Your care isn’t the only thing that can suffer if you choose the wrong doctor. It can also cost you a lot of money if you make the incorrect choice.
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Millions of Americans will be getting new health insurance next year, prompting many to look for doctors. Choosing any in-network primary care physician is the easy and often common way to do it, but asking questions before making your choice can save you a ton of money as well as improve your level of care.
“There’s a relative shortage of primary care physicians as a result of the Affordable Care Act,” says Tom Doerr, an internist in St. Louis and director of innovation research at medical technology company Lumeris www.lumeris.com. “You don’t want to sign up for a primary care physician only to discover the next appointment is six weeks from now.”
From making sure the doctor is in-network to seeing if the physician performs certain procedures on their own, here’s a look at five questions that can save you a lot of money.
Loyalty can cost you
Loyalty pays isn’t always the case when it comes to health insurance. Many people are loyal to a particular doctor or specialist and will keep going, even if the caregiver isn’t in the insurance plan’s network. That’s fine if you have excess cash laying around, but for most people being loyal is going to cost them a lot. “Typically out of network charges subject you to your deductible and the average deductible is now $4,000 to $5,000,” says Carrie Mclean, director of customer care at eHealth.com www.ehealthinsurance.com. “You will have to pay out of pocket for those doctor visits up until you reach the deductible.” According to Mclean if you have a doctor you want to keep seeing make sure he or she accepts your particular plan. It’s not enough to say do you take XYZ insurance. You need to give them the exact name and type of health insurance.
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What’s the access like after-hours
After-hours access to your doctors isn’t only a convenience it can also save you potentially thousands of dollars if you can avoid a visit to the emergency room or urgent care facility. That’s why experts say it’s important to find out what happens if you need to reach your doctor when the office is closed. According to Doerr, ideally you want to hear the doctor say he or she is reachable via cell phone at any time or at the very least they have an answering service that will call you back. “You want to be able to get advice about healthcare issues when your office is closed instead of just going to the ER or urgent care center,” he says. “If you go to the ER it’s going to cost more money out of pocket.”
Is this considered preventive care?
While this question won’t come up until you are actually seeing the doctor, it’s an important one because the answer could mean the difference between paying nothing and paying a lot. “Under the Affordable Care Act, many preventative care services are free if you have health insurance. However, not everything is free,” says Michael Mahoney, senior vice president of consumer market at GoHealth www.gohealth.com. ”For example, your doctor may order tests that are not considered covered preventive services, so you may be required to pay a copayment or bill that will count toward your annual deductible.”
Another money saving questions to ask your doctor when prescribing treatment is whether the service is optional or highly encouraged. That’s important because it may end up the treatment isn’t necessary and could result in an expensive mistake whether it’s something routine or a major procedure, says Mahoney.
Do you do office procedures or outsource them
Your primary care physicians can’t do it all but if you can avoid going to a specialist for certain producers it can save you money on co-payments and co-insurance. According to Doerr it’s important to know what type of procedures they do themselves and which ones are referred to a specialist before you choose your doctor. It’s particularly important if you need regular treatments. “An orthopedic surgeon can charge $300 for an injection and I charge around $65,” says Doerr. Asking that question, he says can give you an indicator of the scope of the doctor’s capabilities and also save you money in the long run.
Does the doctor prescribe only brand name drugs
Anyone who has to take medication on a regular basis knows how expensive it can get, especially if you are paying for brand name drugs. Because of that, experts say it behooves you to find a primary care physician who is willing to provide alternatives to costly medication. “Asking the doctor is there is a generic version can save a lot of money,” says eHealth’s Mclean.