Tuesday, August 24, 2010
Applying Out-of-pocket expenses to my deductible
Tuesday, August 24, 2010 3:26:31 PM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | High deductible Health Insurance )

My family has a high deductible health plan with a $5,200 annual deductible and a Health Savings Account (HSA).  I really like our health plan because it provides my family with great coverage in case of any major medical events, and our monthly premiums are considerably lower.   In a typical year, we never meet this deductible.   

This calendar year my family has accumulated some medical expenses and it looks like we might be meeting our deductible by the end of the year.   I have a number of prescriptions filled at our local Walgreens Pharmacy so I joined the Walgreens prescription savings club to save 25% on all my prescriptions.   This is a huge savings for my family.  Almost a month ago I realized my prescription out-of-pocket spending was not being applied towards my annual deductible and since this was almost $2000 in Rx expenses – I was concerned. 

It turns out that if you join the Walgreens savings club and use your savings club discount when you pay for prescriptions, Walgreens does not submit these drug claims to your health insurance plan.   In order for these expenses to be applied to my deductible, I am required to submit these receipts myself.  Why Walgreens cannot forward these claims is a mystery.  But now that I know, I will make sure these drug expenses get applied to my deductible.


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 Wednesday, August 11, 2010
Websites help patients compare prices for health care
Wednesday, August 11, 2010 1:35:40 AM (Central Standard Time, UTC-06:00) ( Consumer-driven health care | Finding the Best Value for Health Care Services | Transparency )
This article by Jillian Berman, was published in the July 30, 2010 issue of USA TODAY.

As Alan Grunberg neared 50, he knew he was going to need a colonoscopy, so the Chicago-based Realtor began shopping around to try and find the best place to get the procedure done.

"I couldn't get anybody to give me information on how much it was going to cost," he says, adding that his insurance wouldn't cover the procedure.

Grunberg eventually found PriceDoc.com and received multiple quotes. "The price was outstanding," he says. "I jumped on it."

PriceDoc is one of several sites that give consumers the ability to shop for procedures ranging from a colonoscopy to teeth whitening. In some cases, the sites allow consumers to negotiate with providers.

Steven Findlay, health analyst for Consumers Union, says sites listing prices for procedures can be helpful, but consumers shouldn't settle for the first price offered. Unlike traditional retailers, health providers don't usually advertise sales, he says.

Patrick Bradley, PriceDoc's co-founder, says his goal is to help consumers find a low price for services their insurers won't cover. Patients search by ZIP code for a list of doctors and their prices.

Some of the doctors listed on the site prefer to negotiate and include the "make me an offer" button on their profile, while others just list their lowest price, Bradley says.

"We've created a free, market-based competitive field if you're paying with cash," he says.

One drawback is that for some locations and procedures, the choices are limited. When Grunberg tried to use PriceDoc again to search for a dermatologist, he couldn't find any providers in his area. "I'm not going to travel 500 miles to have something done unless I need to do it," he says.

Bradley says most of the consumers using his site are looking for dental, vision, cosmetic and dermatology procedures. Many have individual insurance policies, which typically have high deductibles, or are paying for care out of a health savings account.

Mona Lori, founder of OutOfPocket.com, says her customers are primarily interested in prices for dental and vision procedures. Lori created the site, which offers a price-based directory of health care services, in 2007 after unsuccessfully trying to get providers to give her prices for various procedures.

Findlay says providers are gradually becoming more transparent with prices.

Brian Douglas, co-founder of New Choice Health, says that should be the goal. Douglas says he started NewChoiceHealth.com, which lists price ranges for procedures at various facilities, to "help educate the consumer that health care is retail.

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