Starting from $0: Help Employees Minimize Health Costs Pre-Deductible

By Tracy Watts

Senior Partner, National Leader for U.S. Health Policy

For many people, January is a fresh new beginning. In the health insurance world, it is the proverbial “reset button” on meeting your deductible. Given that the majority of Americans live paycheck to paycheck, and a growing number are enrolled in high-deductible plans, the stress of meeting deductibles is real. So we thought this would be a good time to share some ideas that could help employees better manage out-of-pocket expenses.

Provide an overview of the health care services that are available at no cost or a lower cost than an office visit. For example, suggest that employees:
- Consult with a nurse for free by calling the nurse-line for a consultation before scheduling an appointment with a physician; it could save you the cost of an office visit
- Try telemedicine. The cost of a telemedicine visit is usually around $40-$50, and can be scheduled at your convenience via phone or video chat.
- Take advantage of preventive services covered at 100%. For example, get a flu shot so you are less likely to get sick.
- Use in-network providers for the lowest possible out-of-pocket expense. If you need to see a specialist, ask for an in-network referral.
- Consider a "convenience care” clinic located in stores like Target, CVS, and Walgreens. They offer a limited number of services at a lower cost than urgent care or a physician office visit.
Offer tips to manage prescription drug cost:
- When your doctor recommends a prescription drug, ask how much it costs and if there is an over-the-counter or generic option. Check a few different pharmacies for the best price.
- If a prescribed drug is very expensive and you have not used it before, ask whether you could have a smaller number of pills at first to be sure it works. Check to see if there are patient assistance programs to help defray the cost.
Promote use of transparency tools
- A variety of tools exist to encourage healthcare consumers to shop around for services and tests. Check with your insurance company if you are not familiar with their transparency tool or need a refresher.
- This is the perfect time to remind employees about tools that help them find out the cost of services. Promote the tools by providing examples and training opportunities.
A few new ideas. If you don’t have these financial management tools in place today, it would be worth investigating them for next year to help with the January out-of-pocket medical expense panic:
- Some HSA vendors will advance reimbursement for medical bills based on amount committed from paycheck for the year.
- Some EOB aggregators will pay the amount due to the provider and assist the employee with a payment plan interest free.

Given that financial issues are the top stressor for individuals, anything you can do to help alleviate the burden of health care costs will contribute to a more productive employee — and that’s a win-win.