Understanding health care costs

Health care costs are rising at alarming double-digit rates. Understanding the cost of your health care–and how your decisions impact that cost–can help you make informed decisions and prevent unnecessary medical expenses.

Some of the most significant factors that contribute to increasing medical costs are:

• Lack of awareness of the actual cost of health care. Since out-of-pocket expenses are often limited to a set amount (copay) or a percentage of the cost of services (coinsurance), medical expenses can be considerably higher than the bills we actually see.
• Increasing cost of prescriptions fueled by the marketing of expensive, new brand-name medications.
• Changing demographics–aging population, living longer and requiring more medical services.
• Demand for new technologies and treatments.
• Use of unnecessary health care services.
• Litigation and regulation of the health care industry.
• Poor health habits such as smoking and over-eating.

You can play an important role in keeping health care affordable by:

• Focusing on a healthy lifestyle, preventing injuries and illnesses whenever possible. Our Health Calculators can help - find out your body mass index or see how long it takes to lose a pound.
• Learning more about treatment options and costs. It’s important to consider your own cost as well as the cost to others. For example, did you know employers spend, on average, five times more than employees do for providing health care?
• Understanding the entire cost of health care options—not just your own out-of-pocket expenses.
• Asking how much a service will cost and what alternatives are available. For example, the charge for an MRI can vary dramatically, from $800 to $3,300 in the same city!
• Becoming familiar with your own health benefits. Find out what the exclusions and limitations are; don’t assume your plan covers all medications or services.
• Developing an ongoing partnership with your doctor, pharmacist, and other specialty care providers. Having an active, long-term relationship with your doctor can ensure the most appropriate care.

Consider asking your doctor these medication-related questions at your next visit:

• Why do I need this medication?
• Is a less expensive generic available?
• Are there any side effects?
• How will this medication interact with others I’m taking?
• How soon should my symptoms improve?

Questions?
If you have questions about your prescription benefits, please call Customer Service at the number on the back of your member card, or the TTY line for people with hearing impairments at 1 (800) 382-1003.