7 Tips to Cut Healthcare Costs in Open Enrollment

Whether you’re a CEO with millions in the banks or a struggling worker barely getting by, the most important asset you have is your health. This is why healthcare cover is such a vital resource, especially in the United States, where private medicare costs are prohibitively expensive.

 

One aspect of maintaining effective coverage for yourself and your loved ones is keeping it up-to-date through the open enrollment process carried out each year. The process offers us a chance to review how our coverage works and adjust it depending on what we expect our needs will be for the foreseeable future.

Saving Cash on Healthcare Costs

As we mentioned, healthcare in the United States is a major financial burden, with the average citizen spending approximately $11,000 yearly. Locating and accessing affordable healthcare is an arduous task for most people, especially those who do not have employer-sponsored health insurance benefits and do not qualify for Medicaid.

 

People in these circumstances can find their most viable options on their state’s healthcare exchanges or the federal health marketplace. Whenever you make a large purchase, such as a house or a new car, you shop around looking for the best deal. You’ll check out reviews, take it for a test drive, consult with friends, and so on.

 

Let’s check out some of the most effective strategies you can use to take control of your healthcare costs.

 

1.  Consider Different Classes of Healthcare Plans

Not all healthcare plans are created equal, and determining which type of plan is the most suitable for you can be tricky. Picking the ‘wrong’ type of plan can result in higher co-pays or denied claims. The type of plan you choose will determine what type of facilities and providers you have access to.

Providers

Choosing a healthcare plan is to get the most efficient and effective coverage possible. Whenever you need to visit someone other than your primary healthcare providers, such as a testing facility or specialist, you should always find out whether they are covered under your plan before setting up an appointment.

 

In emergencies, your health will be your priority before any financial considerations. Even so, you can still manage your costs by visiting an urgent care facility rather than the emergency room or setting up an online consultation.

 

Plans

As a whole, PPOs (Preferred Provider Organizations) give their members greater freedom when looking for specialized medical attention than HMOs (Health Maintenance Organizations). If you are a frequent traveler, for instance, or feel that you might need specialized care in the future, PPOs will be a good option for you. On the other hand, if your primary consideration is keeping costs down, then HMOs, which generally have lower out-of-pocket costs and charge less in premiums, might work better for you.

2.  Create Healthy Habits and Take Preventative Measures

Unfortunately for many of us, our genetic makeups predispose and make us susceptible to certain conditions and diseases. Even so, there is plenty we can do to optimize our health and minimize the need for medication and medical visits. Under the Affordable Care Act (ACA) terms, certain preventative procedures and processes such as counseling, depression screening, certain vaccinations, obesity screening, and so on are covered with no out-of-pocket costs.

 

Aside from such initiatives, you can also improve your health and wellbeing by exercising regularly, maintaining a healthy diet, managing stress, and getting adequate sleep. Many employers and insurers offer money-saving perks that promote healthier lifestyles, with some providing incentives such as gym membership discounts and enrollment in wellness programs.

 

3.  Compare Different Plans Before Making a Decision

The open enrollment program window for State Exchange, Marketplace, and individual healthcare plans usually takes place towards the end of each year and typically spans about six weeks. The plan you choose during this period will take effect when the next calendar year begins. It’s always a good idea to shop around and investigate different options before settling on one. Evaluate the following aspects of any plan before signing the dotted line:

 

  • Ensure that its out-of-pocket options, such as prescriptions and co-pays, are within your budget. Look at any extras offered by the plan, such as wellness programs, screenings, and so on.
  • Make sure your plan facilitates nearby on-network care options because out-of-network care provision is considerably costlier.
  • Take a good measure of your current needs and what you anticipate for the future before making your selection. The cheapest-seeming plan may cost you more in the long run if it fails to cover certain medical needs, so be careful not to fall into this trap.
  • Don’t focus solely on the monthly premium when evaluating different plans. A low premium coupled with a high deductible may end up putting you in medical debt if you can’t afford the deductible in case of an emergency.

 

4.  Review all Your Bills and Statements Before you Pay Them

The medical industry, like any other industry with massive numbers of consumers carrying out countless daily transactions, is prone to errors. The affected individuals must identify and address billing errors whenever they occur. Make it a habit to review all your medical billing statements and ensure that the correct amount is shown. In most instances, errors stem from simple, honest mistakes such as mixed patient numbers or incorrect codes.

 

Take a close look at the EOB (Explanation Of Benefits) form that your insurer provides to all subscribers, which details everything they cover and what they do not. Whenever you spot an error in one of your bills, address it as soon as possible and keep an eye out for any future errors.

5.  Set Up a Health Savings Account (HSA)

Should you have a high-deductible health insurance plan (HDHP), the ACA allows you to enroll in an HSA to assist in paying out-of-pocket expenses and deductibles. An HSA allows you to set aside pre-tax funds into a dedicated account with no capital gains taxes. In 2021, the individual HSA fund limit for individuals was $3,600.

 

This facility, which operates under the auspices of the IRS (Internal Revenue Service), covers a wide set of services, such as:

 

  • Eye exams, contact lenses, and glasses prescriptions
  • Dental work
  • Birth control
  • Orthodontia
  • Feminine hygiene products

 

HSAs, unlike Flexible Spending Accounts (FSA), can be rolled over from one year to the next, so you don’t need to worry about any ‘use it or lose it’ conditions.

6.  Choose Generic Drugs

According to the FDA (Food and Drug Administration), generic medicines can be up to 49% cheaper than their name-brand alternatives. These FDA-approved drugs have the same active ingredients as their counterparts, meaning they are just as effective. If you require a generic drug that your insurer doesn’t cover, you could have your doctor seek prior authorization from them before making the prescription.

 

7.  Advocate for Yourself

You will need to stay on top of everything regarding your care plan if you’re to save money. This involves asking questions and being inquisitive about every aspect of your plan. The following are some of the key areas you need to pay attention to:

Care

Do not hesitate to ask questions when your health is involved. Appropriate inquiries include:

  • Are there optional payment plans or ways to get a lower price?
  • Is there a cash discount?
  • What are the out-of-pocket costs for this treatment or medication?
  • Do I need this medication, surgery, procedure, or therapy? What options are available to me?

 

While this might not seem relevant in terms of trying to save money, it’s important to find a doctor willing to listen to you and address any concerns you might have.

Billing

As we mentioned, billing errors are the client’s responsibility, and you will also need to keep an eye out for false claims. Billing fraud is also a possibility, even though it is relatively rare. If you suspect your insurers or providers of billing fraud, you can report them to the relevant authorities.

Final Thoughts

With almost sixty percent of Americans struggling to keep up with their medical debt, it’s becoming increasingly clear that healthcare is one of the biggest financial challenges facing Americans today. Even though solving some of the contributing factors exacerbating the healthcare dilemma, such as racial inequities and employer reliance, might be somewhat difficult, there is plenty we can do as individuals. Take the opportunity to assess your options before the open enrollment season, and you might save considerable sums of money in the coming years.

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