Dr. Amy Tomlinson, with Dr. Amy Tomlinson’s Wellness and Gynecology in Frisco and Buena Vista, would like to share money-saving tips with you.
As we all know, healthcare costs have been steadily increasing. At the same time, it feels like insurance covers less and deductibles are higher than ever. There are some ways to hack the system and pay less. Here are some resources that provide discounts and price-transparency*.
Use your HSA or FSA accounts
You can use a HSA (Healthcare Savings Account) and FSA (Flexible Spending Account) to pay for healthcare expenses like office visits, copays, medications, and supplements. The money in a HSA can be used for healthcare expenses. The money you put in a HSA account will “roll over” from year to year–so you won’t lose the money if you don’t use it all in that year. The other pre-tax account, the FSA, can be used for many types of expenses including medical and childcare. FSA accounts are generally “use it or lose it”–any money that you put in the account needs to be used the same year or else you will lose that money.
How much of a discount can I get? Pre-tax money is used to fund these accounts--so the savings you will get will depend on your tax bracket. For instance, if your tax rate is 20%, then you would essentially save 20% on expenses paid with your HSA or FSA.
I have a job. How do I get one of these accounts? These accounts may be offered by your employer. If you have a Human Resources department at work, then you can ask them questions about what accounts your workplace offers. In general, people contribute to these accounts during their annual benefits enrollment period.
I'm self-employed. How do I get one? For people who are self-employed, you can open your own account with an HSA administrator like HealthEquity. The money in a HSA can also be invested which could generate more savings.
Check for deals on prescription medications
I have 5 strategies to save money on prescriptions including using your health insurance, using discounted programs to self-pay, getting your medications compounded. Health insurance usually “covers” prescriptions. This can mean that they pay 100% of the cost of the medication, but usually they only cover a percentage of the cost until your prescription deductible is met. If you are on a lot of expensive medications, it makes sense to go to your usual pharmacy, use your insurance, and pay for the non-covered fees until your deductible is met. After that, the prescriptions would be no-cost to you*. Oftentimes, there are many different medications that can be used to treat the same condition. You can look at your insurance company's prescription "tiers" to see what medications are "preferred" by your insurance company. It can be easy to change brands and save money. You would need to contact your provider and supply them with the medication tiers for your condition.
Prescriptions may be cheaper if you don't use insurance. If you think that you will not spend enough for prescriptions to pay off your deductible, then you can consider the following 4 self-pay options. This is a gamble…if you have a change in your health status and suddenly need a lot of medications, then any money you spend on these “self-pay” options cannot be applied to your insurance deductible. The four self-pay medication options include paying the “cash price” at your pharmacy, using GoodRx, using CostPlus pharmacy, and getting your medications compounded at a pharmacy like Prescription Alternatives. Remember those FSA and HSA accounts above? They can be used to reduce your medication costs.
Check prices at local pharmacies. Your insurance company will tell the pharmacy how much it will pay for a medication. For instance, your insurance company could tell Walgreens that it will pay $40 per month for Prozac. If you haven’t met your prescription deductible, then you may be paying Walgreens $40 to get the Prozac. Maddingly, Walgreens may have a lower price for the same Prozac if you don’t use your insurance. Many generic medications are on a $9 list–and you could pay $9 instead of $40. Each pharmacy has a discounted medication list–you can find the lists on their websites. You could also just ask the pharmacy staff what the self-pay cost would be. GoodRx is a service that will check the self-pay cost at all of the pharmacies in your area. You put your medication and dose into the app and it will generate a coupon code. At the pharmacy you will have to say that you are using GoodRx and not your usual insurance–and you will need to give them the coupon code off of the GoodRx app.
Check prices at CostPlus. Marc Cuban, from the TV show Shark Tank, founded this innovative service. It cuts out pharmacy brokers (used by traditional pharmacies like Walgreens and CVS), who add to the cost of medications without any benefit to you. Check the price of your medication on the CostPlus website. If it is less expensive than other options then you can have your doctor send the prescription there.
Consider compounding. Finally, it can be cheaper to get medication compounded rather than factory-made. Compounded medications are mixed by hand in small batches. You can contact our local compounding pharmacy, Prescription Alternatives, to see if your medication would be cheaper through them.
Unfortunately, getting medications at multiple pharmacies can have a down-side. Medication interactions are easier to “catch” when all of your medications are prescribed to the same pharmacy.
Consider self-pay labs
Just like prescriptions, sometimes it can be cheaper to self-pay for labs. Your insurance would not pay for these self-ordered tests and the cost would not apply to your insurance deductible. The 365Health Fairs (formerly 9Health Fair) provide low-cost screening labs like cholesterol, vitamin D, thyroid, and more. The Health Fair travels to different communities throughout Colorado. You can also choose self-pay pricing directly with labs like Labcorp and then have them drawn at a Labcorp location.
Use this tool to quickly check prices at different facilities
Did you know that the same CT scan, for example, can be hundreds of dollars more expensive at some hospitals than others? The state of Colorado has a price comparison tool that allows you to check prices in advance so that you can choose your location with the price in mind. The price comparison tool is provided by the Center for Improving Value in Health Care. You can price out procedures like surgeries, and radiology studies like diagnostic mammograms.
Get free medication and support
You may find free or low-cost HIV testing, STI (sexually transmitted infection) screening, and PREP treatment with HIV.gov provided by the CDC. PREP is medication taken to prevent HIV transmission for people who are at increased risk for getting HIV.
Smokers can get free nicotine patches, gum, and support at 1-800-QUIT-NOW.
Price transparency is available at my office
I can provide the information that you need to save money on healthcare. Upon request, you can know the cost of your appointment or procedure based on your insurance coverage. I have reduced self-pay charges for people who do not use insurance. If you chose to pay up front for labs, then discounted “concierge” lab pricing is available. If your health insurance is Affordable Care Act-compliant (most are), then they have to pay in-full for your pap smear and annual office visit–there would be no charge to you–not even a copay*. If you choose to have other labs billed through your insurance, then unfortunately I have no way of knowing whether your insurance will cover them or not. You can call your insurance company in advance of your visit to check.
I am always looking for ways to save money on healthcare
If you know of other resources then please let me know–I’d love to share them with others. Be well and please schedule a visit if you need a partner in healing.
*Insurance coverage information can change. This article is only meant to provide guidance. Your particular coverage or situation may be different.