Simple Questions That Can Reduce the Cost of Arthritis Care

A good insurance plan plays an important role in how much you pay for health expenses.  But did you know that your doctor and the office staff, as well as your pharmacist, can help you manage costs?  Asking the following questions could make a big difference.

For Your Doctor:

• Will you be in network with my insurance plan for the new plan year? If you not, which health plan network will be part of?  
• Is there a cheaper test/medication/procedure that can replace the one you recommend?
• Can you use the results of tests ordered by another doctor recently instead of repeating the test?
• If you work at different facilities, where would the cost of this procedure be cheapest?
• Can we review my medications and eliminate ones I no longer need?
• Can you write a prescription for 90 days (instead of 30) for a drug that I will use long term?
• Can I get a prescription for a higher strength pill that I can split to save money?
• Do you know of online discount programs or patient assistance programs for medication?
• Do you have samples of the medication that you prescribed me?
• Do you provide telemedicine services? (This could help you save money on office visit copays).
• What steps can I take to be as healthy as possible? Do you know of  resources that can help me get started or stay motivated?

For the Doctor’s Billing Manager:

• Which labs do the practice use and are they in my health plan’s provider network?
• What is the cost of this office visit or test if I use my insurance?
• Do you offer a discount for paying the same day or paying cash instead of using insurance?
• Do you offer need-based discounts on procedures and imaging tests?
• What is the Current Procedural Terminology (CPT) code for the test or procedure that the doctor wants me to get?  (You can provide this code to your insurance company to find out how much of the cost they will reimburse or comparison shop among health care providers or facilities.)
• Who are the providers that will be involved in performing this procedure? (Asking this question will ensure that you don’t get an unexpected bill from an out-of-network provider like an anesthesiologist or pathologist.)
• Do you know if my insurance requires prior authorization for my medications or tests/procedures and if so has this been completed yet?

For Your Pharmacist:

• Is the same active ingredient in my prescription medication available in a cheaper product?
• Would I save money by filling a 90-day instead of a 30-day prescription?
• Would it cost less to pay cash or use discount card for my prescriptions than to use my insurance?
• Do you know of online discount programs or patient assistance programs for medication?

While paying cash instead of using your insurance for some health services could be beneficial, these payments won’t count towards your plan’s deductible or out-of-pocket maximum.  But you can take advantage of a flexible spending account or a health saving account to use pre-tax funds.

Also, always discuss cost with your doctor.  Sometimes a billing manager may say no without checking with the doctor who may agree to a discount.