Open enrollment season — the period that kicks off at the start of November during which you can enroll in, renew or change your health care plan — may serve as an unwelcome reminder of just how costly taking care of yourself can be. From routine costs — like co-pays at doctor’s visits, therapy sessions and prescription medications — to unexpected medical bills, health care expenses weigh heavily on many people’s budgets. And that expense is about to get even steeper.
“According to surveys by industry groups and benefit consulting firms, employers expect the costs of those benefits to jump as much as 9% on average in 2025, after years of more modest increases,” said The New York Times. The semi-good news here is that “workers probably won’t be asked to shoulder them all,” as “in recent years, employers have assumed much of the cost increases.”
Still, said the Times, “such increases can be significant for some workers, especially as families have dealt with higher prices for groceries, cars, and home and auto insurance.” Read on for some tips to make these often non-negotiable costs feel a little less burdensome.
1. Stay within network but shop around
An important rule of thumb to keep in mind: “If you visit a provider that doesn’t fall within your plan’s network, you’ll pay more for care,” said Kiplinger. With a “preferred provider organization (PPO) plan, you may receive some level of coverage for out-of-network,” but if you have a “health maintenance organization (HMO) plan, you’ll likely pay the full cost.”
Even if a provider is in-network, do not assume they are going to give a good deal. “Comparing prices for procedures at different facilities could save you big bucks,” said Kiplinger. “Typically, you’ll pay more for outpatient services — such as x-rays, MRIs and minor surgeries — performed at a hospital than at facilities not owned by a hospital.”
Some easy ways to price shop include visiting www.healthcarebluebook.com, where you can “use a free tool that offers estimates of fair prices in your area for a range of procedures,” or checking www.fairhealthconsumer.org, which lets you see “both in-network and uninsured pricing estimates for procedures in your region,” said Kiplinger.
2. Use generic prescriptions, ideally from big-box retailers or by mail
Buying the generic version of a drug as opposed to the brand name is an “easy way to save that makes no difference — except to your wallet,” Ramsey. You might also ask if an [over-the-counter] OTC drug “can treat your symptoms for less money,” said Investopedia.
You could save further on prescription drugs by getting them at “warehouse club stores like Sam’s Club” or at “large retail chain stores,” which may also “offer significant discounts (without health insurance),” said Investopedia. Mail order can trim down costs too, as can opting for a “larger prescription package (e.g., a three-month supply instead of a typical one-month supply).”
3. Request itemized bills and check them carefully
Staggeringly, “up to 80% of medical bills are incorrect, according to the advocates for transparent medical billing,” said Investopedia, so it is important to give yours more than a cursory glance when you receive them.
To know exactly what you are being charged for, ask for an itemized bill, as the standard “explanation of benefits (EOB) statement you get in the mail does not contain a detailed breakdown of all costs,” said Investopedia. With that in hand, review each charge to “make sure that you actually received all of the services, medications and other items on your bill.”
4. Remember to ask about assistance
Since many health care-related costs are non-negotiable, you may figure that your final bill is too. But as it turns out, “you can often get a discount on services simply by asking,” said Investopedia.
One option if you are stressed out about paying a hefty sum all at once is to “ask the billing-office staff if they will work with you to create a plan enabling you to make smaller, more manageable payments over an extended period of time,” said Investopedia.
Or, “if you’re anticipating a hospital stay, review its website for information about financial assistance programs,” said CNBC, citing Caitlin Donovan, a spokeswoman for the National Patient Advocate Foundation. “You may qualify for a reduced or even no-cost stay,” Donovan said to CNBC.