9 Ways to Take the Sting Out of Medical Expenses

Likewise, you'll also want to explore how much of your prescription drugs the policy covers, called the "drug formulary." Most insurers give estimates that make it easy to look up specific medications (brand name and generic).

Pick the plan that best fits your needs. Check out how much the policy covers for typical medical care such as urgent care visits and diagnostic tests. And look for waiting periods (which might require that you have coverage for a specified amount of time before benefits will be paid) or if the policy excludes coverage of specific treatments you may need, such as weight loss drugs, acupuncture, or vasectomies.

Strategy 3: Pay Direct

Because your health insurance provider represents thousands of patients, they often have negotiating power to get you a better deal. But sometimes, you may be able to lower certain costs by choosing to pay for the service directly, rather than filing a claim through your insurance. According to a recent study, in some cases, cash prices for services, such as diagnostic tests like MRIs, CT scans, and X-rays, can cost as much as 47% less than the negotiated insurance rate.

Do the math. Hospitals are required to publicly post information on self-pay prices for all services and all negotiated rates with insurers. The rule also requires hospitals to provide patients with an out-of-pocket cost estimator tool or insurance-negotiated rates for at least 300 medical services.

But before you pull out your credit card rather than your insurance card after your appointment, consider the bigger picture. McGuire offers this perspective: "If the test reveals a serious health problem and you need further medical care, your insurance may require a diagnostic test that was covered by their policy," she says. "By paying cash, you're gambling that your insurance provider won't require a second test down the road."

Also keep in mind that the services you pay for directly will normally not be included in your total deductible (the amount you pay for covered health care services before your insurance plan starts to pay) or your maximum out-of-pocket cost, which must be met before your insurance pays a percentage of costs.

Strategy 4: Seek Out Prescription Savings

It might be tempting to skip filling that pricey prescription, but not taking your medications as prescribed can lead to more serious illness and/or more treatments. If you're concerned about the cost of your prescriptions, there are a number of ways you might be able to lower the price tag:

• Ask your doctor if there's a generic option for the medications they prescribe.
• Inquire about treatments that are less costly but provide a similar outcome.
• Check with your insurer to find out if they provide a mail-order option that's less expensive.
• Ask if there's a discount to receive your prescriptions in a 90-day supply.

Drug companies often offer help to offset the cost of their medications, especially when the treatment or device is expensive or considered a specialty drug. You can often enroll in patient assistance and copay programs on the drug company's website, or through your doctor. There are also prescription assistance programs specifically for people who are enrolled in Medicare. And many states provide drug discount programs to cover the cost of prescriptions that Medicare Part D does not.

Strategy 5: Know When to Go to Urgent Care

When an unexpected injury or illness happens, where and when you go for medical treatment can make a big difference to your wallet. In the past, the emergency room was the only option if you needed to see a doctor without an appointment. Today, you have choices when you need on-demand medical care, but there is usually a distinct difference in price. Urgent care clinics may provide a more affordable option, depending on your needs.

Convenience, time of day, seriousness of the problem, and the overall condition of the person with the illness or injury should all be considered to figure out which health care facility to choose. In most cases, emergency room visits will be a lot more expensive than a trip to your local urgent care clinic, costing as much as 10 times the price.

Keep in mind that urgent care facilities are best for treating conditions like colds, coughs, eye infections, sore throats, and sprains or muscle strains. For more serious injuries, such as chest pain or having a hard time breathing; sudden weakness, dizziness, or loss of balance; or unexplained changes in mental status, head to the emergency room as soon as possible.

Strategy 6: Ask for Discounts

It never hurts to ask! Some health care providers and facilities will offer a discount if you pay your bill right away. For example, Moab Regional, a non-for-profit 501c(3) hospital, offers a 20% discount if you pay within 30 days of getting your first statement. Plus, there are other discounts for those who don't have insurance. Look on your health care provider's website for information about discounts or cost-saving options or ask when you check in.

Strategy 7: Look for Financial Assistance

Nonprofit hospitals, such as Moab Regional, are required by law to provide financial assistance to eligible patients. Many for-profit hospitals provide financial aid, too. Financial assistance programs (also called "charity care") provide free or discounted health care if you are uninsured or have less-than-ideal health care coverage. Social workers and financial navigators within the health care facility are there to guide patients to their best options.

"Our social workers and the financial navigators are well-versed in determining what is available to you based on your income," McGuire says. "Even if the patient doesn't qualify for financial assistance, we provide payment plans through the hospital or, if those payments are too large, through receivable services, both with interest-free payments."

Besides the hospital's paid patient advocates, you might also tap into help via the Patient Advocate Foundation, a nonprofit that helps people with chronic illnesses receive and pay for care. The foundation's TotalAssist program gives guidance for accessing over 130 disease-specific and health equity financial assistance funds, supporting patients across a wide range of conditions – from cancer and rare diseases to chronic and complex illnesses. Patients may use the grants provided by TotalAssist for out-of-pocket health care costs, including medication copays, coinsurance, deductibles, health insurance premiums, office visit charges the day of treatment, and administration charges related to treatment.

Strategy 8: Set Up an HSA or FSA

One of the best strategies for managing health care costs is to anticipate the expenses and set the money aside. Health savings accounts (HSAs) allow you to do just that! By establishing an HSA through your employer, you designate pretax dollars to be directly deposited into the HSA. These accounts are only available to people who choose high-deductible health insurance plans. There's a limit to how much you can set aside each year, and the account can only be used for health care expenses (although many over-the-counter items are eligible). The fund accumulates year after year, so your money is there when you need it. Your human resources manager can provide you details about how to set up your account.

 A flexible spending account (FSA) is similar, but with one key difference: You must use it or lose it by the end of the calendar year. And unlike HSAs, you can set up an FSA regardless of the type of health care plan you choose.

Strategy 9: Explore Medicare, Medicaid, and CHIP

Even if you are already enrolled in one of the federal health care insurance programs, you may be eligible for more financial assistance. If you are enrolled in Medicare, depending on your income level, you may benefit from the one of the following:

• Qualified Medicare Beneficiary (QMB) Program
• Specified Low-Income Medicare Beneficiary (SLMB) Program
• Qualifying Individual (QI) Program
• Qualified Disabled & Working Individual (QDWI) Program

All of these supplemental assistance programs are handled through your state's health and human services department or similar service.

Medicaid and CHIP are separate state-run health care programs available to low-income adults, families and children, pregnant women, the elderly, and people with disabilities. Each state's qualifications are different. You can apply for Medicaid or CHIP directly through your state's Medicaid agency or through the Health Insurance Marketplace.

Ultimately, health care is like any other service where the consumer can shop for the best price and hunt for cost savings along the way. It may take planning and research, but finding options to help lower your medical bills may be worth more than just dollars saved.

"The cost of health care can impact your emotional and mental health as well as your pocketbook," McGuire says. "And there are resources out there to help you get the treatment you need."