Consider the following tips. They may reduce your out-of-pocket healthcare expenses.
- Ask “Is this in my network?”
While many doctors and providers will take your insurance, it doesn’t mean they are in your network. Staying in-network: significantly reduces your out-of-pocket medical expenses and ensures the costs you incur are applied towards your plan’s deductible and out-of-pocket maximum (out-of-network costs don’t count!) See The Importance of Staying In-Network
- Don’t pay federal taxes on qualified medical expenses!
Use a tax-advantaged account to reduce your out-of-pocket expenses. See HSA, FSA, HRA Comparison Table
- Use generic drugs.
Ask your doctor whether a generic version of your prescription medication is available and appropriate. Generic drugs cost less than brand drugs and meet the same FDA requirements on effectiveness.
- Consider mail-order prescriptions.
If you have a medication that you take regularly, using mail-order services for prescriptions can save you money.
- Ask about pricing before agreeing to services.
Sometimes asking is all it takes to get a better rate.
- Call an advice nurse.
Most health insurance carriers offer a free advice nurse 24/7. For non-emergency situations, an advice nurse can provide medical advice about how to care for your illness/injury at home or provide guidance on where to go. Also, see Emergency vs Urgent Care
- Use a virtual visit.
Many insurance carriers offer online virtual visits 24/7. For non-emergency care that doesn’t require a hands-on exam or tests, a virtual visit can be a good, low-cost option. It allows healthcare professionals to evaluate, diagnose, and treat you remotely—using your mobile device, tablet, or computer. Also, see Emergency vs Urgent Care
NOTE: You’ll likely need to register through your insurance carrier. Consider setting this up before you need care, so it’s immediately available when you need it.
- Inspect your Explanation of Benefits (EOB).
Each time you present your insurance card for payment at a health care provider, you’ll receive an EOB in the mail from your insurance carrier. While an EOB is NOT A BILL, it does break down your share of the cost. Think of it as a "preview of the bill you can expect" from your health care provider. Always check its accuracy.
- Know your plan renewal date, and track your costs.
Your annual deductible resets on the plan renewal date. Knowing how close you are to reaching your plan deductible and out-of-pocket (OOP) max can help you better manage your costs.
- Is your domestic partner a “qualifying relative”?
The IRS considers health coverage for a domestic partner a taxable fringe benefit that must be included in the employee’s gross income (known as imputed income)—unless your domestic partner is a qualifying relative for healthcare purposes.
The IRS definition of “qualifying relative” for a domestic partner is not as strict as “tax dependent” because the Gross Income Test does not apply. Ask your tax advisor whether your domestic partner meets the criteria. If so, be sure to report to your employer that your domestic partner is a qualifying relative. Also see:
- Who Can I Add to My Health Plan?
- Employers, Domestic Partnerships, and the IRS, and
- Domestic Partnerships and Employer Health Plans
Last updated 9/06/19