If you are having so much trouble deciding between the villa in Italy or the ski chalet in Switzerland for your second vacation home that you might buy them both, then this column is not for you. If you just took a third job because your rent went up and you are having trouble putting food on the table, this column may not be not for you. If you can pay your bills and have enough left over for the occasional splurge, then here are some tips to help you manage your medical expenses.
- Get health insurance if possible. If you have declined health insurance at work because the premiums are higher than your basic annual well-care costs, look at your budget again and try to make it work. For years our family’s health insurance premium cost was more than what insurance paid out to our doctors, but my eight months of cancer treatment reversed that ratio dramatically. If we had been uninsured, I shudder to think what would have happened.
If your work doesn’t provide health insurance, don’t assume you can’t afford private insurance. A basic plan with a high deductible may be less than you think, and it could save you from bankruptcy if you have a catastrophic illness.
The health care bill working its way through Congress may solve your insurance problems especially if breast cancer has made you uninsurable, but it will take a while, so get insured now if you can.
- Create your own health savings account. I used to pay doctors’ bills as they came up, and in bad months ended up having to put them on my charge card. Now I’m trying to save ahead for known medical expenses. With my $1,000 dollar deductible on my insurance plus the copays on routine health care, I know that I will spend at least $1,200 in most calendar years. So I need to set aside at least $100 a month for medical expenses in months when I don’t see a doctor.
If you are uninsured, it is especially important to try to save ahead. Decide how much you can put in a special account and make putting those dollars away more important than a pair of cute shoes.
- Work out payment plans directly with the provider when possible. Talk to the doctor or hospital if you do have a bill that is higher than you can pay from your savings. Several times I have worked with the hospital to set up a payment plan that I could manage when my bills have been too high to pay immediately. Talking to the billing manager face to face is much better than ignoring the bill and ending up with a bad credit rating or a bill collector calling you. Often the interest rate will be lower than the interest on your credit card.
- Use a flexible spending account if your work place provides it. Many employers offer a plan called a Flexible Spending Account (FSA). Financial planner Carl Johnson says, “Participating in your FSA is an excellent way to get medical care and prescriptions at a discount. You have income withheld by your employer prior to beginning the year and pay medical bills from those withheld dollars on which you have paid no taxes. But be careful! Do not overestimate medical, dental and prescription expenses for the upcoming year. You will forfeit any dollars you do not use.” The money in your FSA reduces your taxable income for the year by that amount. How much you will save depends on your tax bracket.
- Make wise decisions about spending your health care dollars. Your annual physical is not a luxury. Finding problems before they get serious will save you money in the long run. On the other hand, it is not necessary to run to the doctor for every little problem. You can usually watch and wait for a few days. Websites like HealthCentral can help you evaluate how serious the situation is and may have some ideas for home remedies you can try first.
If you do have symptoms of something serious, don’t procrastinate about seeing the doctor. For breast cancer, the usual recommendation is that any breast change that lasts longer than a menstrual cycle needs to be checked out. Of course, if you have severe pain or symptoms of an infection, don’t wait that long. An early appointment can save you money in the long run and may save your life. Often your primary care provider is the best place to start because your copay is probably lower, and he or she can help you decide on the most effective specialist if you do need a referral.
Let your doctor know you are concerned about costs. See if a generic or less expensive medicine will do the same job as that new drug. Ask the doctor about why imaging tests are being ordered. If the outcome of the test won’t affect the treatment, it may not be necessary.
Most communities offer free and reduced-cost clinics for low-income patients. Use them or urgent care clinics rather than a hospital emergency room for problems that are not true emergencies. This list shows clinics that offer free mammograms. The American Cancer Society and Susan G. Komen for the Cure can also help you find sources to help with cancer expenses.