How to Use Healthcare with a High Deductible or No Insurance at All
Health insurance–most people hate it. Why? Because it’s ridiculously confusing (unless you’re young and your parents take care of it for you…consider yourself lucky while this lasts).
In the past two years, I’ve learned way more about health insurance than I’d bargained for by signing up for the high deductible health care plan at work. They offer two options–a “PPO” plan that gives some coverage before the deductible is met, and then the high deductible health plan (HDHP).
Okay, so you’re probably already confused. If you’ve had other types of insurance, they usually make you pay full price of whatever you have insurance on before providing coverage of any sort up to a certain dollar amount. That amount is called the deductible. For the high deductible plan that I’m on, I would have to pay up to $2600 on medical expenses before the insurance company will pay any portion of my bill. It’s rough, but the best part about it, is that I’ve learned more about how much healthcare costs people without insurance. On an average year, I don’t anticipate using $2600 of medical expenses–I’m relatively healthy, and don’t like going to the doctor.
However, there are times where I end up with sinus infections, or whatnot, and have to turn to antibiotics as my last resort. An office visit to a clinic or general practitioner will usually run you $75-125 on average. Just the office visit. Nothing else. If your health plan has a $15 office visit copay (a co-pay is the amount you are responsible for) where the “deductible does not apply”, you pay the $15 and you’re square–assuming all you had was an office visit.
The last time I had a sinus infection, I was probably sick for a solid miserable month. It was time for me to go to the doctor. I popped into ZoomCare ($99 a visit without insurance), and they prescribed me some sort of antibiotics. I called it in to the pharmacy so I could pick it up once I got there, and asked how much it would cost. The pharmacist replied, “$56 for 10 pills.”
Yes, $5.60 per pill. Not happening. Not on my budget. I asked the pharmacist what I should do because I definitely wanted to be back in working order, but that seemed like I was getting my meds from Saks on Fifth instead of Target. She suggested I talk to my doctor about other alternatives, so I called ZoomCare and asked them if there was anything else they could prescribe–that this was too much. They ended up prescribing a different medication that does the exact same thing, but for half the price. Now you’re talking my language.
I couldn’t believe that they would prescribe a drug to me that was twice as expensive, even though both medications would do the same thing. That’s when I learned: not all doctors charge the same, not all pharmacies charge the same, and not all doctors prescribe the most affordable option for you.
Not a huge deal if you have good insurance, but if you have a high deductible plan or no insurance, I suggest you call around and figure out if you’re getting the best bang for your buck. And if you have anticipated medical expenses from year to year, one of these days I’ll tell you more about the Flexible Spending Accounts (FSAs) and how you can save some money there.
Oh, and of you’re under the age of 26 and it costs you and your parents little to nothing to add you back onto their health insurance (if their company pays for it or you have younger siblings they’re already paying for…same price for one kid as it is multiple kids), DO IT. If you have dual coverage, that can save you a ton of money for both medical and dental. I had to get 7ish fillings and a crown which would’be cost $2000 without insurance, over $1000 with, and was under $100 with dual coverage. #win