Smart Benefits: Make the Most of Your Health Plan in 2014

Amy Gallagher, GoLocalProv Business/Health Expert

Smart Benefits: Make the Most of Your Health Plan in 2014

Every year it seems health insurance premiums and out-of-pocket expenses increase while plans cover less. So how can consumers get the most out of their coverage in 2014? Here are five ways to put your plan to good use next year – and reap some savings along the way.

1. Get your Annual Wellness Check. An annual dose of prevention can mean early detection for a myriad of illnesses. So be sure to see your primary care physician (PCP) annually for a wellness check this year. Healthcare reform requires your coverage to provide this service at no cost – meaning, you’ll pay no copay or deductible. Get age-appropriate screenings as part of your visit since those are also covered.

2. Switch to lower cost prescription drugs. Carriers charge up to three or even four different prescription copays depending on the coverage. And the differences can add up. Tier 1 medications are usually $7 or $10 while Tier 3 copays are often $50 or $60. Ask your physician if there is a lower cost equivalent of your Tier 1 medication to save $43 or more per month – with potential annual savings of greater than $500.

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3. Move to mail order and save even more. Most insurance carriers offer mail order benefits for maintenance medications, which can typically save you the equivalent of 2-4 weeks of medication costs per quarter. Plus, you’ll save on gas by having the medications shipped right to your door. And you’ll avoid impulse buying at the pharmacy while waiting for your prescriptions to be filled.

4. Join a fitness club. Carriers offer discounts, and in some cases, reimbursements if you join a fitness club and use it. Tufts Health Plan just enhanced its fitness discount reimbursement program to include studio classes for programs like Pilates and dance classes.

5. Comparison shop. BCBSRI and UnitedHealthcare both offer cost estimators that allow consumers to shop and compare costs for care by type of service (e.g. MRI versus x-ray) or by setting (e.g. hospital, doctor’s office or stand-alone facility) and even check prescription copays by pharmacy. If you’re willing to do the research, you can save a tremendous amount of money. And if you have a plan with a deductible, any savings realized means less money from your pocket.

To save even more, remember to enroll in either a Health Savings Account (HSA) or Flexible Spending Account (FSA), both of which help to pay for out-of-pocket expenses on a pre-tax basis with money you are able to set aside through payroll deduction or savings deposits. Money saved is loaded onto a credit or debit card and can be used to pay for purchases through the year – so you don’t have to take from your spending money.

Amy Gallagher has over 21 years of healthcare industry experience guiding employers and employees. As Vice President at Cornerstone Group, she advises large employers on all aspects of healthcare reform, benefit solutions, cost-containment strategies and results-driven wellness programs. Amy speaks regularly on a variety of healthcare-related topics, and is often quoted by national publications on the subject matter. Locally, Amy is a member of SHRM-RI, the Rhode Island Business Group on Health, and the Rhode Island Business Healthcare Advisory Council.

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