Five Tips for Planning Your 2018 Personal Health Care Budget

Health care should be a key part of a family budget, but costs are hard to predict. The true cost of health care can change, based on the health conditions of family members, your health care plan and how you use health care resources.

To help manage your health care budget in 2018, use these tips:

Don't forget deductibles and copays

Most health plans have deductibles you must pay, along with copays for health care services. A deductible is the amount you owe for certain covered medical services before your health plan begins to pay for them. A copay is just a fixed payment for covered health care. Most often, it’s the amount you owe each time you visit your primary care physician, a specialist, the emergency room or urgent care. Your copay amounts are specific to your plan. To determine your copay amounts, log in at hap.org and click “My Benefits.” From there, you can estimate how many times you might need to visit your PCP or a specialist and budget accordingly.

Generally, there are two types of plans:

• Low-deductible: These have higher premiums, (the amount you pay for your health plan each month) but, because the deductible is low, you’ll likely meet it earlier in the year.
• High-deductible: These have lower premiums, but, because the deductible is high, it may take longer to meet it.

Consider which type of plan best meets your needs. Also, keep in mind some plans cover office visits before you meet your deductible.

Choose generic drugs when available

Many drugs have generic versions with the same active ingredients and therapeutic effects as brand-name drugs that cost much more. Many popular but expensive drugs are now available as generics.

If family members are taking long-term medications, generics can significantly lower your health care budget. Also, make sure your prescriptions are on your health plan’s drug list. You don’t want to learn after signing up for a plan that a much-needed drug isn’t covered.

More prescription drug tips:

Research your drug copays

Drugs are categorized in tiers that determine copays. These tiers can vary, but many plans have the following categories:

• Tier 1: Generic – Non-brand name drugs with the lowest copay.
  
• Tier 2: Preferred brand – Brand name drugs with the lowest copay.
  
• Tier 3: Non-preferred brand – Brand name drugs with a higher copay.
  
• Tier 4: Specialty drugs – Biologics or prescription drugs used to treat complex or chronic illnesses, which require special handling, provider coordination and patient education for safe and effective use.
• Preventive: Generic preventive prescription drugs used to prevent illnesses, diseases or other health problems.
• Medical drugs: Drugs infused or administered in a doctor’s office or facility that are covered under your medical benefit. 

Find out where your drugs fall in your plan’s drug list. This will help you know their costs and allow you to ask the right questions. You can find HAP’s drug lists here.

Talk to your health care providers about cost

If you find a drug is too expensive, tell your doctor and pharmacist that you prefer lower copay drugs and generics. We all want to pay less for health care. Your doctor or pharmacist will work with you to find an affordable treatment with a lower-tiered drug.

Consider mail order with a 90-day supply, when available

Using mail order with a 90-day supply will reduce your copay or coinsurance in many prescription drug plans. Most plans offer this option at only two or two-and-a-half times the 30-day copay. That’s less than paying for three 30-day supplies.

HAP members may have their prescriptions home-delivered by Pharmacy Advantage's convenient mail order service. You can refill or renew your prescriptions by phone or on the Pharmacy Advantage website. For more information, visit PharmacyAdvantageRx.com or call (800) 456-2112.
 

Understand costs before getting care