need some medical cost saving info

[ER_Hopeful]

background info:
DD has been having some back pain, so wife took her to the doctor. a 20-minute visit plus some x-ray at a in-network hospital came out to about $600, (good news is that they found nothing wrong with her.) My family is under my employer's policy and we have a high deductible PPO with anthem blue cross. With co-pay and my portion of the dedu, I think I pay around $150.

This got me started researching on how to save on medical costs before we have another incident. Found this article An Independent Diagnostic Center Can Save You Thousands. It seems you can save a lot by using Freestanding diagnostic centers. Can anyone recommend such facilities in SoCal? would appreciate any other saving tips also.

 

[zinger1457]

background info:
DD has been having some back pain, so wife took her to the doctor. a 20-minute visit plus some x-ray at a in-network hospital came out to about $600, (good news is that they found nothing wrong with her.) My family is under my employer's policy and we have a high deductible PPO with anthem blue cross. With co-pay and my portion of the dedu, I think I pay around $150.

Was $600 the insurance company negotiated rate or the initial bill from the doctor/hospital? Since it was in network your cost should be based on the insurance company negotiated rate which I would think should be a lot less than $600 since it was just a simple office visit and a couple x-rays.

 

[ER_Hopeful]

Was $600 the insurance company negotiated rate or the initial bill from the doctor/hospital? Since it was in network your cost should be based on the insurance company negotiated rate which I would think should be a lot less than $600 since it was just a simple office visit and a couple x-rays.

The $600 was the combo of several bills (doc, imaging place plus radiologist,etc) I assumed those were negotiated rates because they were all in-network providers.

But I'm not investigating those bills, I just want to do my research now so I'll be better informed for future medical visits.

 

[athena53]

First of all, try the Internet. Not if you've got chest pains or a compound fracture, but it's amazing what resources are out there. I developed a case of "frozen shoulder"- couldn't reach behind me with my right arm without agonizing pain. I found a YouTube video with exercises for frozen shoulder and started doing them. They just felt right. In a couple of months, it was mostly cleared up and now it's completely gone. Traditional treatment includes painkillers and, in extreme cases, surgery. Similarly, my husband was able to stay off gout preventatives for years by eating dried cherries regularly. (The gout pills had bad side effects.) He's had to go back on the meds again, but at least he got 3 or 4 years without them.

I've always been big on prevention and avoiding doctor's offices except for regular checkups and dire problems- with a $6K deductible, I'm heading even more in that direction!

 

[Lancelot]

When I return to the US, health care will be one of the biggies. I have already scheduled an appointment at the VA, so that will be my health care base, along with non emergency health care trips to Mexico.

With three years to go before Medicare coverage, I'm pondering 'The' question.

Sign up for ACA or roll the dice for another three years...

 

[jerome len]

For me the cheapest and best medical plan is to find a good general Doc and stay with him/her. I've had the same Doc for 21 years, she gives me names of specialists, best hospitals for service I need and sees me whenever I need her help. I call this relationship building....and my Doc is the most important one. Now, to cost.......deductibles are getting higher, spending $150 on a $600 bill sounds OK. Many of the plans carry high deductibles before you get any coverage......and, each State is different. I don't know how we can help each other......so much depends on your health, State, drugs you need, possible future operations.....I just read the 2015 medicare book from the government.....I'm not ashamed to admit I'm confused.....so I'm staying with the same health care, same Doc and hoping my health holds up......for me it's best care not cheapest care.

 

[athena53]

For me the cheapest and best medical plan is to find a good general Doc and stay with him/her.

This is huge. If a good doc who knows your whole history and context can save you from one trip to the ER (where they'll run 6 tests and bring in that many specialists), they're worth it. My DH has multiple health issues and his GP is overworked. At some point we might look into concierge care for him so one doctor can co-ordinate it all and knows the whole picture.

 

[RonBoyd]

For me the cheapest and best medical plan is to find a good general Doc and stay with him/her.

Except if this happens:

http://www.nytimes.com/2014/09/29/u...0140929&nl=todaysheadlines&nlid=16231639&_r=0

Patients have no choice about which physician they see when they go to an emergency room, even if they have the presence of mind to visit a hospital that is in their insurance network. In the piles of forms that patients sign in those chaotic first moments is often an acknowledgment that they understand some providers may be out of network.

(Photo Caption: They were billed nearly $5,000 for stitches that were done by an out-of-network surgeon. Credit Ozier Muhammad/The New York Times )

But even the most basic visits with emergency room physicians and other doctors called in to consult are increasingly leaving patients with hefty bills: More and more, doctors who work in emergency rooms are private contractors who are out of network or do not accept any insurance plans.

 

[calmloki]

For me the cheapest and best medical plan is to find a good general Doc and stay with him/her. I've had the same Doc for 21 years,..... .....so I'm staying with the same health care, same Doc and hoping my health holds up......for me it's best care not cheapest care.

Here's a shocker: The great doctor you have a long term relationship with? They are also aging. Decades plus dentist and doctor retired. Not fun building new relationships as one's body demonstrates it's increasing falibility. Soooooo .. start with a sprout as a care provider?

 

[athena53]

One of the few things I ever re-posted on FB was an item from a friend who printed up a supply of labels, stating, "I (name), consent to all necessary procedures and agree to pay for them to the extent that they are covered by my Medicare Policy (number) and Medicare Supplement (Number)". When confronted with the usual pile of forms at the hospital, he pastes one of these on and signs it. That may not be his exact wording but you get the idea. He said that one hospital gave him forms to sign after they'd locked his glasses in a locker and he scribbled out the same thing. He claims that every time hospitals have come after him for more money because his policies didn't pay the whole amount he's been able to get them to back off by pointing out what he signed.

YMMV but it's sure as heck worth a try.

 

[RonBoyd]

"I (name), consent to all necessary procedures and agree to pay for them to the extent that they are covered by my Medicare Policy (number) and Medicare Supplement (Number)".

Terrific!! The exact wording would be nice but nonetheless...

 

[athena53]

With three years to go before Medicare coverage, I'm pondering 'The' question.

Sign up for ACA or roll the dice for another three years...

Be careful about rolling the dice. When you sign up for Medicare they want proof you had "creditable coverage" up to that point. If you had no coverage there are heavy surcharges that continue as long as you're on Medicare.

 

[Brat]

I didn't know that, maybe because we had 'creditable coverage', whatever that means.

 

[inquisitive]

Except if this happens:

http://www.nytimes.com/2014/09/29/u...0140929&nl=todaysheadlines&nlid=16231639&_r=0

I hadn't heard of this before but I think it's outrageous and don't see how it could be legal. The hospital should be sued. The onus is on the hospital to match doctors with patients who have eligible insurance as clearly patients cannot determine which doctors in the ER match. In any case I suppose the negative publicity will shift patients toward hospitals with more reasonable practices.

To the OP, I agree with others' suggestions of a good PCP. Also hospitals are expensive, why did she go to the ER instead of to a PCP? Obviously if it is serious there is no choice. And the question is what kind of insurance coverage is there. From looking at your plan information it should be possible to determine the cost in advance.

 

[aja8888]

Be careful about rolling the dice. When you sign up for Medicare they want proof you had "creditable coverage" up to that point. If you had no coverage there are heavy surcharges that continue as long as you're on Medicare.

Hmmm, I had no medical coverage when I signed up for Medicare (self employed consultant, wife's employer did not cover family members) and I signed up in person. I would like to see a link to a medicare.gov page that shows this requirement of having creditable coverage.

 

[M Paquette]

I hadn't heard of this before but I think it's outrageous and don't see how it could be legal.

Before we moved to an HMO, we had conventional insurance, in which the local hospital was in-network. The laboratory services were run by a subcontractor who was not in the network. The birth of DD1 there was interesting. Our Ob-gyn was in-network. Some pediatrician that poked the kid in the nursery later was not. With a plan that today would look like 'Silver' ACA coverage, more or less, we were still hit with a set of massive out of network and copay bills, somewhere north of $2,000 almost 3 decades ago.

This has been going on a long, long time.

 

[athena53]

Hmmm, I had no medical coverage when I signed up for Medicare (self employed consultant, wife's employer did not cover family members) and I signed up in person. I would like to see a link to a medicare.gov page that shows this requirement of having creditable coverage.

Now that I think of it, it may be that he needed proof because he was signing up for Medicare at age 75 because he'd been in my employer's policy up to then. They wanted proof that he'd had creditable coverage since age 65. Fortunately we were able to provide it even though a previous employer had been through an acquisition. Sorry for the confusion.