Thank you for attending the third webinar in our 4-part series, Take Care of Your Health and Thrive. Today we’re going to be talking about health care and your pocketbook, and tips to stretch your family’s budget. This is a webinar series that marks the beginning of all that we have to come for Thrive. Thrive has been recently established to serve state employees, state education employees, and local government employees and their families, and our goal is to empower you all to enhance your well-being. So I would like to turn it over to HLM to begin the webinar. Great, thank you so much, Chrystal. Hi, everybody! And welcome to the third of four webinars in the Take Care of Your Health and Thrive webinar series.

Thrive Oklahoma Employee Well-being partnered with us at Health Literacy Missouri to help employees better understand health care and health insurance.

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Today we’ll talk about tips to stretch your health care budget. It will take us about an hour. Along the way, we’ll do audience polls by asking you questions, and we’d like you all to participate. To send your response, select the answer from the poll box or type it into the chat box at the bottom right of your screen.

There are a couple of things you should know before we get started. Number one, your phones are muted today to make sure everyone will be able to clearly hear the presentation, so if you have a question or a comment, please type it in the question or chat box at the right side of your screen. Two, we’ve left time for you to ask questions at the end of the presentation, so think about your questions as we go through today’s presentation. And three, we’re recording the webinar. Within a week or so, you’ll be able to find a recording on Thrive’s YouTube page.

So, let’s get started. My name is Phil Horn. I’m a Health Literacy Program Coordinator at Health Literacy Missouri in St. Louis, Missouri. At Health Literacy Missouri, we help people better understand health information so they can make good health decisions. Our health care system is complicated it uses medical terms most of us aren’t familiar with and sets up complex processes that we need to follow especially when it comes to health care cost. As a patient, it can be hard to know what to do.

We explain health care in a way that we all can understand. It’s normal to worry about health care costs.

According to a Gallup poll in April, health care costs are the top financial concern for families. People don’t know how to find information about health care costs or how to budget for unpredictable healthcare expenses. Everyone has questions about health care costs, even people who have been in the health field for years. Common questions we see include: How much will my health care service cost? It’s hard to figure out how much it will cost to do things like go to the doctor, get prescriptions, or any number of other services you need from your doctor’s office. How does a Flexible Spending Account (FSA) or Health Savings Account (HSA) work? There are a few types of savings accounts that can help you save money for health care expenses.

How can I make sure preventive care is free? It’s hard to know which services are considered preventive, and who you can ask about them. And, How does in-network care save me money? What is an in-network doctor and how does it save money? And how can going to one or the other save you money? This can all be very overwhelming.

Here’s one of the polling questions I told you about at the beginning. I’m going to give you five possible answers, and I want you to select your answer from the poll box. If you choose “other,” you can type your answer into your chat box. Our first question is, “What is your top question about health care?” And the answer choices are: A How much will my health care service cost? B How does a Flexible Spending Account (FSA) or Health Savings Account (HSA) work? C How can I make sure preventive care is free? D How does in-network care save me money? E Other- and in that case, you’ll type your answer in your chat box if it doesn’t fit any of the first four So we’ll wait a couple minutes for results, and then we’ll talk about it a little bit.

There are many questions that come up as we get, use, and keep our health insurance and go to get care. Okay. It looks like everyone’s top question today is, “How can I make sure preventive care is free?” So, we’ll talk about that today, and also people had some concerns about, “How does an FSA or HSA work?” and “how much will my health care service cost?” So we’ll actually talk about all those today.

Preventive care can be confusing, and so, we’ll definitely clarify how you can ask for preventive care and make sure that it’s free when you go to the doctor. When it comes to understanding health care costs, it’s easier to understand when looking at a real life situation.

So, we’re going to follow a sample family as we talk about tips to save money on your health care. Meet Greg, Sharon, and their 3 kids. Greg just got a new job with the State of Oklahoma and enrolled in the Health Choice High Deductible Health Plan (or an HDHP for short) during last month’s option period.

His wife, Sharon and 3 kids are also on his new health insurance plan. Greg and Sharon are new to the plan. They aren’t sure how to best use their new health insurance coverage to stay within their family’s budget. Like many of you, Greg and Sharon have a budget for their family.

It’s hard to balance their health care costs with all of their other expenses. For example, if one of them suddenly got very sick and had to go to the doctor, how would they pay for it? We’ll follow their story today as we talk more about health care costs and potential ways to save money with your plan. So today, we’ll give you 5 tips to save money on your health care costs: The first is to take advantage of savings accounts to stretch your budget.

The second is to check if your doctor is in-network before every health care service. The third is to use free preventive care services. The fourth is to ask your doctor or pharmacist for generic drugs. And the last one is to pay the right amount for a service. Let’s talk first about savings accounts and how they can help you stretch your health care budget. Benjamin Franklin once said, “Beware of little expenses; a small leak will sink a great ship.” Even expenses that you think are small, like going to the store to grab some Tylenol or buying cold medicine, can be expenses that add up quickly.

Luckily, there are savings accounts you can use just for health expenses. Let’s talk about the 2 main types of accounts you can use to save money for health care expenses: A Flexible Spending Account (FSA) and a Health Savings Account (HSA). The main benefit of these types of accounts is the money you put in is tax-free. What we mean by this is the money you put in is taken out of your paycheck before your taxes come out of your earnings.

When you enroll, the money is automatically taken out and put into the savings account.

So, it’s convenient and you may not notice a big difference in your paycheck! As great as these accounts are, it can be confusing trying to figure out the difference between FSAs and HSAs. It’s important to know the difference because you can only enroll in one of these accounts. You can’t have both an FSA and HSA at the same time. So, let’s talk about the differences between these accounts. So, first, what is it and what can I buy with it? So, what is an FSA? An FSA is a Flexible Spending Account, and it’s an account that lets you set aside money from your paycheck.

The money you put in isn’t taxed by the federal government and can be used to pay for qualified medical expenses, such as deductibles, co-pays, and over the counter items prescribed by your doctor. A HSA is a savings account available to people who enroll in a High Deductible Health Plan. The money you put in isn’t taxed by the federal government and can only be used to pay for qualified medical expenses, like doctor visits and medicines.

How do you enroll? For an FSA, you can enroll during the Option Period every year. Talk to your Benefits Specialist about how to get started with an FSA. For an HSA, you must enroll in a High Deductible Health Plan (or HDHP for short) during the Option Period. You can choose to sign up for an HSA that is paired with your health insurance plan. Remember, you can only have one savings account at a time, so, if you enroll in the High Deductible Health Plan, you can’t have an FSA too. How do I put money in, and how much can I save? For an FSA, when you enroll, you decide how much you want to save.

You can only change the amount during the Option Period or if you have certain life changes such as a change in marital status, a change in your employment status, or a change in the number of your dependents.

In 2016, the most you can save is $2,550 a year, or about $2a month. For an HSA, when you enroll, you decide how much you want to save. You can change it at any point in the year, not just during a qualifying life change. In 2016, the most you can save is $3,350 or about $280 a month for individuals, and $6,750 or about $560 a month for a family every year. Does the money roll over to the next year? For an FSA, yes. But you can only use the money until March 15 of the next year. For example, if you have money left in your account in December of 2016, you can use it until March 15 2017.

And for an HSA, yes. Any money left over at the end of the year rolls over to the next year.

The money in your HSA is yours to keep, even after you leave your job or retire. It’s hard to remember the difference between FSAs and HSAs. When in doubt, ask your Benefits Specialist. So, what can you buy with your FSA or HSA? There are many different health related items you can buy with your FSA or HSA. This includes items like: over the counter medicines with a doctor’s prescription. These are medicines you can buy at the store, such as Advil or Tylenol. For these to be covered, your doctor must write a prescription for the over the counter medicine. Co-pays, co-insurance, and deductibles. Dental care, such as oral surgery and braces. Vision care, such as glasses, contacts, and lasik surgery. Transportation to medical appointments. X-rays and diagnostic care. This is not an exhaustive list. For a full list of what you can and cannot buy with your FSA or HSA, visit www.ebd.ok.gov/flexible-spending.

This is a great list to check and refer back to before you purchase items with your health savings account.

So, you might be wondering, why should I get an FSA or HSA? Both accounts can save you money. The main way you could save money is you’ll pay less in taxes. The money comes out of your paycheck before your earnings are taxed, so your taxable income is lower, meaning you’ll pay taxes on less money.

The money in your account isn’t taxed, so you can pay for health care with pre-taxed dollars. By spending the money in your account on health care, you’re saving the money in your wallet, and all-in-all your take-home pay is more.

So I know that’s hard to picture, so let’s look at an example of what the tax benefits really look like. Let’s go through an example. Let’s say you make $35,000 a year and you are trying to decide if you want an HSA or not.

Take a look at the left hand column, which is what will happen without an HSA. The first row is your yearly salary (which is $35,000). The second row is your yearly HSA savings, which in this case is $0 because you don’t have an HSA. The third row is your taxable income. In this case, this amount is the same as your yearly salary, $35,000. The fourth row is your estimated taxes for the year. About 30% of your salary is taken in taxes, so in this case, you’ll have about $10,500 taken out in taxes. The fifth row is the cost of your out-of-pocket health care cost for the year.

This could be things like buying medicines or paying co-pays or deductibles when you go to the doctor.

Let’s say over the course of the year you’ll pay $1,200 for health care. Your take-home pay would be your yearly salary minus $10,500 of taxes and $1,200 of out-of-pocket health care costs. So, your take home pay is $23,300. Now let’s see what would happen if you enrolled in an HSA. The first row is your yearly salary, which would be the same at $35,000. The second row is your yearly HSA savings, so let’s say you save $100 a month in your HSA, which would be $1,200 for the year. This is the amount that is automatically taken out of your paycheck before taxes. The third row is your taxable income, which is your yearly salary ($35,000) minus your yearly HSA savings of $1,200. This means your taxable income would be $33,800. This is because the money you save to your HSA account is not taxed.

The fourth row is your estimated taxes, which again is about 30% of your income. In this case because your taxable income is less, you’ll pay less in taxes. So you’ll only pay $10,140 in taxes. The fifth row is your out-of-pocket health care costs. Because you’ll use your HSA for health expenses you don’t have to pay any out-of-pocket, so it’s $0.

The fifth row is your take-home pay which is your taxable income of $33,800 minus your taxes of $10,140 dollars. This is $23,660 in this case. Your take home pay is $300 more because of your HSA. That’s the difference between your take-home pay of $23,660 with an HSA and $23,300 take-home pay without an HSA. The more money you put into an HSA, the more savings you’ll have every year. You may be wondering, How much money should I put in an FSA or HSA? This is especially important for an FSA because your money doesn’t roll over year to year. Luckily, there are online calculators. One of these resources is the FSA savings calculator on the State of Oklahoma Benefits website. The website link is listed on the slide. This FSA savings calculator can help you do several things, including calculate how much money you should save in your FSA based on your family’s expected health care costs.

This can help you make plans for the coming year and ensure that all of the money you spend on health care costs is used with pre-tax dollars and you can see how much money you can save in taxes with an FSA.

This can also help you make a decision about whether an FSA is right for you and your family. You can see how much money an FSA will save you over the course of a year in taxes. Another helpful resource about HSAs and FSAs is the Mayo Clinic website. We’ve talked in past webinars about how this can be a great resource for health information, there’s also a useful article about the benefits of HSA accounts too at the link provided on the slide.

You can use this resource to learn more about the benefits of HSAs so you can learn more about how HSAs help you save money in taxes with simple explanations. You can learn if an HSA is right for you and your family. You can refer to this resource to see a simple explanation for why HSAs can be helpful when paying health care costs for not just you but your whole family. And you can learn more about High Deductible Health Plans (or HDHPs). High Deductible Health Plans have both pros and cons and this article can tell you more about these plans and how HSAs are a great tool to pair with your insurance plan.

Let’s go back to Greg and Sharon’s story for an example of how this works. Since Greg enrolled in a High Deductible Health Plan, he has the option of an HSA. Greg and Sharon decide to enroll in an HSA to take advantage of the pre-tax dollars they can put into their account.

They decide to put in $1,200 for the plan year so they have plenty of money on hand for health expenses.

Greg gets his paycheck monthly. From each paycheck, $100 will be taken out before taxes and put into the account. Greg may hardly notice the difference. Greg is also worried the money won’t roll over into the next plan year, so he talks to his Benefits Specialist.

His Benefits Specialist lets him know that the money he puts into the account will roll over into the next year. The money in Greg and Sharon’s HSA is theirs to keep, so they can continue to use it for medical expenses even after Greg moves to another job or retires. However, they can only put money into it while they have a high deductible health plan. So let’s do another poll question. When Greg and Sharon go to use their HSA, which of these things can’t Greg and Sharon pay for using this account? And there are five choices.

A is Lab Tests, B is stop-smoking programs, C is therapy, D is contact lenses, and E is over-the-counter medicines without a doctor’s prescription. So, I’ll give you a moment to answer that. Great! So it looks like 63% of people said “over-the-counter medicines and supplements without a doctor’s prescription” and that is the correct answer. So you can’t pay for this over-the-counter medicine unless you have a prescription for that over the counter item from your doctor. So, when in doubt, check the list of what you can buy with your HSA account on the State of Oklahoma website at www.ebd.ok.gov.

So health savings accounts like HSA and FSAs are one way to stretch your health care budget. Our second tip: check if your doctor is in-network before every health care service. A wise person once said, “It pays to be in the know.” That is definitely true with in-network and out-of-network care. If you’re not careful, you can be charged higher rates for the same health care services. To understand how in-network care can save you money, you first need to understand what it is.

Let’s talk about the difference between in-network and out-of-network providers.

In-network providers are health care providers who contract with your insurance plan to give you health care services at a lower cost. These are the doctors and hospitals that you want to turn to because they’ll give you the same care as other doctors for less money. Out of network providers on the other hand are health care providers who haven’t contracted with your insurance plan. You’ll have to pay more for their services. So, in short, if you want to save money and still get the same great health care services, go with in-network care.

So you may be asking yourself, how do I find an in-network provider? Well, to find an in-network provider, turn to your insurance company. Your insurance company has several resources to help you find an in-network provider. This includes your insurance company’s online provider directory. You can look for many different types of health care providers here such as primary care doctors, specialists, or mental health care providers.

If you’re still in doubt, you can call the customer service number on the back of your insurance card and ask for a list of in-network providers.

Insurance customer service representatives can also help you look up particular providers if you have a certain provider in mind. One important note: networks can change throughout the year, or even month-to-month. Check to make sure your doctor is in-network before every visit, just to make sure you aren’t going to an out-of-network provider. Remember, if you go to an out-of-network provider, you’ll pay more for their services. So, to sum up, why should you use an in-network provider? They’ll save you money because your insurance company and provider have negotiated a lower cost for plan members so you’ll pay less for their services, and this leaves more money in your pocket for the same services and the same great level of care. Also remember that some insurance plans won’t cover fees for any services you get from an out-of-network provider. That’s why it’s important to stay in-network. When looking for an in-network provider, there are a couple of resources you can turn to.

One of these is the Employees Group Insurance Website at the link on the slide.

This website provides useful information about which providers are in-network and out-of-network. You can choose your insurance plan on this website, and then the website will link you directly to your insurance company’s provider database. Also, you can learn about the cost of health care services. Some insurance companies even have cost estimators which can help you see how much your health care services will be before you go to the doctor. Remember, these are estimates and the actual cost may vary.

The other resource that can help when choosing in-network providers is the Health Choice Select website at the link on the slide. This website provides useful information about how Health Choice Select works with certain insurance plans. Health Choice Select works with employees who have Health choice High, High Alternative, Basic, Basic Alternative, High Deductible Health Plan, and Focus Plans.

Medical facilities that take part in the program: you can look up the service type and facility name to see what facilities take part in the program. Let’s go back to Greg and Sharon’s story for an example of how in-network and out-of-network providers work.

Greg needs to take his son to the doctor for a sore throat. Greg and his family recently moved to the area and they need to find doctors.

Greg asks his coworkers for the names of pediatricians they go to and he hears about Dr. Smith and Dr. John. Greg then decides to call his insurance company because he wants to see if Dr. Smith or Dr. John are in-network providers. Greg found out that Dr. Smith is in network but Dr. John is out of network, so he went to Dr. Smith for his son’s care. Let’s look at what Greg’s son’s care cost under Dr.

Smith in the first column on the left. In the first row is the doctor’s charge for his services.

Dr. Smith charges patients $100 per doctor’s visit. This is how much Greg would pay without insurance. In the second row is the contracted cost with Greg’s plan. Dr. Smith and Greg’s insurance company negotiated a rate of $50 for the visit for people with Greg’s Health Choice High Deductible Plan. This is $50 less than what Dr. Smith would charge out of network patients. In the third row Greg’s plan then pays $40 of the cost since Dr. Smith is an in network provider. In the fourth row, in the end Greg only pays $10 for Dr.

Smith’s services. Now let’s see what would happen in the second column if Greg had taken his son to Dr. John, who is out of network. In the first row is Dr.

John’s rate that he charges everyone for a visit, which is $100. In the second row, Greg would have had to pay the $100 since his insurance company doesn’t have a contract or negotiated rate with Dr. John. In the third row, Greg’s plan pays nothing because Dr. John is an out of network provider.

In the fourth row, that means that Greg has to pay the entire cost for the visit, or $100.

In the end, in network care saved Greg $90 and he gets the same services for his son. The best part is, Greg used his HSA for the doctor’s visit so he didn’t pay anything out of his pocket for the visit. It looks like Greg is really getting the hang of saving money on health care costs. Our next tip is to save money by using free preventive health care services. Benjamin Franklin once said, “an ounce of prevention is worth a pound of cure.” Prevention, or in this case, preventive care, is much easier to do than cure a condition later on down the road, or in this case, diagnostic care.

It can also be a lot cheaper. So what is preventive care? Preventive care is routine health care that includes screenings, check-ups, and patient counseling to keep you healthy before you have a health problem.

Preventive care catches problems early. This can save you time and money down the road. Thanks to the Affordable Care Act, your health insurance covers many preventive care services for free such as tests and screenings for conditions like high blood pressure, cholesterol, and Type II Diabetes.

Counseling about healthy eating, weight loss, and depression – your physician can counsel you about these topics. Additionally, some of the insurance companies that the State of Oklahoma works with offer employees nutritional consultations with a Registered Dietitian. Additionally, you can use the FSA funds we talked about earlier for nutritional consultations with a physician referral. Cancer screenings for colon cancer, breast cancer, and other types.

Vaccines or shots for chicken pox, flu, measles, and other diseases.

And yearly check-ups or wellness visits – this is when a lot of the test and screenings are done by your doctor that can be covered as preventive care. You may be asking yourself, “that sounds great, how do I get preventive care?” Here are three steps to get preventive care: 1. To make sure your service is considered preventive care.

To make sure, look at your insurance plan’s Summary of Benefits, or SBC, that your insurance company sent to you shortly after you enrolled, or call your insurance company to ask.

2. Call your doctor’s office and schedule the health care service. When you call your doctor’s office to schedule a visit, such as a yearly checkup, tell the appointment scheduler that you’re coming for preventive care. That’ll let the doctor know it’s for preventive care only and will help the billing department know that it should be a free visit. And� 3.

During your visit, don’t ask about other services. When you go for a preventive care visit, such as your yearly checkup, don’t ask the doctor to look at a health care problem you may be having, such as a skin rash. That would be diagnostic care, not preventive care and your doctor will need to charge you for it.

If you have a health problem, schedule another visit before you leave the doctor’s office. Preventive care can definitely save you money because first of all, it’s free and who doesn’t like free things? If you don’t use your free preventive care benefits, it’s kind of like leaving money on the table.

Your insurance company pays the full cost of many preventive health care services from in-network doctors. This means that when you visit an in-network doctor for preventive care services, you won’t pay a co-pay or pay money for the preventive care services you received. And you can catch problems before they get worse and cost more. For example, if you get a blood pressure test and you find out that your blood pressure is high, you can take steps to lower it, like exercise and taking blood pressure medicine before it becomes something worse like a heart problem. To help you remember what preventive care is, we created a handout that explains the difference between preventive and diagnostic care, and it also explains when preventive care becomes diagnostic care.

We’ve uploaded this handout to the webinar. You can download the PDF from the box on the right hand side of your screen.

After the webinar, you can find it on Thrive’s website. Another great resource to learn more about preventive care is healthcare.gov. If you follow the link on the slide, you can find out more about preventive care for adults, specific preventive care for women, and children. Healthcare.gov will tell you what health care services are considered preventive care and also warn you to make sure that you get these services from an in-network provider for them to be free. Another great resource is the information about Global Health Plan, which is one plan you can choose that has unlimited $0 primary care physician visits, $0 lab tests, $0 X-rays, and no deductibles or co-insurance. This website can help you learn more about the cost for health care services under this plan for in-network providers and how much you can save by paying Global Health Premiums.

Let’s go back to Greg and Sharon’s story and see how preventive care works for them.

Sharon has a family history of colon cancer, so her doctor recommends that she has a colonoscopy (which is a screening test for colon cancer). She goes to an in-network doctor that she finds in her plan’s provider directory. The doctor ends up finding a small growth during the colonoscopy that could have become colon cancer. Luckily, her doctor removed it during her colonoscopy. If Sharon didn’t have a colonoscopy, the growth could have become colon cancer, which would be much more expensive.

To give you a better idea of how preventive care can save money by catching health problems early, let’s compare Sharon’s cost of her colonoscopy to the cost of colon cancer treatment. When she gets her colonoscopy, it’s covered as preventive care under her plan so she pays $0. During the colonoscopy, her doctor discovers a mass and removes it. The doctor bills her insurance to remove the growth. The doctor bills $2,000. Her insurance company has a contracted rate with the doctor, which is $1,200. Her insurance company pays 80% of the cost, which is $960.

At the end, Sharon pays $240 for the service, which is the $1,200 contracted rate minus the $960 the insurance company paid. If Sharon didn’t have a colonoscopy, her growth could have become colon cancer. Let’s say she would start to have symptoms and go to the doctor.

This would be considered diagnostic care. The doctors would do tests and find colon cancer. Let’s look at estimated costs of colon cancer treatment. The surgery to remove the cancer costs $10,000. The contracted cost with Sharon’s insurance company is $6,000. Sharon’s insurance pays 80% of the cost, which is about $4,800. Sharon ends up paying $1,200 for getting the cancer removed, which is the contracted cost of $6,000 minus the $4,800 her insurance pays. Remember the colonoscopy and removal for growth only cost her $240. She saved hundreds of dollars by taking care of the health problem early. This isn’t to mention the time Sharon would have to take out of work, her lost earnings for the family, and the toll this would take on her family.

Now let’s talk about how to ask your doctor or pharmacist for generic drugs.

First, let’s talk about what generic drugs are. Many people think that brand name drugs are a lot better than generic drugs. However, generic drugs are copies of brand name medicine that are the same in dose, safety, strength, quality, and performance but at a cheaper price. For example, Advil is a brand name medicine. Ibuprofen is the generic version of the medicine that costs less. Many stores have their own generic store brand for over the counter medicine, but generic and brand name medicine aren’t just for over the counter medicines, it applies to prescription medicines too. In other words, generic drugs and brand name drugs are the same and are equally effective, but generics cost you less money. So how do you get generic drugs? There are a couple of ways to get generic drugs.

One is you can talk to your doctor or pharmacist about getting a drug for your condition that has a generic form. The other is you can also double check that the drug you pick up at the pharmacy is the generic version, if there is one. You can ask your doctor or pharmacist about this in a couple ways.

You can ask, “is there a generic?” or you can say, “I’m worried about how much I’ll have to pay for this drug. Is there a generic version?” Doctors may switch your prescription to a different drug if you ask which can save you a lot of money.

To summarize how generic drugs save you money, they save you money because they’re the same as brand name drugs but you’ll pay less for them. They can help you get the same level of care for less cost. This will leave money in your pocket for other expenses. If you’re looking for other ways to save money on prescriptions, here are a few ways to get low cost prescriptions. The first is: check your local pharmacies for discounts or savings clubs.

Many pharmacy chains have special programs for customers who get their prescriptions from the same pharmacy month to month. Some pharmacies give store credit or coupons for your loyalty. Look at other sources for discounts, such as Blink Health. Blink Health is an app that provides cheap prescriptions by using technology to pool patient groups together to increase collective purchasing power to buy medicines at lower prices.

For example, generic Lipitor which retails at about $163 and costs about $under other prescription discount programs costs just $with Blink Health. 50% of the medicines on Blink Health are $10 or less, and can be used whether you have health insurance or not. You can also use mail order if your prescription plan allows. Many times, you can get a 90 day supply of your medicine delivered right to your front door for a lower price than at your local pharmacy. You can also ask for coupons or samples at your doctor’s office or pharmacy.

Many doctors and pharmacies have samples on hand to give to patients who want to save on costs. Let’s go back to Greg and Sharon’s story to see how they save on prescription costs.

Remember how Greg’s son had a sore throat? He went to the pediatrician and found out his son had strep throat. The doctor prescribed his son an antibiotic to treat strep throat. The doctor prescribed the brand name of the medicine. When Greg got to the pharmacy, the pharmacist told him that the brand name of his son’s medicine is $30. To save Greg money, the pharmacy gave him the generic version of the same drug, which only cost $4. Greg saved $26 on his son’s prescription and got the same medicine. Besides medicine to treat a short term problem like strep throat, many people also have long-term medicines. For example, Greg has a prescription for seasonal allergy medicine that he takes every day.

After picking his new insurance plan, he called his insurance company to ask about his pharmacy options for a long-term medicine. His insurance company lets him know that he can either get a 30-day supply at his local pharmacy for $15 or he could get a 90-day mail order that costs $20.

So at first look, it might seem like the local pharmacy is less expensive, but we need to look at the number of medicine that you’re getting, or supply that he’s getting. The local pharmacy is only a 30-day supply but the mail order is a 90 day supply, or 3 times more medicine.

He would need to pay for three 30-day supplies at his local pharmacy to have as much as the mail order, so 3 times $15 is $45. So mail order saves $25 on a 90 day supply, and it will also be delivered right to his front door. Lastly, let’s talk about how you can stretch your budget by paying the right amount for a health service. There are four ways you can make sure you pay the right amount for a health care service.

The first is to find out how much the health care service will cost.

The next is to check your bill against your Explanation of Benefits (or EOB). You can talk to your doctor’s office about your bill. Or, you can file an insurance appeal. We know how frustrating it can be to find out how much a health care service costs. Here’s a little trick that can help you budget for health care services: Try to find out how much a health service will cost before you get it.

First, call the billing department for the provider’s office, and ask them how much the service will cost. If they can’t tell you, ask for the billing code for the service. Don’t blame the billing department for not knowing the cost they’ve negotiated different rates for all of the different insurance plans their patients use.

Then, call your insurance company. Give them the billing code for the service, and ask the insurance company how much they’ll pay if the provider — pay the provider if you get the service, and ask how much will be left over that you’ll have to pay yourself.

They should be able to tell you the cost and how much, if any, your insurance plan will pay. After you get a health care service, you’ll get a bill from the provider and an EOB, or Explanation of Benefits. Before you pay any bills, make sure to check your bill against your EOB.

An EOB is a written explanation your insurance company sends you after you get a health care service. An EOB shows how much money the insurance company pays, and how much money you must pay (if any) for the covered health care service or item. Remember that an EOB is not the same thing as a bill. According to the American Medical Association, up to 20% of EOBs have errors. Check your EOB against the bill that you get from your provider to make sure they show the same amount. Catching these errors can help you save on costs.

To help you better understand EOBs, download the handout from the right side of your screen. This is another handout we created through our partnership with Thrive. You can also find it on Thrive’s website after the webinar. The next tip is to talk to your doctor about your bill.

If your medical bill costs too much, do your research first. Look up the average cost for the procedure in your area, and then call the billing department for your provider’s office after you have found out this information and have a good idea of the average cost of the procedure. When you get on the phone with the billing department, ask if you can set up a payment plan so you can pay over a longer period.

An important note on this is to make sure that you don’t get charged interest or an added fee for spreading out your payments.

And then, ask if there is payment assistance programs for patients at the doctor’s office. Many doctor’s offices will work with you to figure out a plan that works for both you and the doctor’s office. You’ll never know if you can save on cost unless you ask. If you think your insurance company made a mistake on your EOB (explanation of benefits), or isn’t paying for something it should, you can file an insurance appeal. An insurance appeal is a request you make to your health insurance company to change its decision about your plan coverage.

Insurance companies can make mistakes, and it’s up to you in the end to make sure you’re getting the benefits that you deserve.

To file an appeal, first call your insurance company and ask them to fix the issue. You can tell them why you think that the health care service you received should be covered under your plan. If they don’t fix the issue, find out how long you have to file an appeal. Read the full details of your insurance plan.

Make sure you understand what is and isn’t covered under your plan, and then mail a brief appeal letter along with a copy of supporting documents to your insurance company. Supporting documents may include the bill you received and a copy of your plan documents. And then, the insurance company will send you a letter with their decision.

Let’s see how this plays out with Greg and Sharon’s story. Sharon doesn’t agree with her colonoscopy charge. Sharon got her explanation of benefits, or EOB, from the hospital where she got her colonoscopy. Although the hospital and her doctor were in-network, she was being charged for having an out-of-network anesthesiologist (or the person who put her to sleep before the colonoscopy).

Sharon knows this charge isn’t right, she couldn’t pay her anesthesiologist. So Sharon calls her insurance company to see how to file an appeal. She writes the appeal letter, and mails it to her insurance company. 30 days later, her insurance company sends her a letter that they’ll pay for the anesthesiologist. Greg and Sharon are now much more informed about how to get the most out of their health insurance plan and how to stretch their family’s health care budget. For more information about appeals, including tips to file one, download the handout on the right side of your screen. You can also find it on Thrive’s website after today’s webinar. So we covered a lot of information today on how to save money on health care, so let’s do a quick review.

It’s normal to worry about health care costs.

It’s hard to figure out how much you’ll pay for health care. Take advantage of health savings accounts. FSAs (Flexible Spending Accounts) and HSAs (Health Savings Accounts) give you pre-tax benefits, and FSAs and HSAs can be used to pay for eligible health expenses. Check if your doctor is in network before every visit. In-network doctors contract with your insurance plan to give you health care services at a lower cost. To find an in-network doctor, look at your insurance company’s online provider directory, or call the number on the back of your card.

Use free preventive care services. Preventive care includes screenings, check-ups, and patient counseling to keep you healthy before you have a problem.

And preventive care can save you money by catching problems early when treatment costs less. Ask your doctor or pharmacist for generic drugs. Generic drugs are copies of brand name drugs that are the same as brand name drugs in dose, safety, quality, and performance. Ask your doctor or pharmacist about getting a generic version. And make sure you pay the right amount for a health care service. Try to find out how much it will cost.

Check your bill against your explanation of benefits (or EOB). Talk to your doctor about your bill. And file an insurance appeal if the insurance company made a mistake. If you use these tips you’ll be well on your way to making the most of your health care budget. We hope you enjoyed today’s webinar and feel confident about stretching your health care budget.

To help us make our webinars better, please take a few minutes to take a short survey about today’s webinar. The link is on the slide and it will also be emailed to you after the webinar.

We greatly appreciate your feedback! Thank you for attending today’s webinar. For more information, take a look at the new Thrive website at https://thrive.ok.gov, and feel free to reach out to us with any questions. This was our 3rd of 4 webinars. Our next webinar will be live on Tuesday November 15th. The topic is how to take charge of your long-term health condition. So now we can go ahead and take questions. What questions do we have? Okay, it doesn’t look like we have any questions, but if you do have follow-up questions definitely feel free to reach out to us, reach out to Thrive, and um, your Benefits Specialists and we can definitely help you out with any questions that you may have. So, thank you so much and we hope you’ll tune into the next webinar!.

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