What's Driving the Cost on Your Health Plan
If you are struggling to stay healthy and happy while facing unmanageable medical bills, you may not be alone. And since it’s tough to plan for what you can’t predict, the strain of the unexpected might be weighing heavily on your finances. You may be asking, “How do medical expenses get out of control so fast?” We’re exploring what may be really driving the cost of your health plan, as well as ways you can make changes that can help keep costs down.
5 Things That Could Be Increasing Your Healthcare Costs
Hefty medical bills can stall you on the road to your financial goals.
From expensive treatments to denied claims and serious illness, can your wallet handle the hit? If you find yourself stuck in situations like these, here are five solutions you can try.
1. Pricey Referrals
When your medical provider says you should see a specialist or get a specific treatment, it’s doctor’s orders, right?
Well, there could be more to it. Doctors may have partnerships with specialists or centers to make things convenient for their patients. But that doesn't mean it’s the only course of action. Finding the best price for your treatment may mean doing a little research beforehand:
- Ask your doctor for cost-effective solutions.
- Explore outpatient care possibilities.
- Find out about low-cost lab services near you.
You've got choices!
2. Brand Name Medication
Ideally, you shouldn’t have to pay a fortune for your current medications. Did you know that 9 out of 10 prescriptions have a generic alternative? And get this: generics are typically 80-85% cheaper than brand name meds.1 So, next time your doctor prescribes something that's breaking the bank, have a chat with them. Of course, not all medications have a generic counterpart or may not be covered. Still, it’s always worth exploring what generic medications could work for your budget.
3. Denied Claims
When health insurance claims get denied, you might be left with big bills to pay out of pocket. If it happens to you, call your provider! In fact, statistics show that 15% of all health insurance claims, including pre-approved ones, are initially denied. Data errors are behind 45% of them, 36% are because of authorization issues, and 30% stem from inaccurate patient details. 2 So, speak up with questions like these and get the clarity you need to set the record straight:
- Why was my claim denied?
- Is there a dedicated representative who can assist me throughout the appeal process?
- What is the timeline for submitting an appeal?
- Are there any specific forms or documents required to appeal?
4. Big Emergency Room Bills
In a medical emergency, you’re probably not going to let a bill down-the-line stop you from getting help quickly. When symptoms seem severe, it’s difficult to know where to go for care. About 32% of emergency room visits aren’t actually an emergency.3
Depending on the level of urgency, injury, and illness, you might want to consider your local urgent care or retail clinics as alternatives. Why? Aside from being generally nearby, average wait times are typically about 30 minutes at urgent care compared to an average of four hours at the hospital.5
For minor injuries or non-life-threatening illnesses like these, walk-in and same-day clinics might be a closer option as well:4
- Sprains and strains
- Sore throat
- Flu symptoms
- Sinus infections
- Allergies
- Bronchitis
- Urinary Tract Infections (UTI)
These clinics offer increased availability at convenient locations like grocery stores and pharmacy chains. And time may not be the only thing you’re saving. Urgent care visits typically average around $200, while a trip to the hospital could cost you up to $1,300.5 Next time an emergency strikes, consider these alternatives to potentially save yourself time and money.
5. Ignored Conditions and Delayed Treatments
While statistics indicate almost 40% of Americans might skip out on medical care because it’s too expensive, this seemingly practical decision could end up costing you even more in the long run.6 By addressing health concerns early on, you may be able to reduce the risk of chronic conditions, hospitalizations, and surgeries that may be necessary if issues remain untreated. Additionally, you may be able to explore less invasive and less costly options.
American Fidelity recognizes the importance of preventative care. Learn more about how AFQuickClaims rewards proactive policyholders.
Take Back Control of the Steering Wheel
You should be the one choosing the direction of your family’s health care costs. Between these five intentional choices and the benefits that American Fidelity’s supplemental products can provide, there is hope. Find more breathing room and flexibility to help you stay covered and keep costs low.
This information is general in nature and should not be considered financial, legal or tax advice. Consult an attorney or a tax professional regarding your specific situation.
This blog is up to date as of January 2025 and has not been updated for changes in the law, administration or current events.
