(Before I continue here, it’s important to point out that I am not a doctor, lawyer or Almighty Purveyor of Everlasting Wisdom. I’m just passing on what’s worked for us over the years. Whatever you decide to do is on your initiative — not mine.)
Thanks to the Brick’s work as an IT man, we have health insurance. We also have a huge deductible: $12,000 per person. Which goes up to $20,000 or so for the family. Him and me.
(You should have insurance, too…Obamacare has made it possible for even the slimmest paychecks — or none at all — to get affordable healthcare. Here’s the process, step by step, to get you started. Plus photos, even.)
That insane deductible keeps us protected in case of a catastrophe, but plays havoc with anything less. The money for any tests, exams, or worse yet, any procedures (like the Brick’s recent colonoscopy) comes straight out of our pockets. It adds up to thousands of dollars — not enough to bump us over into full coverage, but enough to really strip the budget, thus causing more stress on our health.
How do we deal with this?
We don’t pay our medical bills. We’ve got some other tricks, as well.
*Get an HSA account….and use it. Have money withheld to cover insurance premiums, prescriptions and other regular needs like glasses, dental appointments, etc. — plus a little extra. The beauty of this: the money comes out before taxes. If your employer doesn’t offer an HSA (Health Savings Account), set one up for yourself.
*Don’t go to a doctor at all. Visit a clinic, instead. Your county may well have one available, for a lot less per visit than a doctor’s office. Or try a store chain: our local King Soopers grocery stores have medical clinics staffed by competent staff. If your illness is minor, or you need vaccinations (offered regularly by Walgreen’s, by the way), you’ll get the help you need, at a much more reasonable price.
*You have the power to say ‘no.’ Doctors seem far more apt to recommend multiple tests, etc. today than they were decades ago. During a physical, my GP rattled off a boatload of procedures he said I needed. When I asked him point-blank whether these were critical to my health, he admitted that he just liked to have all his bases covered. (And this is an intelligent, wise man — not a quack.) When I mentioned our deductible, he backed off right away, admitting that his family was in a similar situation.
There were still a few tests he wanted done — but one of these could be postponed for a year. I’d have to come back anyways, for refills on thyroid medication I must take regularly. Which brings up another point:
*Get the maximum number of refills possible on necessary medicines. Ask for these at the same time you visit your doctor for an annual checkup, the sniffles, etc. In the case of the thyroid meds, my doctor likes to check levels at least once a year. Fine — I get the test done, then results in hand, ask for a year’s worth of prescription refills during that appointment. It means I don’t have to revisit (at $100-150 a pop) for no other reason than to ask for refills. If you must take a regular prescription as well, this might work for you.
*Use a discount provider for prescriptions. Wal-Mart has a standard $4 fee for many drugs. We’ve also had good success with mail order companies like Signa-Tel Home Drug Delivery. The only caveat: you must order at least a 90-day supply. (Which you should be requesting anyways — see above.)
*Ask for a detailed bill. This isn’t generally an issue with doctor’s office visits, which are usually quite specific — but it can be a lifesaver for any hospital stay and medical procedure, however brief or long. Make sure you received everything you were charged for — and protest anything you didn’t. For example, an epidural or other painkillers, when you used natural childbirth. Celebrate the baby — not the bill!
*Don’t pay your medical bills. At least…don’t pay them right away. If you’ve got insurance, this is especially important. Medical bills often have inflated expenditures…like $10 for a couple of aspirin! Insurance companies allow set amounts for various tests and operations — and your bill will be reduced accordingly. Wait until you get your benefits statement before moving forward.
*Got enough to pay the bill? Ask for a discount. Even after the insurance companies strike off their share, there’s still a sizable amount owing. Can you pay less? Maybe…if you ask. Twice in the past year, we’ve paid 20% less on adjusted bills — which saved us hundreds of dollars. All I did was ask, “Do you give a discount if we pay in full?”
If you don’t have insurance, this discount might well be even greater. I’ve heard of people getting a 40-50% discount on their bills, just by enquiring politely. (Reminding you once again how many providers mark their prices up.)
*Not enough to pay in full? Ask for a payment plan. Hospitals and medical centers have plenty of patients who can’t dredge up full payments. Again, if you ask politely, they’ll set up a payment plan over a 3-year period. Make your payments regularly, and they won’t charge interest. (Ask, to make sure.)
*Can’t even do that? Pay what you can — but do it regularly. If you’re in serious financial trouble, even a payment plan isn’t feasible. In that case, inform the hospital that you can’t afford it — but you can afford a smaller amount, and will be sending them payment every month. And do it faithfully!
We had friends in this situation, who owed $5000 from an emergency room visit. They paid $25 faithfully every month for two years. At that point, our friend asked (again) for a discount — and was told that if they could come up with $2000, the bill would be paid in full. Total cost: about $2550.
*Don’t give up. This too will pass.