Pay for your Health Care

Choosing Health Insurance

If you have a choice of insurance plans, it can be very confusing to sort them all out. If you have health insurance through your employer, then reviewing enrollment materials and talking with human resources or benefits staff is likely to be helpful. If you are buying insurance as an individual (perhaps you are self-employed or just off insurance due to COBRA benefits ending, exceeding age limits for a family policy or leaving school), you might want to check to see if any groups you belong to offer health insurance. But regardless of the reason why you are choosing health insurance, it is recommended that you do some research on the best coverage at the best price for you and your medical status.

Healthcare.gov is a Web site managed by the U.S. Department of Health & Human Services. It helps you find insurance, learn about preventing illness, compare hospitals in your area, and learn more about health care reform provisions.
http://www.healthcare.gov/index.html

Agency on Health Care Research and Quality (AHRQ) has created a guide of health insurance plans and answers to common questions.
http://archive.ahrq.gov/consumer/insuranceqa/

Consumer Reports Health.org has provided some advice on how to choose an insurance plan.
http://www.consumerreports.org/health/insurance/best-health-plans/how-to-choose/best-health-plans-how-to-choose.htm

Consumer Reports also offers basic information about new health reform provisions and their impact on health insurance:
http://www.consumerreports.org/health/insurance/health-insurance/new-health-insurance-basics/health-insurance-guide.htm

HowStuffWorks is produced by Discovery Communications and provides a broad range of information including this article on how to choose a health insurance plan.
http://health.howstuffworks.com/choose-insurance-plan.htm

AARP offers information on buying individual health insurance.
http://www.aarp.org/health/medicare-insurance/info-2006/individual_insurance.html

U.S. Government Health Insurance Programs

The U. S. government offers several health insurance programs.

Medicare is a federal program available to people older than 65 and some people with disabilities.

Medicaid is administered by the federal government in conjunction with state governments and is available to certain low-income individuals and families who fit into an eligibility group recognized by federal and state law. Benefits and eligibility vary from state to state.

The Children's Health Insurance Program (CHIP) is a state and federal program that targets uninsured children and pregnant women in families with incomes too high to qualify for most state Medicaid programs, but their income is too low to afford private coverage. The government has several websites with information about these programs. You can find out which programs you might be eligible for at: http://www.benefits.gov

Medicaid
http://www.cms.gov/MedicaidGenInfo/
1-800-FED-INFO (1-800-333-4636)

Medicare
http://www.medicare.gov

Here is a Medicare resource that assists with choosing a Medigap plan: private insurance designed to help pay for some of the health costs that Medicare doesn't cover.
http://www.medicare.gov/publications/pubs/pdf/02110.pdf

AARP, the non-for-profit, nonpartisan organization for those over 50 years old offers information about Medicare.
http://www.aarp.org/health/insurance/

The Medicare Rights Center is a national, non-for-profit organization working to ensure access to affordable health care for older adults and those with disabilities. More information about Medicare is available here.
http://www.medicarerights.org/

Children's Health Insurance Program (CHIP)
http://www.cms.hhs.gov/LowCostHealthInsFamChild/

Legal Services Corporation is the single largest provider of civil legal aid for the poor. It is a nonprofit that can assist low income families with completing forms for Medicaid, Supplemental Security Income (for the disabled) and Children's Health Insurance. A legal aid program near you can be found with this state by state service locator.
http://www.lsc.gov/map/index.php

Understanding Your Benefits

In addition to materials you may get from your employer, insurance agent or state or federal government that describe the type of coverage offered by various health plans, here are some resources that explain common insurance terms and benefits.

About.com is owned by The New York Times Company and is a network of expert guides who provide information on a variety of topics. This is an article about common health insurance terms.
http://personalinsure.about.com/od/health/a/aa032805a.htm

District of Columbia.gov has published, "Five Health Insurance Terms Consumers Need to Recognize and Understand."
http://newsroom.dc.gov/show.aspx/agency/disr/section/2/release/19139

Keep Track of Medical Expenses

At a minimum, you should have a file or even just a shoebox where you keep copies of all medical receipts and any letters you get from your insurance plan that describe payments they have made on your behalf (these are often called "explanation of benefits"). You might also want to separate the "paid" from the "unpaid" bills so you can keep a watchful eye on what you might owe versus what the insurance company may owe.

MyOptumHealth.com employs a Medical Advisory board of physicians and experts to provide health information. This article offers information on how to keep track of your medical expenses.
http://www.myoptumhealth.com/portal/Information/item/Following+the+Money:+How+to+Keep+Track+?archiveChannel=Home%2FArticle&clicked=true

Quicken Medical Expense Manager is a software program that helps you manage your medical expenses. It is $49.99, and allows you to keep a record of what is owed, paid, and reimbursed.
http://quickenmedical.com

Bargaining Tips for Lowering Health Care Costs

Sometimes you need help covering the cost of health care. Either your insurance coverage is not adequate or you may be without coverage. Here are some tips about how to approach negotiating lower fees for health care services.

The New York Times published an article in 2009 titled, "Bargain down the Medical Bills" with information about how to negotiate medical bill payments or set up payment plans.
http://www.nytimes.com/2009/03/14/health/14patient.html

Forbes.com published, "Eight Ways to Cut Your Doctor Bills."
http://www.forbes.com/2009/07/21/health-medical-bills-lifestyle-health-doctor-bills-debt.html

The Chicago Tribune published, "It'll Only Hurt for a Minute" with more tips on getting quotes and negotiating the cost of your health care.
http://articles.chicagotribune.com/2010-06-24/health/sc-cons-0624-save-negotiate-medical-c20100624_1_medical-bills-medical-care-doctor

Prescription Drug Assistance

Prescription medications can also vary in price, and without adequate coverage, can be rather expensive. It often pays to check prices with several pharmacies as well as mail-order or online pharmacy options.

Consumer Reports has a report on the best drugs for less:
http://www.consumerreports.org/health/prescription-drugs/best-drugs-for-less/overview/best-drugs-for-less.htm

NeedyMeds is a non-for-profit that offers resources for prescriptions and tips for lowering the cost of care.
www.needymeds.org

Partnership for Prescription Assistance is a program that offers a single point of access to more than 475 public and private programs to help patients without prescription coverage get the medicine they need for free or nearly free. You can search for programs that cover your medicines and download application forms for some programs on the Web site or request information over the phone at the toll-free number.
www.pparx.org
888-477-2669 (toll-free)

RxAssist is a clearinghouse Web site of pharmaceutical companies' patient assistance programs that help people gain access to free or discounted prescriptions.
http://www.rxassist.org/
401-729-3284

SelectCare Benefits Network is a patient advocate organization that specializes in helping uninsured, low income Americans access help with prescriptions on an ongoing basis from patient assistance programs.
http://www.scbn.org

Medicare beneficiaries can qualify for "Extra Help" with their Medicare prescription drug plan
http://www.ssa.gov/prescriptionhelp/