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Chapter 9: Cure your health care costs

We made this a question because reducing family health care costs is usually the toughest place to cut.
A recent survey showed that 22 percent of Americans considered health care to be the single most critical issue facing the U.S. today. And for good reason. Since 2000, health-care costs have nearly doubled, rising at five times the rate of salary increases,
These cost increases have forced many families to make some hard choices. A study done recently by the Employee Benefit Research Institute (EBRI) found that 25 percent of insured adults had reduced their contributions to a retirement plan to help cope with higher medical expenses. Nearly half reported they were contributing less to other types of savings accounts as well.  A Kaiser Family Foundation study even found that 15 percent of people with health insurance had postponed treatment because of the cost.
So, can you actually trim these costs?
Consider the fact that the single largest medical expense for most families is the cost of heath insurance. Unfortunately, the differences in premium prices among health plans have narrowed significantly. However, if yours is a healthy family who uses a lot of routine care, you can probably get by with a Health Maintenance Organization (HMO) plan, if available at your work. If you use a doctor in the HMO’s network, you probably won’t have to worry about deductibles and the co-pays will be lower.
What if you have a medical condition that means you need to see a specialist or you have long-time relationships with doctors that are not in the network? In this case, you might want to look into a Preferred Provider Organization (PPO). These plans allow you to see specialists and doctors not in the network, without a referral. However, you’ll have a pay a deductible and you’ll most likely have higher co-pays.
Some employers also offer Point-of-Service (POS) plans that combine fea- tures of both PPOs and HMOs. They generally offer better out-of-network coverage than HMOs, but require higher premiums and co-payments.

Finally, there may soon be another choice – a high-deductible insurance plan (a deductible of $1,000 or more) that you combine with a Health Savings Account (HSA) that allows you to save money pretax, that you can then use to pay your health care costs.
What’s best for you? This will depend on your family, your family’s health and your employer. PPOs usually required the cheapest premiums but might cost just a few dollars less than an HMO or POS. You would save the most with an HSO but it’s really only for healthy families who can afford to pay for routine care and need only catastrophic coverage.
Pay less for your medications
One area where you might be able to trim health-care costs is in prescriptions. Many employers are offering financial incentives to encourage the use of less expensive drugs. In fact, nearly nine out of 10 workers are now in some kind of a plan that has a tiered cost-sharing formula for medicines.
The way these work is that there is one co-payment for generic drugs. Then, there is usually higher co-pay for preferred, brand name drugs such as Clari- tan  or Prevacid. for which there is no generic substitute, and even higher co- pays for non-preferred drugs. Some companies are now adding a fourth layer with steeper co-pays for the so-called “lifestyle drugs” such as Viagra and Rogaine.

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