Human Resources and Benefits

Being a Wise Consumer of Health Care and Keeping Health Care Costs Low (Summer 2012)

 Many businesses are faced with the issue of how to keep health insurance premiums low while still offering a good health insurance program for their employees.  As health care costs continue to increase, this problem will only become more prevalent.

One of the ways you can keep your premiums low while still offering significant options to your employees is to involve your employees in the cost of their health care.  You can do this by encouraging your employees to make careful, thoughtful, and cost-conscious decisions when purchasing health care services.  Many employers are implementing high-deductible health plans to help accomplish this goal.

High-deductible health plans do not obscure the true cost of services as co-pay plans tend to do.  High-deductible plans are driven by the consumer as they motivate the consumer to research their options and choose not only what makes sense healthwise but also what makes sense from a cost perspective.

This type of plan encourages the consumer to live a healthy lifestyle to prevent unnecessary medical problems, match the medical need with the appropriate level of service, and research to find the best cost option for medical procedures and refilling prescriptions.

Being a wise consumer of health care doesn’t happen overnight, and it doesn’t mean putting off necessary services simply because a person would rather not pay for them.  Rather, being a wise consumer of health care requires cost-conscious decision making along with living a healthy lifestyle.

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Keeping Health Care Costs Low

In regards to health insurance, some individuals may think, “I paid for it, so I’m going to use it,” or, “Now that I have met my deductible, I can use the plan all I want”?  By instead keeping a “wise consumer” mentality, plan participants can avoid contributing to unnecessarily high health care costs.  Following the steps below can ultimately lower the costs for health care services.

diet, health, healthy, choices,

Exercise and a healthy diet can help prevent a myriad of health-related problems.  Research shows that people who are obese incur an average of $1,700 more per year in health care costs than those who are not obese.  Even those who are overweight but not considered obese have been found to spend more on health care.  In addition, smokers incur on average $1,600 more per year than nonsmokers.

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This type of plan can often be less expensive in the long run when considering the total out-of-pocket expenses, premiums, and company contribution to employee health spending accounts.  When a HDHP and HSA are combined, they also provide a tax-advantaged way to help individuals save for future medical expenses.

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By getting the medical screenings that are recommended for an individual’s age and gender at the appropriate times, many medical issues can be identified and cared for in the early stages when the cost is the lowest.  Putting off these screenings will only worsen and prolong the problem.  Those with ongoing health concerns should follow the recommendations of their doctors to help keep these issues from worsening unnecessarily.

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If a condition is life-threatening, call 911 or go to the emergency room.  If it is non-life threatening, determine which course of action would be appropriate.  For no cost, individuals can utilize home health care books, online medical websites, and nurse hotlines available through their insurance provider.  If medical attention is required, go to the doctor’s office; or, if urgent but not life threatening, go to an urgent care facility rather than the emergency room.

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If a doctor recommends a medical procedure, it is a good idea to seek a second opinion.  Individuals may be able to find a less expensive option that is more appropriate, or they may find that the original recommendation is not necessary at all.  They should keep accurate records of tests and procedures and provide this information to their doctor to prevent repeating a procedure that is not needed.  In regards to prescriptions, if they are not needed, then they don’t need to be filled. Also, individuals should ask for generic/lowest-cost or over-the-counter alternatives, obtain pricing from several different pharmacies to get the best value, and utilize the 30-60-90 day refill plan if available.

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Individuals should ask their provider if the cost can be reduced if paid in advance rather than waiting to be billed.  If a bill is sent for a service, a careful review of the “Explanation of Benefits” document is key to ensuring that the services being billed for were received. Only the amount that the insurance company indicates is owed should be paid.

These small actions can add up to big savings in health care expenses.  By taking the time to do these things everyone can become wise consumers of health care.

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