Seven ways to keep your health care costs in check

Chances are that no matter whether you’re healthy or hurting, you’ll feel the effects of rising health insurance costs in 2011.

An employee’s out-of-pocket costs for health insurance are expected to climb to $2,177 in 2011. That’s a 13 percent increase from 2010, according to an analysis published in September 2010 by Hewitt Associates, a human resources consulting firm.

While businesses will be hit with some of the direct increases in health insurance costs, employees will take a hit as well. Health insurance deductibles are climbing for plans at large and small employers alike, says Karen Davis, president of The Commonwealth Fund.

Carefully evaluating treatment options can help you avoid costly surgery.

Employees of small businesses — which employ the bulk of Americans — are much more likely to see a higher health insurance deductible than those working at large companies. For the employee of a small business, the deductible for a single-person plan may be $1,200, while a worker at a large employer might find an average deductible closer to $800.

No matter where you work, here are seven ways to help ensure that rising health care expenses don’t make your blood pressure rise:

1. Understand your plan

To get the most out of your current health insurance plan, spend time understanding how it works and making sure you get the full benefits from it, says Jim Schade, a principal of The Alpha Group Agency, an independent insurance agency in Cleveland. If you and your spouse work and can obtain health insurance through separate employers, sit down and compare each of the plans. You may find that one offers better coverage for your family’s needs than the other.

Once you’ve settled on a plan, look carefully at the options. You may realize that certain alternatives make more sense, such as going to a less costly urgent care center rather than a more costly hospital emergency room if your medical need isn’t critical.

2. Take charge

You don’t need specialized training to make the most of your health care and reduce costs, says Elizabeth Bewley, author of “Killer Cure: Why Health Care is the Second Leading Cause of Death in America and How to Ensure that It’s Not Yours.”

“A CEO doesn’t know everything — he just knows what questions to ask. It’s the same for health care,” Bewley says.

For instance, if your doctor recommends taking a medication for an extended period of time, consider posing these questions:

Sharing a written record of symptoms with your doctor can prevent a misdiagnosis — and a batch of expensive tests and treatments.

• What is this drug intended to do?

• How will we know whether this drug is working for me?

• When will we know whether this drug is working for me?

• What problems should I be watching for?

These questions can help you find the benefits, as well as the drawbacks, of the drug. That includes the potentially high cost of a prescription. Furthermore, some medications, such as prescriptions for diabetes patients, may cause significant weight gain — a hazard in and of itself.

3. Set aside cash

If possible, participate in a flexible spending account (FSA), says Schade, the insurance agent. This type of account is offered by many employers. With the plan, you can have money set aside for health costs each month before income taxes are applied. You’ll save on taxes and have money readily available for deductibles and other medical expenses. When you need the cash, it’ll be waiting for you.

Employers usually let employees set aside between $2,500 and $5,000 a year. Once you agree to a certain amount, you can access it at any time during the year.

4. Save on medication

Don’t bypass the generic options at your grocery store or pharmacy, Schade says. For prescriptions, ask the pharmacist whether there’s a generic version available that costs less than the co-pay on your drug card. If you have a drug card with a $10 co-pay, and there’s a generic equivalent available for $6, you can avoid using the drug card and save $4.

Also, check into signing up for mail order prescriptions when possible. “They generally give you a three month’s supply for a cost of only two months,” Schade says.

5. Avoid misdiagnosis costs

If you’re diagnosed with a condition that you don’t have, you could end up shelling out large sums without good reason. In Bewley’s case, she was once diagnosed with a middle ear infection that she didn’t have. After treating the wrong condition for six months, her doctor realized she had a brain fluid leak — a condition that required surgery.

To avoid misdiagnosis, keep careful track of your symptoms, says Bewley, the author. Write down the symptoms you’re experiencing, the date and time when they occur, what activity you were doing at the time, how long the symptoms lasted, and whether certain things made you feel better or worse.

Take a copy of this written record to the doctor. It can help you get an accurate diagnosis, Bewley says.

Be sure to explore generic medication options at your grocery store or pharmacy.

“You won’t forget something important. It will be easier for the doctor to see patterns and clues, and harder for the doctor to brush off,” Bewley says.

Follow up by checking your medical records — once a year or after a significant health event — to make sure they’re accurate.

6. Get online

A growing number of insurance providers are creating interactive websites. At these sites, you can find detailed information regarding drug costs. You also can compare data regarding the costs of certain procedures, as well as surgery success rates. Some sites offer health risk assessments, which allow you to see what costs would decrease if you improve your health in certain areas. Insurance rate comparison sites also let you compare the costs and benefits of different providers.

7. Evaluate treatment options

“In talking to doctors about treatment, it’s reasonable to collect information that allows you to compare information about things you care about,” Bewley says.

If your doctor suggests a certain medication that will give you poor balance as a side effect, and you love to walk, ask about physical therapy or other options to avoid the medicine.

“Deciding whether a treatment is going to help me lead the life I want to can end up saving you money,” Bewley says.

She had a doctor suggest bunion surgery on both of her feet, a procedure that can take up to six months for recovery. Bewley had no problems doing the things she loved – walking, driving, riding a bike, hiking up mountains, sleeping – so she opted out of the surgery, saving herself money and a long recovery period.

Depending on your lifestyle, getting certain treatments that have minimal benefits for your health may not be worth it. In fact, for some treatments, you may decide to skip them entirely. Consider this option if your doctor suggests something that would inhibit your ability to do activities you enjoy. “That changes the cost from $100 to zero,” Bewley says.

–Rachel Hartman