Anyone out there with a high deductible health insurance plan with coinsurance? tips

[Shanna-like-Banana]

we once had a high-deductable plan, after about 3-4 months we cancelled it.

We were paying the $500 a month premium and then paying 100% OOP to all the docs and Rx's.

It was insane. we were hemorraging moneyleft and right. We cancelled it and notified our docs that we had no insurance. They automatically gave us a 30%discount for being a "cash" patient. Also, magically out of no-where we would regularly get free samples to start the treatment.

no more monthly premium and paying 30% less than before. we took adventage of a lot of the free Rx's and the low-cost rx's from wal-mart/target/etc.

I had printed out the low cost Rx types from 3 stores and always took it with us, the docs had no problem picking one from those lists and it wasn't just a way to keep costs down, it's not like we were cutting corners on getting better.

now, we only did this for 6 months or so, it wasn't a long term life-style, at the time it was a right-now decision.

 

[Shelly F - Ohio]

OP for RX prices what Ins provider do you have? We have the same typy of plan with Cigna and I can go online and price RX's. It gives me the prices at all the pharmacy in my zip code.


As PP said make sure to tell the doctor you are on an HSA plan and need a cheaper RX.

 

[thomas998]

There are several things you can do when you are on insurance that has horrible prescription coverage.

1. When your doctor gives you a prescription let him know that you don't have any drug coverage. There will sometimes be alternative meds that do the same thing but are cheaper, or in some cases they can provide you with enough free samples that you wont need a prescription.

2. For maintenance type meds that you have each and every month, or simply expensive meds that you know you will likely need at least once or twice during the year... buy them from overseas. Alldaychemist.com is a site in India that has Indian versions of a lot of drugs that are used in the US... I have found that a blood pressure pill I take here costs over 120 a month without insurance with insurance the cost is still $40 a month... yet I can get a months supply from India for less than $11 a month... the trick is to order enough that you can spread the shipping costs enough to keep saving money. Also the government does not go after individuals that order overseas meds as long as they are for no more than a 3 month supply... You might wonder why you can get such a great saving from India, it is because they don't honor patent protections on drugs and the drug industry in India has the prices of all drugs set by the government. The upside is that the manufacture of drugs in Inida is heavily regulated. Also if you have friends in South America some drugs can be procured there that are also very cheap and often come from the same plants that make the drugs you buy in the US... I know lots of people like to buy from Canada but prices for Canadian drugs aren't that much of a deal compared to what you can get in other countries.

 

[PrincessSuzanne]

OP for RX prices what Ins provider do you have? We have the same typy of plan with Cigna and I can go online and price RX's. It gives me the prices at all the pharmacy in my zip code.


As PP said make sure to tell the doctor you are on an HSA plan and need a cheaper RX.

I had Cigna, too, that is the website I used to check prices, I would even find that sometimes they would be a little cheaper once I got to the pharmacy, but I still had some idea of what they would cost.

 

[mrsklamc]

Don't forget to check $4 generics lists- I think at least walmart, kroger, and target participate.

 

[barbarabini]

I have horizon blue cross blue shield nj
Also, has anyone had experience pricing out radiology services, ultrasounds ect? was there a difference between providers?

 

[thomas998]

I have horizon blue cross blue shield nj
Also, has anyone had experience pricing out radiology services, ultrasounds ect? was there a difference between providers?

You might find it cheaper when pricing testing out to also check on the price while telling them you have no insurance. Sometimes it turns out that the testing places have two different prices, prices for the insured and prices for those with none... there are some test that if I have them done and tell them I have no insurance I will actually pay less than if I get the same thing done with insurance and only pay my 20% of the cost... sounds a bit crazy but it is true.

 

[Shelly F - Ohio]

I have horizon blue cross blue shield nj
Also, has anyone had experience pricing out radiology services, ultrasounds ect? was there a difference between providers?

My husband had to have an ultrasound two months ago. The hospital quoted us $860 our dr office quoted us $300 we went with the dr office and the actual price was just under $200. So I would call around.

 

[LoveBWVVBR]

You might find it cheaper when pricing testing out to also check on the price while telling them you have no insurance. Sometimes it turns out that the testing places have two different prices, prices for the insured and prices for those with none... there are some test that if I have them done and tell them I have no insurance I will actually pay less than if I get the same thing done with insurance and only pay my 20% of the cost... sounds a bit crazy but it is true.

While you might save some $$ that way, keep in mind that that cost does not go towards your deductable. If you or a family member has a $$$ medical need during the year and your deductable is met, you will be forgoing some cheaper or free medical care by having told providers that you had no insurance (if this makes sense). I learned this the hard way when we ordered prescriptions from abroad out-of-pocket and then suddenly met our deductable. If we'd bought the prescriptions through our insurance, they would have gone towards the deductable that we ended up having to meet anyways.

 

[PrincessSuzanne]

While you might save some $$ that way, keep in mind that that cost does not go towards your deductable. If you or a family member has a $$$ medical need during the year and your deductable is met, you will be forgoing some cheaper or free medical care by having told providers that you had no insurance (if this makes sense). I learned this the hard way when we ordered prescriptions from abroad out-of-pocket and then suddenly met our deductable. If we'd bought the prescriptions through our insurance, they would have gone towards the deductable that we ended up having to meet anyways.

You are right on that one. Once the provider does file the insurance, you usually get a better discounted rate, because your insurance will only have you pay their allowed amount, the amount they have agreed in the contract with the facility, so you may just come out cheaper. I know we have.

Even with the $4 prescription at Target, that $4 still went towards my deductible and every cent counts.

 

[Mickeyluver37]

Does anyone out there have a high deductible insurance plan with coinsurance?
If so, do you have any tips on trying to make it affordable? For children? Are you able to check the prices somehow on your prescriptions? I went to the phartmacy for a child's prescription decongestant and my price was 141.82. Any way to shop around to at least lower these prices? Also, do you find it cheaper to do the flu shots at doctors or at the pharmacies? Any other tips?

Our deductible is 3000. We also pay 40% coinsurance on every claim. So its going to get pricey.

Is it linked to an HSA? If so, make sure you max out your contributions! That's the biggest thing that helps us- as long as there is a cushion in there, I know I can afford those $$$ prescriptions. I generally don't have time to shop around when a kid is sick, so I use our regular pharmacy. There's still usually an insurance negotiated savings built in even if I have to pay the whole thing out of pocket.

We haven't heard official work on 2012 yet. Right now our co-insurance is 20% for anything that isn't considered preventative, and 25% on brand name prescriptions.

 

[barbarabini]

A big thank you to those on the board.

I looked up the target 4.00 prescriptions. A prenatal vitamin was on it. I happen to have my ob appointment the next day and asked them to switch my script to that one so now, instead on pay 71.80 for the vitamins, I paid 4.00. This will save me 520.00 alone in the prescript cost for the year.

I fund an FSA for the amount of the deductible and a little more. How do i get and link and HSA? Do i open one at any bank? Does it have any different advantage than the fsa?

Last, I will definitely shop around for the lower provider cost for the ultrasounds.

 

[DISNEYSIX]

Our family deductible is $2,500 and I pay towards a Health Savings Account each month and that takes the "sting" out when ever we visit the doctor. All of our co-pays go towards this account as well as the doctor visits and then the insurance takes over. It used to be 100% tax deductible but our low-life government is slowly doing away with that so they can bankrupt us and have an excuse to take over health care. What low-life individuals we have running this government (all who are exempt of all of this BS health care bill).

 

[DISNEYSIX]

How do i get and link and HSA? Do i open one at any bank?

I did not read all of your posts so I don't know your employment situation but your employer or insurance carrier (not positive) should offer this to you. A HSA is great to have because they will even debit your medical expenses towards the amount that you have not even paid yet. A great system that the government will do away with before long. Speaking of which, we have quite a balance left in our HSA. Time for a family visit to the dentist. You need to use it up by year-end or there are consequences.

 

[barbarabini]

I looked. We have an FSA. We had an HRA as well but since the employer defunded it - the HRA has ended. Did not see an HSA option.

Is the difference just being able toi roll it over from year to year? unlike the fsa?