MONEY Health Care

4 Smart Year-End Strategies for Maximizing Your Health Benefits  

Tray of dental instruments
Peter Dazeley—Getty Images Dental plans often have annual coverage caps. Have you used up yours yet?

In these winter months, don't overlook these valuable health perks—and the crucial deadlines for getting your money's worth.

The first and last months of the year can be the best time to use your health insurance benefits. Here’s how to make the most of four common scenarios:

You’ve Met Your Deductible

This is the amount you must pay for your own health care before your insurance starts covering a larger portion of the costs. If you’re close to that cut-off, consider a last-minute appointment, says Carrie McLean, director of customer care at online insurance exchange

“If you’ve already met your deductible for 2014, or are close to it, medical care rendered before the end of the year may be covered at a lower out-of-pocket cost,” McLean says. “Conversely, if you expect to have a lot of health care expenses in 2015, you may want to schedule non-emergency medical care for early next year so you can fulfill your deductible as soon as possible.”

You Have Unused Dental Benefits

In most cases, dental coverage works differently from regular health insurance. This benefit is often capped at $1,000 to $3,000 annually, according to the American Dental Association. If you have unused benefits remaining, now may be the time to schedule a last-minute appointment, especially if you might need serious dental work soon. That way, you can spread the cost over both years and pay less out of pocket for dental care.

You Have an Leftover FSA Money

If you set up a flexible spending account, or FSA, through your employer as a supplemental benefit to your health insurance, you were able to contribute pre-tax money to it each year and use that money for qualifying health expenses. Now’s the time to check your balance.

Some FSAs allow you to roll over up to $500 of unused funds into the following year, or give you a 2 1/2-month grace period to spend the money, but many don’t. In that case, you’ll forfeit your remaining balance.

If you have funds left in your FSA, or you are over your rollover limit, it’s time to spend the money. The good news is that a lot of expenses qualify, starting with purchases you’ve already made. If you can prove it, you can reimburse yourself for health costs you paid earlier in the year, says Craig Rosenberg, benefits specialist at human resource firm Aon Hewitt.

“Check to see if there are any out-of-pocket health care expenses you haven’t submitted for reimbursement. It’s easy to forget co-pays, prescription drug expenses, or certain medical supplies,” says Rosenberg.

“December can be a good time to stock up on health supplies,” he adds, and that goes for a lot of expenses, from bandages to braces and more.

If your FSA has a grace period, you have until March 15, 2015 to use your 2014 funds. In that case, it might be a good idea to schedule checkups for January so the costs count toward next year’s deductible. Check your FSA summary of benefits first, because in some cases that grace period is only for vision and dental expenses.

You Have an HSA

Whatever you do, don’t confuse your health savings account, or HSA, with an FSA and hurry to spend it, Rosenberg says. “FSAs have ‘use-it-or-lose-it’ rules that apply each year, but HSAs do not,” he says. “Any funds in your HSA are yours to keep indefinitely, even if you change jobs.”

Some even look at HSAs as a retirement savings vehicle since the funds can be used to pay for Medicare premiums and medical costs in retirement. That’s a big deal: Fidelity Investments estimates that the average couple retiring this year will face $220,000 in medical costs in retirement.

You may even want to add funds to your HSA now, McLean says. “Maximize on your tax saving by funding [the HSA] fully before year’s end,” she says, but know the limit. The contribution cap for HSAs in 2014 is $3,300 for individuals, or $6,550 for families.

Lacie Glover writes for NerdWallet Health, a website that helps consumers lower their medical bills.

MONEY Health Care

The Hidden Financial Benefits of Keeping Yourself Fit

running shoes hovering over a scale
Geir Pettersen—Getty Images

Investing in fitness can generate financial rewards as well as health benefits.

You know exercise is good for you. What you may not know is that working out can have financial benefits too.

Plenty of research suggests that overweight people spend more on health care, but it’s not just the thin who stand to save. Fact is, regardless of your weight, if you’re a couch potato you’re likely missing out on earning and saving opportunities.

The Payoff in Your Paycheck

Health care costs aren’t the only way physical activity is a benefit. People who work out regularly, as in at least three times per week, are more productive at work than those who don’t, according to research published in the Journal of Occupational and Environmental Medicine. Those who get sufficient exercise also miss fewer workdays, according to the same study. Those absences can translate to lost income and lost opportunities for advancement.

Another study published in the Journal of Labor Research found that men who work out regularly can expect to make 6% more than their sedentary counterparts, on average. For women, the pay boost is higher: Fitness-savvy females make 10% more, on average.

A Nudge From the Boss

If you’re not already working out, it doesn’t have to cost an arm and a leg to start.

For starters, some employers just flat-out pay their employees to work out as part of workplace wellness initiatives. For example, IBM offers cash to employees who meet certain fitness goals. Employees at Google and Zappos can use on-site fitness classes and facilities, enabling them to skip membership fees at traditional gyms. Even if your company doesn’t currently offer wellness benefits, it might soon: Under the Affordable Care Act, employers can receive grants to get one started.

Your employer may have a deal worked out with a local gym where employees can get discounted rates. Even if your company doesn’t offer such an incentive, chances are that your health insurance provider does. UnitedHealthcare offers reimbursements of $20 per month to members who use one of many participating gyms, while Blue Cross Blue Shield has worked out a $25 membership fee for their members at over 8,000 gyms nationwide. These insurance giants aren’t the only ones in on the game—most health care insurers offer some type of fitness benefit for members.

Just Do It

On the other hand, skipping the gym altogether may be your biggest money saver. If a participating fitness center isn’t available near you, or you’re just not the gym-going type, there are plenty of ways to get in shape for free. You can use the myriad online videos in the comfort and privacy of your own home, such as those offered on Bodyrock.TV or YouTube’s workout channel. If you like mobile apps, try Daily Workouts free app, or iPump. If you’re close with your co-workers you can start a lunchtime walking group. Your boss may just end up rewarding you for it.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care and lower their medical bills.

MONEY Health Care

How to Protect Your Heart Health—and Save Big on Medical Costs

Heart Monitor
Justin Lambert—Getty Images The costs of treating heart disease in America has hit $444 billion a year.

A single heart attack could leave you on the hook for thousands. That’s just one reason prevention pays off.

You may have heard that heart disease is America’s biggest killer, but it’s also one of America’s costliest health problems. More than a third of adults in the U.S. have heart disease, and treatment costs totaled $444 billion in 2010, according to the Centers for Disease Control and Prevention. Yet heart disease is largely preventable, and most of us can do our part to avoid it — and the associated high medical bills.

“The patient who has a heart attack and comes to the emergency room within 90 minutes and is seen immediately…can be discharged the next day and return to work in a week or two,” says cardiologist Lawrence Santora, medical director of the Orange County Heart Institute and Research Center. “The cost is about $1,000 or so for the cardiologist and $15,000 to $20,000 for the hospital.”

In fact, the average cost of treating a patient admitted to a hospital with a heart attack is $18,200 according to Medicare data. Unfortunately, you don’t get to opt for the average charge, and if an ambulance brings you to one of the higher-cost emergency rooms for cardiology, the total tab for a single heart attack could be $100,000 or more.

That’s the cost without insurance. But even with health coverage, you’ll still have to pay out-of-pocket costs, which normally include your deductible and co-insurance. The cap on deductibles this year is $6,350 for an individual and $12,700 for a family, and rises to $6,500 and $13,000 in 2015. However, that includes only what you spend on covered items. Anything that your insurance doesn’t cover is billed at full price and does not count toward your deductible.

It’s hard to know what a heart attack will cost you because every hospital sets charges for individual services. The total cost of a heart attack varies widely across the country, and even within some metro areas. To get an idea of average costs in your area, check out this comparison tool by NerdWallet.

A single heart attack with no complications isn’t common, though. “The patient who delays coming to the hospital usually has more extensive heart muscle damage,” says Santora. “This is when costs skyrocket. A severely damaged heart muscle can lead to congestive heart failure and a lifetime of future hospital admissions.”

The Best Prevention

Fortunately, it’s far cheaper to prevent and detect heart disease early. While many people are genetically predisposed to heart problems, there are two ways you can protect yourself: a healthy lifestyle and early detection. When compared to the high cost of heart disease, and especially ailments such as heart attack and stroke, these are well worth the investment.

So what does that healthy lifestyle entail? It’s not as strict or as difficult as you might think, according to the American Heart Association. Just an average of 30 minutes of exercise each day, five days per week, and a few dietary changes will do.

“Do any exercise you enjoy,” Santora says. “A reasonable target is 150 minutes of aerobic exercise per week and light weight training for 20 minutes, three times per week. Buying a pedometer and walking 10,000 steps per day is another simple method to lower heart risk.”

As for diet, that’s also pretty simple, according to Santora. Stick to a Mediterranean diet and avoid processed meats whenever possible—although steak and other lean, unprocessed red meats are fine a few times a week—to keep your heart healthiest, he says.

“Don’t focus on cholesterol,” Santora says. “The cholesterol you ingest doesn’t raise the levels in your blood—it’s animal saturated fats that do that.” In other words, eggs and plant-based cholesterol are fine.

The Tests You Need

Lifestyle changes aren’t the only preventive measures you can take. Under the Affordable Care Act, many preventive services are free, including those that help improve heart health. Obesity and diet counseling, aspirin, blood pressure screenings, and cholesterol screenings are all provided free of charge as long as you have an ACA-compliant health plans.

Early detection means visiting your doctor regularly, sometimes getting diagnostic scans like echocardiograms or CT scans, and seeking immediate medical treatment whenever you suspect heart problems. Under the ACA a visit to your primary care doctor is also free once per year. Preventive and diagnostic measures are also likely to be covered in part by your health plan, because prevention saves insurance companies money down the road as well, according to the American Heart Association.

That monthly $60 gym membership fee is looking more and more like a bargain.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care and lower their medical bills.


6 Surprising Reasons Eating Right Pays Off

French Fry Packaging with rolled up dollar bills
Mike Kemp—Getty Images Saying no to the fries is a smart money choice.

You know a better diet will make you fitter and healthier. What you may not realize is that replacing fries with a salad can help your finances too.

Eating healthy can make you look and feel better, but it can also be great for your wallet. Whether by reducing medical costs or helping you earn more, a healthy diet has benefits beyond a slimmer waistline. Consider these ways your diet can improve your finances:

1. You’ll Lower the Likelihood of Needing to Take a Sick Day

Fruits and vegetables contain vitamins and minerals that help boost your immune system so it can better fight off viruses and bacterial infections. Staying healthy during flu season means you can go to work and get that paycheck (or promotion), and you won’t have to spend money on meds and extra doctor’s visits.

Not only does consuming a lot of produce increase your immunity in the short term, but it also helps prevent disease in the long run. Notably, eating more vegetables reduces the risk of heart disease, which afflicts about a third of all adults and costs about $444 billion a year to treat in the U.S., according to the Centers for Disease Control and Prevention.

2. You Can Stay More Productive

Not much is better for your finances than making more money, and one way to do that is to work harder. According to 2012 research conducted at Brigham Young University, eating healthy can help you do that. The researchers evaluated 19,800 employees at three large companies and found that eating well every day may lower your risk of productivity loss by 66%. They also found that exercise lowered the risk of lost productivity by 50%, and getting five fruit and vegetable servings lowered the risk by 39%. (Other research has found that frequent exercise is connected to higher pay.)

3. You Can Take Fewer Pills

Disease costs a lot of money in terms of doctor’s visits, procedures, surgeries, and medical devices, but a large chunk of medical spending goes toward prescriptions that could be discontinued. In fact, three of the top five most commonly prescribed medications in the U.S. are for preventable heart conditions, adding up to more than 160 million scripts per year. Keeping your heart healthy and your weight down through diet will help reduce the need for these medications and the monthly expense that goes along with them.

4. You’ll Steer Clear of Complications

When you’re unhealthy or obese, you’re more likely to have complications with an existing condition. For example, obesity decreases lung performance and is thought to exacerbate asthma symptoms. But foods rich in antioxidants and omega-3 fatty acids can increase lung performance. In addition, high blood pressure and diabetes can complicate your pregnancy, according to the CDC, and those costs can add up. Eating a healthy diet and keeping a normal body weight can help you avoid these problems.

5. You’ll Age Better

When most people think of retirement planning, they think of 401(k)s and IRAs. That’s a great start, but if there’s anything that can deplete your retirement funds, it’s unplanned medical costs. Studies conducted over the past 20 years show that plant-based and Mediterranean diets increase longevity and health, helping you work longer (if you want), save more toward retirement, and hopefully spend less on health care later.

More recently, researchers in Rome and the Washington University School of Medicine jointly published a paper that concluded that calorie restriction may be the best way to prevent disease and lengthen lifespan—even for people at a normal weight. The paper, published in 2011, took into account studies on rodents and humans. More human studies are needed, but the paper provided a basis for in-depth trials to come.

6. Your Insurer May Reward You

Employers and insurers are doing what they can to get you to eat right and work out (and need less high-cost medical care). That can mean discounts on the food you should be eating. The health-care network Harvard Pilgrim rewards workers for buying healthy food (up to $20 a month) and recently announced that it would roll out the program to other employers. Blue Cross Blue Shield offers Jenny Craig discounts, and Humana gives members a 10% discount on healthy groceries purchased at Wal-Mart.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care, and insurance.


MONEY Health Care

Why Does an MRI Cost So Darn Much?

Blood vessel with human brain MRI
Yuji Sakai—Getty Images This is a very expensive picture to take.

A single scan runs $2,600 on average (before your insurance kicks in). Here's what makes this common diagnostic procedure so expensive.

When it comes to pricey hospital procedures, MRIs come to mind. Sure enough, according to recently released Medicare pricing data analyzed by NerdWallet Health, the average cost of an MRI in the U.S. is $2,611. Here’s what’s behind that number.

Make Room for a Big Machine

Magnetic resonance imaging machines use magnets and radio waves to produce black-and-white images of bones and organs, usually to help with a diagnosis. Only five companies make MRI machines, and each specializes in a few magnet strengths, so there is relatively little competition when it comes time for a hospital or medical center to buy one.

Machines come in a variety of sizes and powers. Their imaging power is measured in magnetic field strength units called Teslas; low-field or open MRI machines measure 0.2 to 0.3, while the strongest currently on the market are 3 Teslas. Used low-field MRI machines can be as cheap as $150,000 or as expensive as $1.2 million. For a state-of-the-art 3 Tesla MRI machine, the price tag to buy one new can reach $3 million.

The room that houses the machine, called an MRI suite, can cost hundreds of thousands more. Safety features must be built in to protect those right outside from the magnetic field. Add in patient support areas and installation costs, and a suite with just one machine can cost anywhere from $3 million to $5 million. Recouping these costs factors into your bill, but that alone does not tell the entire story.

Add in the Doctors and Hospitals

Charges for a single MRI scan vary widely across the country for reasons beyond startup costs. According to the recently released Medicare data, MRIs charges are as little as $474 or as high as $13,259, depending on where you go. (Another recent study of medical claims by Change Healthcare found that in-network prices for certain MRIs can run from $511 to $2,815.) That’s because hospitals and medical centers can charge whatever they want, and in most cases they don’t have to justify prices or even disclose them ahead of time.

Doctors can also charge whatever they want, and though the MRI facility probably sets the rates of their staff doctors, you’ll be charged separately for a radiologist to read the MRI. Additionally, your ordering physician may ask for the MRI to be done with or without contrast dye, or both. This “dye” is actually a paramagnetic liquid that responds to the machine’s magnet and helps enhance certain abnormalities on the scan that would not have otherwise been visible, common in neurological MRIs.

This means that in addition to cost of the scan, your total bill for the MRI will include the radiologist fee, the contrast dyes, and the cost of the procedure itself. Depending on the medical center, these charges may be bundled together into one charge. Bundling is one type of common error on medical bills, so always check over an itemized statement before paying for any costly medical procedure.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care, and insurance.













MONEY Health Care

Don’t Miss Out on This Powerful Way to Cut Your Health Care Costs

Burazin—Getty Images Medical bills are lengthy and complicated—and often wrong.

Doctor and hospital bills are riddled with errors. Learning to spot them could save you thousands on your care.

Health care is a $2.8 trillion industry in the U.S., and the billing system is filled with errors. How many? While it’s impossible to know for sure, there are some fairly good indicators.

Medicare overpayments in 2013 totaled $36 billion, according to the Department of Health and Human Services. A report by the Office of the Inspector General found that 42% of evaluation and management bills sent to Medicare in 2010 contained errors, costing taxpayers $6.7 billion. Those services don’t even include emergencies and hospital surgeries and inpatient stays, where there’s a lot more room for error.

Mistakes on hospital bills are widespread, says Pat Palmer, founder of Medical Recovery Services, a Salem, Va. organization that helps patients check and negotiate medical charges. “It’s astounding that eight out of ten hospital bills we receive contain numerous over-charges,” Palmer says.

Scrutinizing a medical bill may seem daunting, but with a few pro techniques on your side, you can catch some of the most common mistakes.

Don’t be too quick to pay

Many hospitals and clinics send statements with only one final amount, so start by requesting an itemized bill.

“My most critical advice to consumers is to never pay a hospital bill before receiving and reviewing a detailed, itemized medical bill,” Palmer says. “Otherwise, you are paying money to these facilities blindly.”

You should also have your health insurance explanation of benefits nearby before checking over the charges, since billing errors can result in coverage denials.

Learn to spot common errors

Once you have your itemized bill and EOB side by side, check to see that identifying information like your name, address, and Social Security number is correct on each statement. Misidentification is a common error, and if either your insurance company or the hospital has the wrong information, your entire claim can be rejected.

Next, make sure all medications listed on the hospital bill are correct and that you actually took them. During a hospital stay medications that have been prescribed are often discontinued or cancelled, yet they still appear on your bill. Similarly, if you know you did not receive a service such as an x-ray or blood test but see it on your bill, you’ve been overcharged, says Palmer.

After you’ve had surgery, look at the charges for the operating room, which are generally by the minute. If you know how long your surgery took, see if the time matches up. If not, check the minutes in the operating room against anesthesia start and end times—they should be similar.

Mistaken room charges also crop up frequently for overnight stays. If you were in a room with more than one bed, double check that you weren’t billed for a private room. This should be listed in the service charge, and will probably be one of the largest items on the bill, especially if you stayed multiple nights.

Finally, see if any item appears more than once, since duplicate billing is also common. These mistakes are the simplest to catch. Because of the fee-for-service coding system is complicated, others may be more difficult to spot.

How to fix what’s wrong

If you’ve found only one or two errors, you may be able to resolve them by simply reporting the mistakes to your hospital and health insurance provider. If mistakes are plentiful, set up an appointment to talk with the billing department of the hospital in person after you’ve alerted your insurance company.

If the bill is still higher than you think it should be, you can hire a medical billing advocate to help. Advocates are experts like Palmer who know how to work with hospitals and insurance providers to lower that bill.

Read more from NerdWallet Health, a website that empowers consumers to find high quality, affordable health care, and insurance.










MONEY Health Care

Rx Relief: How to Save Up to 80% on Prescription Drugs

Five strategies to help you leave the pharmacy without having to swallow a bitter pill.

The average American filled 12 prescriptions last year, according to the IMS Institute for Healthcare Informatics, and as a result the pharmaceutical industry grossed $329 billion. (You’re welcome, Pfizer.)

Minimize your pain at the pharmacy counter by taking these steps when your next script is written:

1. Use coupons. For expensive prescriptions, you can save 50% or more this way. There are a lot of ways to get your hands on prescription coupons, but start by asking your pharmacist. Call ahead or ask at the counter; the pharmacist may have some on hand or be able to tell you where to find them—most likely online. If you want to search yourself, try the drug company’s website first, then check the website of your pharmacy.

2. Try mail order. Mail-order pharmacies save you money by skipping the bricks-and-mortar middleman and sending the drug directly to you, typically in 90-day quantities. Your health insurer may work with a specific mail-order house, and often you’ll get better pricing by going this route. Alternately, your prescribing doctor’s office may have a preferred pharmacy they work with regularly, so inquire when the prescription is written.

3. Ask your doctor about pill splitting Most drugs come in more than one dosage, but aren’t priced on the same scale as the dosages. This means that, per milligram, higher dosages of the same drug are often cheaper—and you could save money by purchasing double doses of your prescriptions and halving them. Not every drug should be split, so consult with your doctor first. If you’re given the go-ahead, make sure to purchase a pill splitter from a drug store to ensure consistent and equal dosing.

4. Opt for generics If there’s a generic version of your brand-name drug available and you’re not taking it, you could be wasting a lot of money—on average, generics are 80% to 85% cheaper than their brand-name counterparts. Contrary to the myth that generic drugs are held to different standards than brand-name drugs, there is no significant difference between them. Generic drugs are allowed to differ from brand-name drugs only insofar as appearance and inactive ingredients. By law, medication dose, safety, quality and instructions must be the same. Stores have gotten into price wars over generic drugs: Target now charges $4 for hundreds of medicines, for example, and Meijer and Publix are among those that offer some drugs gratis, which is why you may want to…

5. Compare pharmacies. Drug prices can vary widely between pharmacies, even locally, so you may want to shop around before simply going to the nearest drug store. Websites like GoodRx and LowestMed compare pharmacies within zip codes for specific medications, and even offer coupons and drug information. You may be surprised to find that some drugs vary by $50 or more for the same supply and dosage. In that case, the cost of convenience may just be too high.


More stories from NerdWallet Health:

So You’re Pregnant? Here’s What You Need to Know About Your Maternity Coverage and Benefits

How to Save On Asthma Medications

Patient Advocates: Your New Best Friend for Managing Your Health Care Experience

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