you will want to evaluate your total out-ofecommend preparing a summary sheet on
keep in the front of your unpaid folder. List
count number, and the amounts due with a
ng on the medical insurance plan design you
ite a lot of money. Having some idea of the
ou owe, you can decide which providers you
ow, and which ones you need more time to
ht consider knocking out the smallest ones
you to spend your time and effort on the
Managing Your Prescriptions
sible for all of the first bills to hit your
e amount of your deductible. Then, you will
he co-insurance amounts. The co-insurance
tals that add up to the percentage of the
ose during enrollment, such as 80%/20%,
nce company pays 80% and you pay 20%.
payment responsibility continues until you
m out-of-pocket amount. You received this
llment, but you can also get it from your
. Each member of your family must be
y under a family plan, but if you are in the
a day or two, you are very likely to reach
of-pocket maximum and perhaps even your
t maximum.
When shopping the prescription, you may find that you could be responsible for 10% of
the bill and pay $20 at one pharmacy, but that same 10% cost-sharing may be $35 out-ofpocket to you just across the street at another pharmacy! You can search online for some
of the free resources that help you find the cheapest pharmacy to use, or better yet, call
the pharmacies in your area and ask what they charge for particular medications. You
will need to have the medication name, whether you can take a generic if available, and
the dosage amount when you call. Ask for the cash and insurance costs, too, because you
may find that the cash price is cheaper for you, even though it will not count against your
deductible or out-of-pocket maximum if not run through insurance.
g to know is that most providers - especially
erate to be paid. They often will work with
yment plan at no interest, and you can pay
mber of months or even years. Just as long
ome money to them on a regular basis, they
e you for collection. You do need to make
discuss payments, though, instead of just
urself. To avoid collection, an agreed-upon
tical, and after that plan is in effect, make
ctly. It is not uncommon for a provider to
o a collection vendor even after a payment
but they often will not trigger a ding on your
e additional steps to collect such as filing a
top paying according to the plan.
Did you know that the total cost for that medication will be different from pharmacy t o
pharmacy?
Pharmaceuticals are one of the biggest drivers for increasing health insurance costs,
which is why most carriers are moving toward a cost-sharing model for medications,
where the carrier only pays a certain percentage of prescription cost such as 80%. You
can help keep costs down by shopping your pharmacy.
Also, many pharmacies have certain generic medications at no cost. They use these
very common meds as loss-leaders, and hope to make it up by an insured getting their
other, higher -medications filled at that pharmacy as well. If you do not mind filling your
prescriptions at multiple pharmacies, in exchange for lower out-of-pocket costs, make
sure to shop around the cost of each of your monthly medications. In some instances, the
pharmacist can discount the medication, particularly if you can prove a local competitor
is selling it cheaper.
Do not let the pharmacies fool you; even after you submit a prescription to them, it can
be transferred to another pharmacy if you find one cheaper.
Often, the big box pharmacies like CVS, Walgreens, and Rite Aid are considerably more
expensive than the locally owned pharmacies or membership club and grocery store
pharmacies.
Online pharmacies can save you money as well. Only use an online retailer that clearly
operates within the U.S. and displays the “VIPPS” symbol to show that it’s a Verified
Internet Pharmacy Practice Site. Avoid internet pharmacies based in other countries
and be suspicious of any that advertise heavily discounted medications. Verify that the
pharmacy website you are using is accredited by the National Association of Boards of
Pharmacy (NABP). Be sure to factor in costs that might be associated with shipping or
handling your prescription.
he lucky ones that can write them a check
now that you still have negotiating power.
ing department and tell them that it will be
entire bill and ask them to accept a smaller
ight be able to pay all at once. Do not be
Finally, ask your doctor for a longer length prescription, as it could save you significant
count the bill by 20% or more just by asking
money to fill a 90-day versus 30-day supply.
although sometimes the billing department
back and act like this is an unusual request,
If you do somehow overpay, and you are reimbursed money that was in
ery routine. For example, the clerk might
a health savings or flexible spending account, you will need to return that
ask a manager’s permission before providing the
money to the special account. Keep documentation of that event in case
ot call you back. Keep pressing on them for a discount
you are audited by the IRS. This is another handy thing to store in the folder.
mitment! The harder you work, the better discount
bills, obtain receipts evidencing payment in full of the
gotiated payment amount so you can clip them to the
you wait on the receipt to be mailed, it is a good idea
ts paid, the dates paid, and confirmation numbers that
ou to reference the payment. We recommend writing
ctly on the bill in case you need to reference it later.
Hopefully we have convinced you that the two-folder method is necessary
for an organized approach to paying only what you owe! You will
probably need access to these folders for up to a year after the hospital
visit, because sometimes providers are very slow to issue a bill. After that,
you should keep these folders with your tax information for however long
you keep those records, especially if you are taking a medical deduction
or paying with funds from a health savings or flexible spending account.
rs are very quick to start hunting you down to collect
ou overpay them, they are very slow to reimburse you.
If you use this folder system, it should make the bill-paying process much
easier to navigate.
edical Bills After a Hospital Visit
Marisa Combs, MyBenefitsChannel