With healthcare costs steadily increasing, it is important for us all to find ways to cut down on healthcare costs. Medical inflation has increased at 3 times the rate of overall inflation since 1960 (roughly 6% a year). Between 2011-2016, health insurance premiums for the average California family increased by $5,208 or 36% while wages had only increased $3,307 or 8%. With healthcare costs and thus health insurance premiums impacting our wages, here is a list of 5 simple tips to save money on your health insurance and medical costs.

Tip # 1 – Choose more affordable EPO or HMO plans for lower monthly premiums

One of the most common ways to save money on your health insurance premiums is by enrolling onto an HMO or EPO insurance carrier, limiting your provider network yet limiting your premium. Many Los Angeles individuals and families have either decided to lower their metal tier one or two levels for the same insurance type or have shifted from PPO plans to more affordable HMO or EPO plans from Kaiser, Oscar or Health Net to just maintain a similar premium from last year. We have seen a rise in Oscar membership, especially in the West LA area, as many Blue Shield PPO members look to more affordable carriers that cover hospitals such as UCLA, USC and Providence. At Solid Health Insurance Services, we will happily look for your providers to see which plans they are in-network at as well as to weigh the pros and cons of each plan type and metal tier for you.

Tip #2 – Search for a  primary care doctor which you feel comfortable with and trust

Finding a good primary doctor, which you feel comfortable with and you trust is very important for your overall health. In all health plans, you have the ability to switch primary doctors. It is important that you start a relationship with your primary doctor. So that when you do not feel good, you can trust in his ability to know if this is something he can solve or a specialist needs to be referred too.  Get your free annual wellness checkup once a year and keep your doctor in the know about your medical needs. Preventative services help to detect medical problems at an early stage, so that with early intervention chronical illness can be avoided. About 85 % of all doctor visits can be treated by primary doctors. Visiting a specialist is more expansive. In the Los Angeles region, a specialist visits cost approx. $700 versus $150 for a primary doctor, and often invasive testing such as MRI’s, endoscopies and colonoscopies are fast ordered, which increases the overall health cost.

Tip #3 – Utilize telemedicine services

With telemedicine services either free or at a low copay for most insurance carriers, you can save money by avoiding taking a trip to your primary doctor by calling a doctor on call, either over the phone or via video chat. This can save you from your regular doctor visit copay, usually between $30-75. Oscar offers free telemedicine services to their members as well as a concierge service consisting of 4 care guides who become familiar with your medical needs and provider preferences. Blue Shield offers their telemedicine services through Teladoc, usually at a $5 copay per call. In the Los Angeles and San Francisco region Heal offers doctor house calls which are in-network with Blue Shield, Health Net, Anthem, Aetna, UHC, and Cigna offered mostly for the same co-payment as a primary doctor rate. Should you have no insurance Heal’s doctor house call visits are offered at $ 99. If you have minor medical needs, you should give telemedicine a try and see if it works for you. Some members like it for its convenience and low or no cost while others may prefer going to their primary doctor face to face to address issues.

Tip #4 – Avoid out-of-network providers

One of the biggest reasons for why PPO plans cost more is due to the fact that these plans cover out-of-network providers. Out-of-network providers do not negotiate rates with insurance carriers and thus can charge significantly more than an in-network provider. On the other hand, the insurance carrier will pay not for the first  $ 5000 of services as they apply on all metal plans an out-of-network service deductible of $ 5000 or higher.  After you meet the deductible a  50% co-insurance for your out-of-network services will be applied. However, the insurance carrier will only pay the usual and customary rate in the region or the in-network rate, which leaves you with the obligation to pay the balance to the doctor. For example, an orthopedic doctor wants to charge $ 800  for a visit, but the insurance carrier pays normally $ 250 for the service. Then with a 50 % co-insurance, you would receive $ 125  from the insurance carrier but would be liable for $ 675, a steep bill to pay next to the regular monthly health. If you need to see service with an out-of-network doctor you a better off to negotiate a cash price.

Tip #5 – Prescriptions

With prescription drugs, you should pay attention to your drug deductible for your health insurance plan. For your plan to cover your prescriptions, you must first meet your drug deductible of anywhere between $0 to $500 per prescription.  For chronical illness, you are best off to review the actual cost of each medication. If the prescription costs are high then the upper metal plan like Platinum and Gold might more sense then buying a Silver or Bronze plan. As you might be liable to pay $ 250 or $ 500 per prescription if the drug is in Tier 4. A very good resource to review the actual cost of the prescription is GoodRX. Good RX gives you an overview of the prescription drug cost with different pharmacies and offers coupons and also generic alternatives, which you might discuss with your doctor.

At Solid Health Insurance Services, we are always here to help our clients find the right plans for their budget and medical needs. Please do not hesitate to contact us with any questions you may have about the carriers and plans available in your area. As independent insurance agents, our services are free of charge as we are compensated by the insurance carriers directly for servicing our clients’ needs. Please call us at 310-909-6135, email us at info@solidhealthinsurance.com or visit our website at www.solidhealthinsurance.com