How to keep your health care costs under control

Americans spend more than $7,500 per capita on health care each year, according to the Kaiser Family Foundation, a California-based nonprofit organization that focuses on health care issues.

Nearly 2 million Americans are living in medical bankruptcy-the No. 1 cause of personal bankruptcy-and one in five adults has trouble affording medical care, NerdWallet.com reports.

Even if you have health insurance, deductibles, prescription medications and co-payments can be substantial.

What can you do keep these expenses under control?

One of the best ways to reduce your health care costs is to proactively preserve and protect your health by seeing a doctor regularly, said Dr. Monjur Alam, who practices family and occupational medicine at Sanford Health in East Grand Forks.

Primary care physicians "are trained to handle a lot of medical conditions-head to toe-and coordinate the care a patient receives from other members of the health care team," he said.

In his practice, Alam recommends healthy adults see their primary care physician when they turn 30 for screening tests.

Younger adults, who are in good health, should have a thorough physical examination every three to five years, or "at milestone birthdays, like 25 and 30."

"A healthy adult female should see a primary care physician starting at age 21 to start age-appropriate preventive tests like a pap smear for cervical cancer screening.

"If you have one or more chronic conditions for which you are taking medications, you should see your doctor at least once a year and possibly more often, depending on how (the condition) is managed," he said.

Preventive care is "a small investment" in keeping one's health costs down, said Jill Cormier, patient advocacy supervisor at Altru. "It's something that doesn't take a lot of time (but) prevents medical problems later."

An annual doctor's visit may cost between $200 and $300 but is much less "compared to an emergency, surgery and months of treatment" resulting from a serious medical problem.

Managing your care

Patients are encouraged to become more involved in managing their own health care through the use of electronic tools to access their medical records or receive useful information, Alam said.

"You might get a reminder on your smartphone that you're due for a certain test or exam, or get preventive health care guidelines or the top 10 health tips for a 25-year-old," he said.

Use of this technology could keep you healthier and reduce medical bills by making a visit to your doctor unnecessary.

It's important to scrutinize your bills for inaccuracies, even though the language can be confusing.

If patients see discrepancies, "they should definitely call a customer service or patient representative at the health care facility," he said. "They are paying for services."

"They should review their benefits with their insurance agent so they understand what's being covered and what is not."

Tips

Here are few other ways to lower your medical costs:

Check for lower-priced services.

Hospitals can charge different rates for the same services. It may be worth it to check various prices and drive a few extra miles to save thousands of dollars.

With tools such as NerdWallet Health's Best Hospitals or Medicare's Hospital Compare, you can look up the cost of common procedures in your region.

Ask your doctor to give you a cost estimate, and call your insurance company to better understand the rate you will be expected to pay out of pocket.

Control medication costs.

By signing up for a retail prescription program offered by several businesses, you can save money on selected prescription drugs, Alam said.

The program, sometimes referred to as "the $4 list," allows patients to order a one-month supply of a prescribed drug for $4. Prescriptions for longer durations also are available.

One national company says the program has saved its customers more than $3 billion. For more information, visit retailers' websites.

Look for billing errors, double charges.

As many as eight out of 10 bills for health care services contain errors, according to Medical Billing Advocates of America.

Many hospitals send a summary of charges, but you have a right to the complete breakdown. Ask for an itemized bill so you can see every charge.

Look at the line charges and the diagnostic codes. These can be hard for the average person to understand, but if something looks off, asked the billing department to explain it.

Ask for an explanation, in writing, from the hospital's billing department for any disputed charges.

Negotiate a cash discount.

If you are paying out of your own pocket-because you have no insurance, have maxed out your insurance or are seeking treatment out of network-it's worth asking for a discount on services, according to Health.com.

Although it can be intimidating to negotiate for lower bills, doing so can save you money.

Be candid about your financial situation. Tell your doctor about your employment status and any upcoming changes in your medical coverage. Ask about discounts for under- or uninsured patients.

Hospitals and doctors sometimes will consider accepting less than the full list price.

Altru Health System may allow "a 10 percent 'prompt pay discount' for those who are uninsured, if the bill is paid within 30 days of service," Cormier said.

Check eligibility for charity funds.

Funds are available to assist Altru patients who may have trouble paying medical bills, either because they can't afford it or are underinsured or uninsured, Cormier said.

"We recognize the need for preventive care," she said, noting Altru has funds designated for financially stressed individuals, including those who need breast and colon cancer screening.

"Anyone who has trouble paying (medical bills) or is concerned about future costs is referred to our HERO Program," Cormier said.

Patients who refuse a medically necessary test because of financial hardship and qualify for the Healthcare Eligibility Resource Option program "are screened for (eligibility for) insurance, federal programs, internal and charity funds," she said.

Consider a medical billing advocate.

If you have a bill of $10,000 or more, it may be helpful to hire a medical billing advocate or auditor, a professional who usually has years of medical billing or insurance experience, according to NerdWallet.com.

A medical billing advocate can lower medical bills by spotting errors and negotiating with medical centers and insurance companies alike. The higher the bill, the higher its chance of containing errors.

Most billing advocates keep a percentage of the reduction they negotiate for you or may negotiate an hourly fee for larger bills.