Consumer news

Take Control: Shop around for medical services such as MRIs

JJ Champa for PiCK News

“Healthcare,” “insurance” and “reform” are words that have rolled off my tongue more times than I can count - more so now that we are riding the unstable world of healthcare.

TAKE BACK CONTROL!  We are relying more now than ever, that our government will make healthcare more affordable. Guess what, we as consumers have way more control than we think when it comes to making health care affordable. Healthcare is a business and we as consumers need to start treating it as such.  

How many of you use coupons for groceries, or shop for items when they are on sale, or when there is a discount provided? My guess is 99 percent of us do. You need to do the same with your healthcare. Here are some TRUTHS that will help you.


1. SHOP for your services
This is no different then buying a car, a home, vacations, etc. These items are large financial expenses and I bet very few of you purchase the first one you see at the original asking price. Same goes for your healthcare services. There is a balance between seeing the doctor you want and paying for services you can afford.  

You don’t have to have lab work or diagnostic testing done at the same facility where you see your doctor. You will be surprised that you may save up to 75 percent on lab or diagnostic testing at a different facility. Outside of emergency situations, you are best to hold off having lab or diagnostic testing done until you shop around. Your doctor may say that you need an MRI on your knee and call up the diagnostic department in their facility to schedule it. Guess what? You don’t have to have it done at that facility if you don’t want. You have the right and the responsibility as a consumer to tell the doctor that you want to shop around for the best-priced service. Remember, the doctor may imply using their facility is better in some way. For the doctor it may be, but the doctor isn’t paying your large deductible or affected by your growing monthly insurance premium.


2. KNOW your insurance coverage
Knowing what is covered and which providers are “in-network” can save you money. No one wants to read a 90 plus page benefit booklet, but a lot of insurance carriers offer online member portals for you to review claims, search for in-network doctors and facilities. Also, some will provide you the ability to price shop based on your specific insurance plan. I am enrolled in a member portal with my health insurance carrier. I did a search in a 25-mile area for MRI pricing for a knee. I was literally shocked when the results came up. (Remember this is pricing tied directly into my insurance plan). Of the three major healthcare providers in my area, one charged $2,200, one was $2,000 and the third was $550.

3. Make SMART choices
Being a good consumer can take some practice. Implementing this consumer behavior into our healthcare decisions is new to most of us. We as consumers have a lot more power than we think in helping drive down the cost of healthcare.  

To those of you who are blessed with wonderful coverage and with minimal out of pocket costs, remember your decisions affect you just as much as the others. Going to the ER because you have met your deductible doesn’t mean you won’t be paying for it. High claims (costs your insurance pays for) contribute to soaring monthly premiums.  Regardless of your coverage, always address your situation based on medical need. Obviously, go to the ER for a life threatening injury or illness. If you have something that doesn’t require the ER, please consider using your primary clinic, Urgent Care or a convenience care clinic. These options cost less and therefore keep claims down.

Being a smart consumer may take some practice, but my hope is that more of us will take action and control of our care. 

~ JJ Champa has more than 15 years of experience in the insurance industry working with employer's and individual's benefits, both in claims and delivery. ~

Don't  just accept high cost of  prescription medications, do something about it

JJ Champa for PiCK News

No matter how anyone feels about the Affordable Care Act, we all share the burden of rising healthcare costs. Most of us are seeing cost increases in our premiums, deductibles, co-insurance, prescriptions, or all of the above.

 

There are many ways consumers can lower out-of-pocket costs.

Most everything we consume has been on a steep, uphill rise over the last 10 years. A lot of us have turned to finding ways to save money, like shopping during sales, using coupons, or canvasing the clearance racks. Believe it or not, you can also be a savvy ‘healthcare shopper.’

 

As savvy healthcare shoppers, we can keep more of our money in our pockets beginning with lowering the cost our prescriptions.

I, like many, have migrated toward pharmacies which offer convenience. Does it have a drive-thru, and if not, how far do I have to walk into the store to get my prescription and get out….especially with a sick kid in tow? My choice for prescription shopping has been the pharmacy’s location within my daily commute from work to home.

Some consumers may choose not to compromise, insisting on patronizing a pharmacy they have used for years, and years, AND years.

More and more, people are questioning why they are paying significantly more for prescriptions they’ve had for many years.

Convenience can be so attractive and for my family, it seemed to be the best choice. I didn’t think there could be that much difference in cost.

I was wrong.

Through my experience with pharmacies and healthcare professionals I have found there can be significant pricing differences.

Guess what? Not all pharmacies charge the same for medications.

The reality is, your favorite pharmacy may charge double the price of a pharmacy just a few blocks out of your way

We must put healthcare at the top of our shopping list.

Yes, I said it. We must shop around for our healthcare, starting with our prescriptions.

First, make a list of your medications. The list should include the name of the medication, the dosage such as 50 mg or 75 mg, and how often you take it.

Next, you open up the phone book, or do an online search of all the pharmacies within a reasonable distance for you.

Then, call those pharmacies and ask for the retail pricing of the medications on your list. Retail pricing is what you pay without insurance. Pharmacies most likely will not give you the cost of your insured prescriptions unless you transfer your prescriptions to them with your insurance information. Retail pricing is the best way for you to make a comparison pharmacy to pharmacy.

Remember, those of you with health insurance will usually get a break on the retail price based on the contract a pharmacy has with your insurance provider and the prescription benefits included in your policy. There are also several computer and phone applications that can help with some basic comparisons of prescriptions prices at local pharmacies

This is where we pause a bit to let the last paragraph sink in.

I like to think checking pharmacy pricing is similar to grocery shopping. In general, we shop for our groceries based on what we need and the convenience of the grocery store.

I may stop at a convenience store or gas station on the way home from work because I need a gallon of milk. I know that it will probably be a dollar or so more for milk at the gas station. But, I can afford the extra dollar and I am willing to spend it for the convenience of getting that one item.

If I am planning my usual two-week, total grocery overhaul, I will break out the coupons and the sale ads. Based on that information, I will then decide if I want to go to a grocery store closer to me or drive a couple extra miles to save some money. Saving 20 percent versus 10 percent on one item is not going to be a deciding factor on where I shop. But, saving 20 percent versus 10 percent on a $200+ grocery bill will be.

One other plus to shopping around for your prescriptions is that we, as consumers, can be a part of driving pricing down.  We can help ourselves drive down the cost of healthcare if we are savvy and conscientious consumers.

 

~ JJ Champa has more than 15 years of experience in the insurance industry working with employer's and individual's benefits, both in claims and delivery. ~

Don't scratch the itch, fight back

JJ Champa for PiCK News
Welcome to the land of 10,000 lakes and billions of mosquitos.  As a Minnesotan, I have grown up with those annoying mosquitos and the uncomfortable aftermath of being their personal buffet.  

With the increase of mosquito borne illnesses, such as West Nile and Zika, we humans are trying to find ways to protect ourselves.
 As a mother, my immediate concern was whether or not I want to expose my child to N,N-diethyl-3-methylbenzamid, or a name we are more familiar with - DEET.  Over the years, I had heard DEET was a dangerous thing for children and pregnant women.  Now, with these viruses, I felt I had to decide which is the lesser of two evils.

I happened upon a Consumer Reports article from April 16, 2016 which referenced a study they performed on bug repellents and how well they worked against the aedes aegypti mosquito, said to be the carrier of the Zika virus and others such as dengue and yellow fever.  According to the study, Sawyer Picaridin and Natrapel 8-hour were the two repellents that lasted eight hours.  Off Deep Woods VIII, containing 25 percent DEET, also kept those vicious creatures at bay for eight hours.  Their top pick was the Sawyer Picaridin because it also repelled Culex mosquitos, which carry West Nile virus and St. Louis encephalitis, and deer ticks which carry a whole host of tick borne illnesses including Lyme disease.  Runners-up were Ben’s - 30% percent DEET, Tick & Wilderness Formula and Repel Lemon Eucalyptus, both lasted seven or more hours.

My fear of DEET brought me to do more research and educate myself on the dangers posed to children and pregnant women.  The Food and Drug Administration (FDA) website (www.fda.gov) had an article from May, 2016, titled ‘Insect Repellent use and Safety in Children.’  The article advises all consumers to read the labels on repellents and to follow the directions for usage.  The repellents with active ingredients registered with the Environmental Protection agency (EPA) do not present health or safety concerns.  The article recommended not to use DEET on children under two months of age and not to use Lemon Eucalyptus on children under three.

Further research brought me to the CDC website (www.cdc.gov), which had an article from March of 2015, titled ‘Insect Repellent Use and Safety.’  The CDC article had similar references to safety as the FDA website.  Both sites state to follow the directions on the repellents, only reapply when necessary. Adults should apply repellent to children with their hands to avoid repellent entering eyes, mouths and cuts.  They also advised if you used an insect repellent, you should wash with soap and water after returning indoors.  

I purchased Repel Sportsmen with 25 percent DEET.  There were no age or pregnancy warnings on the repellent can.  I applied it very conservatively to myself and my child. It had a very mild scent to it.  To ensure the safety hazards, I actually looked up the material safety data sheet (MSDS) information.  It did have a warning and and what to do if the product was swallowed.  It protected us for the couple of hours we were out planting flowers.

For those of you who are concerned about your or your child’s safety with use of these repellents, I encourage you to ask your physician.

To all you campers, gardeners and outdoor enthusiasts, I wish you a safe and happy mosquito season.


 

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