If you’re one of the millions of Americans who pays for his or her own insurance as an individual (and not through your employer), open enrollment is here and that means it’s time to make some important decisions for your healthcare.
For some of us, it’s a simple decision-based on medical background history and current income. For many, there are a lot of factors that go into this hugely important choice. Not helping matters are the daunting number of choices, the cost, and the lack of definitive resources to assist you.
Let’s talk about the various choices you have in terms of picking a health care plan, how to navigate costs and shedding some light on price shopping and average costs for common appointments.
How do you select the right health plan?
First, ask yourself, do you have specialized medical needs? Are you paying for health insurance on a budget? Do you make healthcare appointments regularly or do you see the doctor rarely for accidents or special situations? How old are you and do you foresee health conditions in your near future?
There are several types of plans to choose from based on the current state of your health and your overall activity level and state of well-being. With many people still confused about how/when to choose the right type of plan, here’s a quick background on the various healthcare plans that are available to you.
The HMO (Health Maintenance Organization):
This plan usually limits coverage to care from doctors who work for or contract with the HMO (aka are “in network”). It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. HMOs often provide integrated care and focus on prevention and wellness and require the patient to choose a primary care provider through which care is coordinated. The downside in having an HMO plan is that you can’t go to just any provider – the provider must be part of the HMO network. If you have a complicated condition requiring the need of super specialists, having an HMO may not be the best idea as not all HMO networks have the right specialists with expertise in every type of disease out there.
Exclusive Provider Organization:
This is similar to an HMO; however, you are not mandated to have a primary care physician through which care is coordinated. A plan member can generally see a specialist or other care provider without the need of a referral from a primary care physician but only if he/she use doctors, specialists, or hospitals in the plan’s network (except in an emergency). This provides more flexibility as one doesn’t have to go through their primary physician to get to the end-goal specialist.
The PPO (Preferred Provider Organization ):
With a PPO you pay less if you use providers in the plan’s network. You can use doctors, hospitals, and providers outside of the network without a referral for an additional cost. These are generally the preferred plans that providers like to accept as they reimburse the most, generally speaking – so if you are looking for flexibility in who you want as a doctor, you’re better off going the PPO route in most cases. You are more likely to be paying higher for your overall plan than an HMO or other.
These are typically people that need the most flexibility in their healthcare options.
A HDHP (high-deductible health plan ):
A health insurance plan with lower premiums (or monthly payments) and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a health savings account (HSA).
These plans are usually purchased by consumers that are young or healthy with limited need for doctor’s visits.
A health savings account (or HSA):
An HSA is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a HDHP. The funds contributed to an account are not subject to federal income tax at the time of deposit. These funds are deposited to a card that can be used for medical appointments, prescriptions and some additional health-related costs when needed.
How and When to Price Shop for appointments?
Now that we have a plan in place, its just a matter of time until you have to visit the doctor whether its planned or unplanned we visit the doctor or dentist a handful of times throughout the year.
With a larger percentage of people selecting HDHP’s, patients are putting off appointments that may seem like small or trivial health concerns at the time, in fear of having to pay too much out-of-pocket for visits.
Putting off healthcare appointments is not a good solution and can make your situation worse, resulting in larger medical bills. This is where you can use ZendyHealth to effectively price shop for common procedures across healthcare, dental and beauty industries. We are also continuously adding new procedures and providers every day.
A recent study by PublicAgenda.org shows that 56 percent of Americans have actively looked for pricing information on healthcare appointments before getting care, including 21 percent who have compared prices across multiple providers. Those who compared prices, say doing so has affected their choices and saved them money.
ZendyHealth ensure quality providers on the site, so all you have to do is select a procedure, bid a price that you can afford and wait to get matched with a provider based on your bid and location. Here are some tips when bidding for an appointment to get your bid accepted:
How much do appointments actually cost?
One of the biggest challenges of bidding the right amount, is knowing how much appointments normally cost. Traditionally the healthcare industry has not been very transparent in revealing typical costs, so consumers are left in the dark, not knowing what to expect for their doctor’s visits. As deductibles get higher, patients taking on these plans are shocked at the price of their appointment and are even avoiding the doctor to save money.
Part of our mission is to create transparency in cost, so that patients can get the best value from their providers. Here’s a quick list of the average cost of common health, dental and beauty appointments in the US.
Allergy Testing, $650
CT Scan, $650
Teeth Cleaning, $300
Laser Teeth Whitening, $375
Tooth Extraction, $500
Dental Implants, $3,900
Botox (10 units) – $160
Dermal Fillers (lip injections, etc.) – $675
Laser Hair Removal – $230
Liposuction – $2,300
Microdermabrasion – $150
In the current landscape of high deductible plans, educating yourself on options on how to save money for healthcare costs could make a difference of thousands of dollars each year. My recommendation is to look at as much information as possible to identify all the areas where you can save money without compromising on your health. Educating yourself on your plan, price shopping and understanding the real cost of procedures are highly effective ways to save money on healthcare costs going into the New Year.