• Raise your deductible; raising your deductible to $1000 will cut your premiums 35 to 40 percent.

  • Select a policy with a higher stop loss, like 80/20 to $5000, to reduce your premiums.

  • Don't pay for maternity benefits with your health insurance. Insurance companies think that only those who intend to use this benefit will select it and they charge accordingly.

  • Don't buy supplemental options like prescription drug, dental, or supplemental accident insurance.

  • Make sure that you know what your health policy does and does not cover so you can make wise decisions when comparing policies and get the most out of the policy you do choose.

  • Choose a managed care option such as an HMO to reduce your-out-of-pocket costs. These plans are based on the service concept (i.e. services are covered rather than specific dollar amounts).

  • Try to get health insurance through a group policy - groups usually get better deals than individuals.

  • Ask your physician if he will accept assignment from the insurance company (in other words, accept what the insurance company is willing to pay as payment in full).

  • Never lie about your health status when applying for insurance. If the company discovers that you misrepresented the facts, it can cancel the contract and leave you holding the bag.

  • Read the exclusions section carefully when purchasing an individual policy and then choose the one with the most liberal coverage for the money you are willing to spend.

  • Try to choose a policy that will minimize your coinsurance and copayments.

  • Choose a policy with a liberal renewal provision.

  • If you have difficulty finding insurance, take advantage of the open enrollment periods of HMOs and other insurance plans in your area. Some employers also offer open enrollment periods so that their employees can switch insurance plans.

  • Take advantage of "free look" provisions when you receive a policy. Make sure that policy you purchased is the one that is best for your needs.

  • Don't carry multiple, overlapping health insurance policies.

  • Don't purchase "dread-disease policies, such as cancer insurance. These policies usually provide limited benefits and promise to pay for things that should be covered in your basic health insurance policy.

  • Do purchase major medical insurance if you can afford it. Save money by carrying the highest stop-loss feature that you can afford.

  • Try not to purchase a policy that excludes pre-existing conditions. If you can't do this, try to limit the amount of time that pre-existing conditions aren't covered - six months is a good amount of time to shoot for.

  • Avoid policies offered to you through the mail.

  • Avoid policies that are endorsed by celebrities.

  • Do not cancel an existing policy until its replacement goes into effect.

  • Check with the state insurance department before purchasing any policy to make sure the company selling the policy is licensed in the state and that it has not generated excessive consumer complaints.

  • Go to the library and check the companies' financial stability. Avoid those companies who do not have an A or A plus rating from A.M. Best.

  • See if you can pay premiums yearly - companies often discount the amount paid for coverage if you pay in a lump sum.

  • Make sure premiums are paid in a timely fashion.

  • Make sure that you exercise great care when purchasing or choosing your health insurance coverage. It could be the difference between financial stability and years of paying and hassling with medical bills.

  • Try to match the insurance policy you purchase to your projected health care needs.

Health insurance is complicated - and it's expensive. But even in this complex area, being a better health care consumer can save you money. As you've read this chapter, you've probably come to appreciate that insurance companies, too, are trying to cut waste and fraud from the health care system. You can help them do that - and save money in the process - if you use only the services you need and pay close attention to what you're charged. By shopping for your medical care with as much attention as you'd give to other major purchases, you can make a difference.

Excerpted from Stay Well Without Going Broke: Winning the War Over Medical Bills, copyright 1993 by Starburst, Inc. Used by permission of Starburst Publishers, Lancaster, Pa., www.starburstpublishers.com, 1-800-441-4123.

Rich Gulling, R.Ph., M.B.A., has experience as an adjunct professor of finance at Wright State University and as a registered pharmacist. John Renner, M.D., is the president and medical director of the Consumer Health Information Research Institute in Kansas City, Missouri. Pattie Vargas, B.S., Ed., M.A., is an educator and prolific writer.

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