Category Archives: Health Care Cost Savings

Use Coupons For Prescription Medications

Greater savings is available using coupons for brand name prescription medications.

Pharmaceutical companies offer coupons for discounts or rebates for two reasons:

1. To encourage you to try their medication

2. To keep you on their medication

Coupons are available through your doctor, your pharmacist or online. Try a Google search for “drug name” and “coupon.” You may even find offers in your local newspaper or favorite magazine.

Some pharmaceutical companies offer coupons for a free trial of medication, from a three-day introductory offer to an entire month’s prescription free. Others offer a discount or rebate on your out-of-pocket expense, including co-pay amounts, as high as $50 per month. Some are one-time offers, but many are renewable for a few months, or a year, or even for as long as you require the medication. The reusable for a few months or a year, or even for as long as you require the medication. The reusable coupons usually come in the form of a plastic card that you present to the pharmacy each time you need a refill. If the discount is in the form of a rebate, make sure you keep your receipts.

Some of these programs are not available to government-sponsored (Medicare and Medicaid) prescription plan beneficiaries.

A second type of coupon is offered through retail pharmacies and commonly involves new or transfer prescription. The coupon may be worth more than the price of the drug you are purchasing! Some stores will honor another retailer’s coupon as well. Potentially you could actually make a profit — transfer a $5 prescription and receive $20 in store merchandise.

Retail pharmacy coupons may appear in local publications, or show up in your personal mail. In general, they apply to either generic or brand name medications. Discounts may be offered on current or future prescriptions, other store merchandise, or even gasoline purchases. Some retailers offer gift cards rather than discounts. Large retailers offer gift cards rather than discounts. Large retailers offer coupons and discounts online as well. Go to your local pharmacy’s website for additional information.

If you’re lucky, you may able to combine a retail pharmacy coupon with that of a pharmaceutical company.

Happy coupon hunting!

Are you spending too much on prescription drugs?

If you have prescription coverage, odds are you have a formulary, which can save you a lot of money on prescription drugs.

What is a formulary?

A drug formulary is a list of prescription drugs (both generic and brand name) that are preferred by your health insurance plan. Your plan may only pay for medications that are on their “preferred” list, unless your healthcare provider talks with your health plan and gets prior approval.

Most insurance companies maintain formularies, or a list of drugs that they pay for as a plan benefit, usually using a tiered system. Less expensive drugs have the lowest co-pay (Tier 1), the most expensive drugs have the highest co-pay (Tier 3), and the remainder lie in between (Tier 2). This tier designation does not go strictly on retail price — insurance companies negotiate for discounts that sometimes may make a costlier drug preferred over a less costly one.

Formularies are organized along therapeutic classes. For example, they all contain several blood pressure pills, antibiotics and diabetic medications, though often only one mediation from each therapeutic sub-class.

How do I save money on prescription drugs with my formulary?

If your doctor chooses from your list of preferred drugs or formulary, it will save you money. How does your doctor know what to choose? In short, your doctor doesn’t… not unless they have access to your formulary or list of drugs covered by your insurance plan. Get two copies — bring one with you to every doctor visit. Have your doctor keep the other in your chart for reference.

Tier 1 drugs may not necessarily be your first choice. You may be intolerant of a certain drug, or perhaps unresponsive to it. You may be stable on a particular name brand prescription for years already and are therefore hesitant to make a change. Some medications require blood level monitoring, and levels may be more consistent with brand name medications. Switching to a generic may not save you money if you need to have your blood level checked more often.

Additional savings are available in the form of coupons or rebates from pharmaceutical companies, which may save you $20 to $50 off your co-pay, thereby lowering your out-of-pocket cost for a higher tiered drug to the same as that of a lower tiered medication.

So to sum it up… know your formulary and partner with your doctor to save money!

Not all doctors see eye to eye

Not all eye doctors are created equal!

An optometrist, also commonly referred to as an “eye doctor”, is not a physician, but rather a trained professional licensed to examine patients for visual defects, and to prescribe glasses and contact lenses.  The glasses themselves, are made by an optician.  An optometrist usually offers a lower examination fee that an ophthalmologist.  If you’re healthy, have no insurance, and only need a pair of glasses, see your local optometrist (or the one employed at your local superstore).

However, if you have a medical problem, it may cost you less to see an ophthalmologist.  Ophthalmologists are physicians trained in the diagnosis and treatment of diseases of the eye, including cataracts, glaucoma, or problems resulting from diabetes or high blood pressure.  Ophthalmologists prescribe eye medications and perform eye surgery, but often prescribe eyeglasses or contacts as well.  Ophthalmologists are covered under your insurance (including Medicare) the same as any other specialist, such as a cardiologist.  (Traditional Medicare does not cover optometrists).  Any person who has high blood pressure or diabetes has a valid reason to see an ophthalmologist.

Physicians and optometrists both refer to ophthalmologists for a variety for conditions including certain infections, injuries to the eye, uncorrectable visual problems, lazy eye, glaucoma, cataracts, persistent styes, macular degeneration, diabetic or hypertensive retinopathy, iritis, and droopy eyelids.

Even if you have no disease of the eye other than poor vision, your insurance may cover a visit to a medical eye doctor.  Again, check your policy first for coverage, and your list of covered physicians (ophthalmologists), optometrists and opticians.  Hopefully this information will help you see your way to savings.

CRM Tip: Most student plans do not cover anything but injury or disease of the eye, so you may need to purchase a separate “Vision Insurance Plan” for help with paying for your glasses or contacts. These are very inexpensive and can cost as little as $15 for a discount vision plan through Co-Health USA. Visit the products page on our website to check it out!

It never hurts to ask

Overall, doctors are a compassionate group.  They became doctors to help people after all.  Given the right circumstances, most would consider granting a discount.  However, before you ask, there are a few things to keep in mind.

First, your doctor may have already discounted their fee without you even asking.  Perhaps they only charged you for ten minutes of their time when you have taken thirty. The receptionist may be able to tell you if this is so, or could apprise you of your doctor’s usual and customary charges.

And, a word about co-pays.  Your doctor is required by law and contract to collect these payments.  Under most co-pay situations the fee has already been “adjusted” downwards by 20 to 50 percent.  If a doctor charges you say, $100, insurance often knocks that down to about $65, the remaining $35 simply disappearing as a “negotiated” adjustment.  Of the remaining $65 a good $40 goes to overhead (staff, rent, utilities, malpractice insurance, equipment, etc.).  If your insurance pays $40 of the $65 negotiated fee, that leaves your $25 co-pay to cover the doctor’s time with you.  These “negotiated fees” have dropped so low that many doctors are finding it difficult to stay in business.

In summary, if you have financial concerns, talk to your doctor about a discount.  Some doctors offer small billing discount for cash up front and others allow interest-free monthly payments.

Also, check out your Health Center on campus!  Health Centers have doctors, nurses and nurse practitioners who can care for you at a discount.  Student Health Centers are great place for SAVINGS!

CRM Tip: Be reasonable, but it never hurts to ask!

How quickly do you REALLY need to see the doctor?

Urgent care visits – cost more – plain and simple!

Doctors normally charge according to a book of CPT codes, which lists every procedure from splinter removal to surgery.  There are codes for routine procedures or office visits and codes for emergency (or urgent) visits. Extra time and urgent visits costs more.

An urgent visit could be one where you show up at the doctor without calling first.  Some doctors code urgent visits whenever a patient calls to be seen the same day, for say a bad cough or cold.

What a patient considers urgent, usually is different than what a doctor thinks is urgent.  Some patients wait too long to seek medical care, but it is more common for a patient to believe they need urgent attention when their problem could have waited a day or two.

If you aren’t sure, call your doctor first and ask.  Ask specifically if you need to be seen right away OR if your problem can wait for a non-urgent appointment.  Ask what you should do in the meantime to alleviate the symptoms and ask about anything that would alert you to the need for an emergency room visit or urgent care visit.

The idea is not to put your health at risk, but rather to allow your body to heal on its own.  For example:

  • Most sprained ankles don’t need immediate attention – if you can walk, odds are, it isn’t broken.
  • Sore throats and ear infections
  • Fevers associated with minor illness
  • Stomach flu or diarrhea
  • Broken small toe (not large toe)
  • Head colds and sinus infections
  • Sprains where you still have use of the affected limb
  • Insect bite/sting with local symptoms only

 CRM Tip:  If in doubt, call your doctor.  You may not need to be seen at all.

How to Prepare for a Doctor’s Appointment

Know why you are going and know what you want!

You can save money and time, by knowing why you are going to the doctor and what you hope to accomplish.  You can save money by saving time.  Charges for physician visits are not based solely on time spent with a patient, it does factor into the equation.  Many physicians note the time they enter a patient’s room and the time they leave, for billing purposes.  You can save money by doing the same.  Keep track and stay focused.

Much can be accomplished if your goals are clear.  Get a notebook and jot down your thoughts.  Make a list of what you hope to address.  Prioritize your needs and let your doctor know what concerns you most.  After your visit, make additional notes regarding your doctor’s comments and plans.

Your doctor is more likely to throw in a “freebie” if you make your requests known up front and stay on task.  If you wait until they are about to leave the room, they will groan inwardly and may adjust your bill upward.

Here are some tips:

  • If you are having bloodwork and forgot to fast, you may have to return
  • Is your knee hurting?  Wear shorts or a skirt to hasten the exam.
  • Bad toe?  Take off your socks and shoes – do you really want to pay the doctor to watch you take them off?
  • Need refills?  Check your prescriptions before you leave home.  Make a list of what you have and what you’ll need for your doctor to review.
  • Plan ahead and organize your thoughts
  • Check ahead if you need refills
  • Know your formulary
  • Bring a record of your blood sugar or blood pressure.
  • Fill out forms ahead that you need to have completed
  • Get a copy of the $4 list from your local pharmacy
  • Keep a notebook
  • Make a computer file of your medicines and print an updated list for every visit.
  • Type out two copies of an organized, detailed description of your problems with room for your doctor’s comments.

Why one doctor visit is less than two!

Almost always, one longer visit with your doctor is cheaper than two shorter visits.  (1 + 1 < 2)

The immediate savings for insured patients is obvious, with only one co-payment due rather than two.  But even for self-pay patients, longer visits are often more cost effective.

Doctors don’t like to be surprised by extra problems or work on two problems in the time allotted for one.  So, the answer to this is to simply plan ahead and when you call for your appointment, explain the situation and request more time.  If a longer appointment is not available at the original appointment time, ask for a different time or different day.  Your doctor will want to allow sufficient time to address your multiple concerns adequately.  Calling ahead alerts the office staff to the need of special coding (modifiers) when a procedure (such as an ear infection or wart removal) is combined with a Pap Smear or Breast Exam.

Plan ahead and your doctor will work with you for a happier solution.

CRM Tip: The list is endless, but the point is clear. Two problems take longer than one, but one visit is cheaper than two.

The Power of Family Doctors

Unless you are having heart by-pass surgery or perhaps a hysterectomy, you probably don’t need to go to a specialist.

For common illnesses such as acne, asthma, or anxiety, your good old family physician is well equipped to diagnose and treat these conditions most of the time and odds are, they will save you money.

Not only is your doctor likely to charge you less, overall family doctors are less likely to order expensive testing.  Specialists often look for  a definite diagnosis, whereas your family doctor may focus more on symptom relief.  He or she may offer a therapeutic trial of medicine, reserving expensive testing for conditions that aren’t easily resolved.

Family or primary care doctors aren’t just for colds and sore throats, they’re trained to handle 90 to 95% of all conditions encountered in their daily practice.  This list of conditions is long and overlaps considerably with a broad range of sub-specialities.

If you have a problem and wonder whether your doctor can handle it, give your doctor a call and if they cannot, then they will refer you to a trusted specialist, ideally one that they would be willing to see themselves!

Below is a partial list of conditions that family doctors treat on a daily basis, which normally do not require a specialist:

  • Acne, psoriasis, eczema, headache, migraine, insomnia, anxiety, depression, Alzheimer’s disease, stress
  • Ear infection, hearing loss, dizziness
  • Pink eye, styes, scleral hemorrhage
  • Allergies, sinusitis, nose bleed
  • Mouth ulcers, thrush, tonsillitis, parotiditis
  • Swollen glands, goiter, stiff neck
  • Asthma, COPD, emphysema, laryngitis
  • Stable heart failure, stable angina, chronic atrial fibrillation, most heart murmurs, most palpitations, most chest pain
  • Acid reflux, ulcers, indigestion, diarrhea, constipation, irritable bowel, hemorrhoids
  • Urine infections, kidney stones, overactive bladder, prostate infection or enlargement
  • Pap smears, birth control, menopause
  • Diabetes, thyroid disease, weight loss or gain, obesity
  • Back pain, sciatica, gout, carpal tunnel syndrome, arthritis, warts, nail fungus
CRM Tip: Did you know consultants charge more, often considerably more, for what is frequently the same service your family doctor may render?

Establish a relationship with your doctor!

Does your doctor know you? 

Doctors assist patients without charging them, for refills on prescriptions to phone advice. That is… if your doctor knows you! If your doctor doesn’t know you, these things are not available to you.

Even if you are rarely ill, it is a good idea to see your doctor once a year.  You can use this appointment to discuss updating vaccines, routine screening tests, or perhaps that itch or dark spot you wouldn’t bother to seek medical attention for otherwise.  Such a visit could last only a few minutes and cost considerably less than a longer visit for an illness.  Patients who see their doctors at least once a year, would benefit from effective partnering as well.

Longer office visits usually cost more than shorter visits, but still less than multiple appointments, and have the advantage of saving a second co-pay.

CRM Tip:  Are you a student?  Can you go to your student health center on campus for routine things first?  Great idea and it will save you money!

How to Save Money on Doctor & Emergency Room Visits

Firstly, Health Centers on your campus are a great resource.  They can really save students money.

Secondly, Don’t go to the doctor, if you don’t need to.  How do you know?  Use some common sense and THINK ABOUT IT FIRST!

One of the many things we see in the Health Insurance field, is that students seem to go to hospital emergency rooms for non-emergencies.  This costs a great deal of money! And we hate to say it but… that was totally unnecessary! Making an appointment with a doctor, or going to an Urgent Care Clinic when necessary will avoid those costly emergency room expenses.

What to do before visiting a doctor

The #1 reason patients make unnecessary doctor’s visits is for a head cold. But here’s the catch, a typical head cold resolves itself in about a week without treatment!  Antibiotics don’t help a cold virus – your own immune system heals you.  But when symptoms progress into your chest, then a doctor’s visit is warranted.  So… to begin with — try chicken soup, instead of antibiotics!

Ask your Mom, grandma, the lady next door who raised seven kids… what they suggest.  Or call a local “Ask-a-Nurse hotline.”  If you call your doctor’s office, make sure you:

  • Give a brief but accurate synopsis of your symptoms
  • Ask them if you should be seen or how long you should give your body to heal on its own

Minor illnesses and accidents can also be treated at home!

Did you know that…

  • Minor sprains can heal within just a few days
  • Back pain be relieved with some exercises and lying still for a few days
  • Burns that doesn’t cause blistering just need to be kept clean and bee stings that only swell locally (without other symptoms) can be treated with OTS antihistamines.

So before you go to the doctor’s office or hospital, be sure to do some research on your own and see if your body just needs a few days to heal on its own.

CRM Can Help:  Call Collegiate Risk Management at 1-800-922-3420 for information on a program we have available called Tele-Doc.  For $40 per year, you can place calls to a medical doctor who can call in prescriptions for you, avoiding costly doctor visits.