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How to cut your medical costs: Do's and don'ts

How you can stretch your health care dollar during tough economic times — without jeopardizing your health.

By Mayo Clinic staff

"The wind began to switch, the house to pitch, and suddenly the hinges started to unhitch."

This line from the "Wizard of Oz" could easily describe many people's experience with spiraling medical costs. About 1.5 million families lose their homes to foreclosure every year because of unaffordable medical costs. Out-of-pocket medical costs, including health insurance premiums and copays, have increased by 45 percent in the past five years — and that's for people lucky enough to have health insurance through their employers.

Given the double-digit increase in medical costs, you may be tempted to stop going to your doctor or to let your prescriptions run out. But before you go to that extreme — and potentially jeopardize your health — consider the following do's and don'ts for trimming your medical costs.

Do know the rules

Each health insurance plan has its rules and requirements. Make sure you know and follow them. Failing to do so can cost you. For example, your doctor gives you a prescription before you leave the hospital after having surgery. After you fill the prescription, you discover that your plan won't cover it because it was written in the hospital — but would have covered it if it had been written in your doctor's office.

Do have a medical home

Research has shown that receiving care from your primary care physician — as opposed to hopping from specialist to specialist — is associated with lower total medical costs. In addition, many minor health problems, such as stitching up smaller cuts, getting a tetanus shot or dealing with a lower urinary tract infection, can be handled in your doctor's office, saving you a trip to the emergency room.

Do use the emergency room but only for emergencies

Emergency room care is among the most expensive options for medical care. Of course, don't hesitate to go if you have symptoms such as significant severe shortness of breath or chest pain, uncontrolled bleeding or sudden weakness anywhere in your body. For less severe symptoms, these tips may help you avoid the cost — and inconvenience — of an emergency room visit:

  • Have a plan. If you have a condition that can suddenly worsen — such as heart disease, migraines, diabetes, back pain or asthma — work with your doctor to develop a plan for dealing with any new complications. Ask about having mediations on hand for common complications.
  • Ask a nurse. Find out if your insurer or employer offers access to a 24-hour nurse line, where you can talk to a nurse trained in directing people to appropriate medical care. If you don't have access to a nurse line, try calling your doctor or even the emergency room for advice.
  • Consider urgent care clinics. Located in drugstores, supermarkets and malls, these clinics are open evenings and weekends when your doctor's office may be closed. They can handle many minor but urgent issues, such as a strep throat or a bladder infection.
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References
  1. Hidden costs of health care: Why Americans are paying more but getting less. Department of Health and Human Services, 2009. http://www.healthreform.gov/reports/hiddencosts/index.html. Accessed July 10, 2009.
  2. Maeseneer JM, et al. Provider continuity in family medicine: Does it make a difference for total health care costs? Annals of Family Medicine. 2003;1:144.
  3. Furst JW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 7, 2009.
  4. When should I go to the emergency department? ACEP Foundation. http://www.emergencycareforyou.org/YourHealth/Default.aspx?id=26018. Accessed July 8, 2009.
  5. Pitts SR. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary, National Health Statistics Report, 2008. http://www.cdc.gov/nchs/data/nhsr/nhsr007.pdf. Accessed July 31, 2009.
  6. Saving money on prescription drugs. U.S. Food and Drug Administration. http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm134215.htm. Accessed July 10, 2009.
  7. Liu D. Stay Healthy, Live Longer, Spend Wisely. Sacramento, Calif.: Stetho Publishing; 2007.
  8. The problem of health care fraud. National Health Care Anti-Fraud Association. http://www.nhcaa.org/eweb/DynamicPage.aspx?webcode=anti_fraud_resource_centr&wpscode=TheProblemOfHCFraud. Accessed July 10, 2009.
  9. 7 ways to make the most of your health plan. Consumer Reports Health. http://www.consumerreports.org/health/insurance/health-insurance-9-07/7-ways-to-make-the-most-of-your-health-plan/0709_health_steps_1.htm. Accessed July 10, 2009.
  10. Facts about healthcare - health insurance costs. National Coalition on Health Care. http://www.nchc.org/facts/cost.shtml. Accessed July 14, 2009.
  11. Online guide to quitting. SmokeFree.gov. http://www.smokefree.gov/quit-smoking/keep_rewarding.html. Accessed July 14, 2009.
  12. Litin SC (expert opinion). Mayo Clinic, Rochester, Minn. July 28, 2009.

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