6 Ways to Control Costs and Get the Care You Need

Healthcare costs continue to rise. According to the U.S. CMS.gov, healthcare spending grew 7.5% in 2023, reaching $4.9 trillion or $14,570 per person.¹ The good news is there are small steps consumers can make to take back some power when it comes to keeping spending under control. Take the time to understand what your health plan offers and make the most of your healthcare benefits. Here are six recommendations to help you save money while getting the care you want.

1. Learn health plan lingo to help control healthcare costs.

Make sure you really understand healthcare billing and insurance terms. Do you know what a copay or coinsurance is? Could you explain deductible to a friend or family member? It’s important that you can answer yes to these questions because that knowledge can help you navigate the complex world of health plan coverage. Learning health plan lingo is a great first step to take when you want more control over the healthcare decisions you make and more control over your financial well-being. Plus, if you need healthcare to be more affordable, a solid understanding of the basics can drive cost savings and help keep your money where it belongs – in your wallet. Learn more about health plan lingo.

2. Be smart about choosing a healthcare provider.

For the best price advantage, take advantage of your PPO network if your plan offers one. A PPO network offers access to a wide range of healthcare providers, including primary care doctors, specialists, hospitals and other facilities, along with savings on many covered healthcare services. In-network doctors and hospitals provide services at a contracted rate typically costing less than those provided by out-of-network providers. When healthcare consumers go in-network when choosing a healthcare provider, they can get the care they need from preferred providers and may save big. Learn more about the value of PPO networks.

3. Use telehealth for the right care, at the right time, and to fight healthcare costs.

Getting healthcare from medical experts via video, phone or mobile app, known as telehealth, exploded in use during the COVID-19 pandemic and remains a popular approach for healthcare consumers seeking non-emergency health services. Patients like the convenience and time-saving aspects of quality healthcare that does not require driving across town for access. According to the Mayo Clinic, telehealth can make it easier for people who live in more remote or rural areas to access healthcare, help keep you and others safe if you have an infections disease and can offer primary care for many conditions.²

Major medical health plans that we administer offer which can be used for access to board-certified doctors, nurse practitioners and pediatricians for treatment of non-emergency conditions. It also includes therapists and psychiatrists to help with stress, anxiety, depression, trauma, grief, burnout and more.

Our major medical plan designs also offer access to Vori Health, which provides virtual physical therapy to employees and their dependents 18 and older for treatment of back, neck and joint pain. Treatment is designed to help patients avoid costly surgery when possible.

4. Stay current with your preventive care.

Preventive care is invaluable. Vaccines can help prevent illnesses. Preventive screenings and tests can help detect issues early, before a disease becomes serious and when treatment costs are less. Federal law mandates that health plans cover certain preventive care at no cost to healthcare consumers. Yet many people, even those who have health coverage, don’t get the preventive care recommended by health experts and available to them at no cost. Keep your health at the top of your priorities. Make the most of your benefits and talk to your doctor about the preventive care that’s right for you. Learn more about preventive care from the Cleveland Clinic.³

5. Use generic drugs to save on healthcare costs.

One of the best ways to save on prescription medicine is to go generic. Generic drugs have the same active ingredients and are as effective as brand-name drugs, but they generally cost significantly less. According to the U.S. Food and Drug Administration (FDA), generic drugs cost 80% to 85% less than their brand-name counterparts.⁴ Healthcare consumers appear to recognize the value of generics: Nine out of 10 prescriptions are filled with generic drugs in the United States, according to the FDA.⁵ There may be important reasons to fill your prescription with a brand-name drug, but the next time you get a prescription refill or your doctor prescribes a new drug, asking about the generic version could be a smart move.

6. Make the most of Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) to help save on healthcare costs

Take advantage of pre-tax accounts, such as HRAs and HSAs, when they are offered by your employer. An HRA is set up and funded by an employer to help an employee pay for expenses eligible for reimbursement. We offer an HRA that can be paired with any major medical plan administered by Star Marketing and Administration, Inc. An HSA is a portable, personal bank account owned by an individual with a high-deductible health plan and used to pay for qualified medical expenses not reimbursed under the plan. Employers and covered employees can contribute to an HSA. HSAs can be paired with our major medical CDHP plan designs.

The information contained in this article has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before acting on the information herein.

¹NHE Fact Sheet | CMS
²MayoClinic. Telehealth: Technology meets health care.
³Cleveland Clinic. Prophylaxis/Preventive Care. 03/2024.
⁴FDA. Generic Drugs: Questions and Answers. 3/2021.
⁵Generic Drugs 4/2023.