what, and who is going to pay for it. It should never have been titled "Affordable Care Act". It is really only affordable to that segment of the population who will pay nothing, or very little. For the rest of us who will be forced into purchasing health insurance, not only paying for our own health care, but also paying for the subsidizing of all those who cannot afford the insanely high costs of health care in this country, it now becomes unaffordable. Like Obama had told us long ago, it is simply the redistribution of wealth. It should be called ROWA. Redistribution Of Wealth Act. If it was truly about making health care more affordable, it would contain some language that would address the actual rising costs of health care. It does not.  
Nov 29, 2013 8:25PM
A couple of weeks ago I cut the side of my thumb about 2" with some scissors and went to an ER in Lansing,Mi. to have it closed.  They glued it shut and I left, 3 hours later.  I just received the bills.  $2,000. to wash out the cut and glue it together, 5 minutes work.  I am unable to get insurance, so they gave me their "uninsured rate".  This is one bill that is going to my attorney.  Besides, it started bleeding again before I hit the parking lot, and the glue fell off totally in less than 12 hours.  I finally taped it shut and put on some antibiotics.  It is almost healed, but the bill is more dangerous than the cut ever was. 
Nov 30, 2013 12:37AM

I have a few

1. Eat well

2. Exercise

3. Don't rely on an inept government to take care of your medical needs.

Nov 29, 2013 7:46PM
Keeping healthy must be the most important, and diminishing medication to the least amount must be right next. I think that actually NOT visiting the doctor may be good for your health.

Nov 29, 2013 5:36PM
lol were constnatly hearing about ways to save in this nation..im pretty sure half the nation saves enough with all these freebies and handouts for having kids..boy i bet other nations wish they lived like that.....
Nov 29, 2013 8:10PM
 The best way I found is not to pay for moron leech democrats health care. The second best way is to understand what a corrupt bunch of scum work in the health care industry. The third way is when your old as dirt and the crooked scum want to extort your estate for a futile cause go home and die.
Nov 29, 2013 8:53PM
Clearly health insurance and healthcare have little in common. When President Obama got together with the rest of the democratic party and started building Obamacare on the shifting sands of health insurance with the Louisiana special deal and the corn husker kickback, it was clear to ALL the republicans that NONE should vote for this circular firing squad. The only ones to benefit will be those who get it free through medicaid if they can find a doctor that will see them. Some will think they did well until they need it. There is no question that many people are harmed by the job killing and reduced hours that others experience. Repeal this bad law.
Nov 29, 2013 8:14PM
Who are the dummies that print silly crap like this.  You can ask but never get the truth about cost. If you ask too many questions they will sock it to you and you will be treated like crap.  Why sure I want to get online with a group of people who know less than I do about it.   Stupid, stupid, far away from reality.  Lets see.  I can work 60 hours a week. Work on my health insurance 3 hours a week.  Work on my retirement and 401k 6 hours a week, so as not to loose it all to Wall Street.  Work on the house, car, and yard 16 hours a week.  Help the wife cook and clean because she is also holding a 40 hour a week job.  Then, when possible, I can see the kids play ball, play in the band or be in the school play couple hours a month.  There is no life left. thanks to the American Corporations, to big to fail banks, and all the rich bastards that only really worry about one thing.  Themselves.
Nov 29, 2013 8:14PM
Instead of just saying how bad Obamacare is, why don't people give some alternative solutions. Doctors and healthcare providers do not have any real competition, and as a result, their prices keep going up without any true market to regulate those prices. The fact is healthcare providers are the ones that are living in socialism, and their patients barely survive with those wild medical prices.
Nov 30, 2013 1:08AM
If NO ONE SIGNS UP for this BS, it will go away like a BAD COLD.
Nov 29, 2013 8:44PM
Nov 29, 2013 10:08PM

Obamacare aside for a moment. Our youngest daughter, husband and one child with another child on the way. Group health covered. Out of pocket coverage as follows. Weekly out of payroll $144.00, yearly $7,488.00. $2500.00 individual and $10,000.00 family yearly deductible, $30.00 co-pays for office visits and $300.00 co-pay emergency treatment and maternity is $2500.00 deductible. My wife and I on Medicare. Total payments out of pocket, $2520.00 for Part B, Part C Supplemental $4680.00 and Part D which is prescriptions $3460.00. Total Medicare $10,660.00. We are not complaining however does any one think healthcare is free? The only fair way to pay for healthcare is through single provider. While you bash and bash, remember our congress people are covered by the best health insurance WE can pay for.

Nov 29, 2013 8:29PM
Dec 2, 2013 4:51AM
REALLY! The first suggestion is "Don't use your insurance" The same insurance were being forced to buy! What a crock of sh!t! So in other words just give your money to us and the government. What a shame! a young person used to have the choice and free will, to make the decision to Live healthy, eat right, exercise, don't smoke or drink too much or do drugs and there is a HUGE possibility that you will be healthy enough to not need health insurance well into your 30's or 40's. By then with a little hard work and perseverance, you can AFFORD to buy what you need.  Well NO MORE! That FREEDOM IS GONE!
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