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It’s Time to Become a Healthcare Consumer

Times are changing. Gone are the days of picking your health insurance plan and being done with it. Now, as healthcare costs soar, you have to be aware of what you’re being charged and take steps to make sure you’re controlling your out-of-pocket costs. Your family’s financial health is at stake. So NOW is the time to become a healthcare consumer.

It’s not as intimidating as you might think. All of us are all already consumers. Every day we make choices selecting brands, products and services for ourselves and our families. These daily decisions can be based on some type of emotional connection, like using the same hairspray Mom uses, or they can be influenced by knowledge and information, like choosing a particular type of bread that contains whole grains and fewer calories. Either way, we are being proactive and making choices that impact our lives. 

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What Is a Healthcare Consumer?

The same goes for being a healthcare consumer. A healthcare consumer makes informed, deliberate decisions for the benefit of their own health and financial well-being.

Healthcare is an industry too and you and your family are paying for care and products. Everyone has different reasons for their choice in healthcare. Maybe a family member recommended a provider or your doctor referred you to a specific surgeon. While these things can factor into your choices, a healthcare consumer goes further. They are empowered to do research, ask the right questions and save themselves valuable dollars as they go through an episode of care.

Think of it in terms of painting your house. You wouldn’t just choose a painter online, let them have at it and then pay whatever amount they end up billing. You’d look for painters offering fair prices, understand what costs will be expected during the payment period and double-check your invoice for correct charges. Why wouldn’t you do the same when preparing for medical care?

Why Now?

Why is it so important to become a healthcare consumer now? Simply put, you can’t afford not to.  Healthcare costs are on the rise. In fact, they are rising 2-3 times faster than your income. If this trend continues, by the year 2021 about 31% of families’ annual incomes will be spent on healthcare related expenses.

Don’t worry — there is something you can do. Follow these five steps to become a healthcare consumer:

Becoming a Healthcare Consumer

1. Understand Your Specific Needs and Healthcare Costs

It’s not enough to choose a plan based on an affordable premium. You need to take the deductible into account too.  Even though a low monthly premium may seem like a financially viable choice, if it is coupled with a high deductible (the amount you’ll pay before your insurance kicks in) it might not be as inexpensive as you think. Read more about premiums and deductibles here.

Consider your upcoming healthcare expenses (as best you can). Are you planning to have a baby? Does your husband have a chronic illness that requires consistent, managed care? Are you going to need a knee replacement? Anticipating these healthcare costs will help determine what type of plan you’ll need and focus your research.

2. Budget For Those Costs

Figuring out what your healthcare costs might or will be is not enough. Now, you need to budget for them. Setting aside funds for medical care is vital; being prepared ensures you’ll be able to pay your bills in a timely manner without draining other parts of your family’s budget or going into debt.

3. Research Care

Every plan, with the exception of Medicare, has a network of providers that your insurance plan covers. Visiting an in-network provider vs. an out-of-network provider will always save you money.

But did you know that even within your network, provider costs can vary by up to 500%! A knee MRI in St. Louis can cost anywhere between $912 to $5,409 and again, those are in-network prices. Shop around for procedures and save yourself money. HooPayz members can check out prices using our Find Fair Healthcare Prices tool. For everyone else, be sure to call in-network providers and ask for their price upfront. This can save you a lot of money depending on facilities and procedures.

Read a little more about in-network providers here.

4. Shop Around For Prescriptions

The same goes for prescriptions. Prices vary widely by pharmacy, so be sure you know the best place to go to make the most of your dollars. Call ahead and ask for prices to make an informed decision.

Find more tips for saving on prescription drugs here.

5. Review Your Bills

Receiving medical bills in the mail can be intimidating and confusing. It’s tempting to write a check and be done with it. Don’t! 50-80% of all medical bills have errors.  Being a healthcare consumer means being proactive in your payment process and making sure you don’t pay a single dollar more than you owe.

  • Wait until you have received an Explanation of Benefits or EOB for the episode of care (this is the “Not a Bill” document you receive from your insurance provider).
  • Match your bill with the EOB by dates of service and make sure your benefits were applied correctly.
  • The “amount due” on your bill should match your EOB. If not, call your provider and request a detailed medical bill to review for errors. Learn about some common medical billing errors here.

Have questions or tips about becoming a healthcare consumer? Share them with the HooPayz community by commenting below!

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