How to save on health care and prescription drugs

By Jon Scott

Health Savings Accounts

Health Savings Accounts (HSA) were established by the Medicare Prescription Drug, Improvement, and Modernization Act in 2003 as a savings account allowing consumers to set aside funds for certain health care services on a pre-tax basis. HSA accounts are coupled with high deductible health plans (HDHPs), requiring enrollees to pay out of pocket medical expenses until their deductible is met (amount varies by plan), then insurance pays for the additional expenses beyond the deductible amount. HSA were specifically created to provide more affordable options to consumers as well as help consumers avoid over-utilization of services.

Preferred Provider Organization (PPO)

A PPO plan provides enrollees with a wide network of providers, who have agreed to provide care to enrollees at a certain rate. PPO plans offered by employers typically come with more comprehensive coverage in terms of level of care and access to healthcare professionals, both in-network and out-network. PPO plans also typically have copays where plan members pay a portion of the doctor visit/care costs while insurance covers the rest. In contrast, HSA plans do not have copays and the enrollee is responsible for the full cost of the visit/care until the deductible is met.

How do I decide between a HSA or PPO

Which plan is best for you will depend on your health situation. However, for younger, healthy individuals an HSA plan will probably be best. HSA plans are better for younger, healthier individuals because this demographic generally have fewer doctor visits as well as little risk of developing a condition that would require healthcare visits.

Older individuals or those who visit the doctor often will usually be better served with a PPO program. This is because the wider in-network and out-of-network providers that are covered and copay offered by the PPO program. However, it is possible an HSA with a low deductible will be a reasonable option as well.

Here are some example of some common plans offered through Anthem Blue Cross Blue Shield

Talk to your doctor about your medical costs

If your medical costs are a burden on your finances, consider having a conversation with your doctor. For example, if you are feeling burdened by high prescription drug costs, a doctor can switch you from a brand name drug to a generic, change the dosage or frequency, reduce the number of medications you take, or find a medication with more affordable copay. A doctor can also put off medical tests until you’ve met your deductible as well as save you appointment costs by communicating via phone or online portal.

Two-thirds of patients who talked to their doctor about drug cost received a recommendation for a lower-cost alternative, and one third received help from a pharmacist. Therefore, it is a good option to also talk to a pharmacist about your prescription drug costs.

GoodRX

GoodRx offers a mobile app and website to help you find discounts for medications. You are able to log onto GoodRx and find the lowest price for your medication at nearby pharmacies. GoodRx allows you to use a coupon on your phone or print one out from the website.GoodRX is accepted at more than 70,000 pharmacies If there are prescriptions you need continuously, it is a good idea–if you are not already–to check GoodRx to see if you are able to find a more affordable option. If you are receiving a prescription for the first time, you will want to open GoodRx to find the cheapest price, and or determine if you can afford the medication.

GoodRx can save consumers up to 80% off the price of prescription drugs. In fact, it is possible to find prescribed medications that are absolutely free. However, there are a couple downsides, GoodRx cannot be combined with health insurance, Medicare, or Medicaid. Therefore, if you have insurance you will want to compare the GoodRX price with your insurance co-pay. Lastly, it is important to know that the lower price drugs displayed on GoodRx will typically be generic. However, there is an option to view pricing for brand-name drugs.

Partnership for Prescription Assistance (PPA)

The PPA connects uninsured and underinsured patients struggling to afford their medications with prescription assistance programs offering medicines for free or nearly free. This is a free and confidential service with information on more than 475 public and private patient assistance programs.