Your Tips: How do you manage out-of-pocket healthcare costs?

There are costs to healthcare that may not be covered by Medicare, Medicaid, or your insurance. These costs can be beyond a family's financial means. Sometimes people seek to raise funds, move locations, switch jobs, or apply for charitable aid.

What resources or steps have you taken to help cover out-of-pocket costs or to get coverage?

Interested in more discussions like this? Go to the Just Want to Talk group.

I am lucky in one respect I have access to the VA. They have helped me so much. Meds and procedures. The VA here where I live is truly amazing,

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Had to dip into savings to pay for out-of-pocket costs when my husband passed this year. A few vendors waived the balance after I provided a Death Certificate, but the majority expected payment in full. Fortunately, I am able to use payment plans with my employer for my healthcare. I'll be paying off my expenses through next year.

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I have Medicare, supplemental policy and Medicare D insurance for prescriptions. Unfortunately, my Medicare Plan D does not cover many of my prescription drugs.

I use GoodRx coupons to reduce the cost of my prescription drugs that are not Tier 1. It can save me over $100 on some prescriptions. There are other programs that do similar coupons.

It takes time to research costs, what pharmacy accept coupons, etc., but worth the time to save money.

I have friends who get their prescription drugs from Canada. I have not researched that yet.

Laurie

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When I first retired, I wasn't old enough/sick enough to qualify for Medicare. Each month I paid out over $300 for insurance to maintain what I had had through my employer. That did not include co-pays. As Medicare coverage loomed, there was a great ombudsman through the county's Area Agency on Aging, who guided me in making decisions, using spreadsheets for comparisons and "talking turkey". She wisely said "you don't know what may happen in the future, so look ahead now and get your coverage lined up". So right! I have kept with my same coverage for over 4 years now, and it remains the best for me, even with the increase in specialists and different scans/procedures. My prescription costs are manageable.

Going onto chemo earlier this year, I researched and found a grant to assist me to cover the co-pay, which is $3,000 per month! I just sent in the paperwork to renew for 2022.

My husband created a spreadsheet for himself this enrollment period, to look up different plans available, co-pays/premiums, and out-of-pocket costs for his meds. If you have it available to you, a mail order 90 day supply may be the best for your situation, or a local brick-and-mortar store that offers discounts.

It takes time to shop around, but it sure can save a lot of headache, heartache, and money. For over-the-counter health needs, using the store brand versus name brand may be a good option. Take advantage of sales and coupons. Partner with a neighbor or friend who might split supplies up with you, if buying in bulk. Some things do not have expiration dates [thinking soap, shampoo, etc here].
Ginger

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@gingerw

When I first retired, I wasn't old enough/sick enough to qualify for Medicare. Each month I paid out over $300 for insurance to maintain what I had had through my employer. That did not include co-pays. As Medicare coverage loomed, there was a great ombudsman through the county's Area Agency on Aging, who guided me in making decisions, using spreadsheets for comparisons and "talking turkey". She wisely said "you don't know what may happen in the future, so look ahead now and get your coverage lined up". So right! I have kept with my same coverage for over 4 years now, and it remains the best for me, even with the increase in specialists and different scans/procedures. My prescription costs are manageable.

Going onto chemo earlier this year, I researched and found a grant to assist me to cover the co-pay, which is $3,000 per month! I just sent in the paperwork to renew for 2022.

My husband created a spreadsheet for himself this enrollment period, to look up different plans available, co-pays/premiums, and out-of-pocket costs for his meds. If you have it available to you, a mail order 90 day supply may be the best for your situation, or a local brick-and-mortar store that offers discounts.

It takes time to shop around, but it sure can save a lot of headache, heartache, and money. For over-the-counter health needs, using the store brand versus name brand may be a good option. Take advantage of sales and coupons. Partner with a neighbor or friend who might split supplies up with you, if buying in bulk. Some things do not have expiration dates [thinking soap, shampoo, etc here].
Ginger

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I am blessed I have the use of the VA. All meds and procedures are mostly done through them. Plus I have good outside insurance. Surely blessed.

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@gingerw

When I first retired, I wasn't old enough/sick enough to qualify for Medicare. Each month I paid out over $300 for insurance to maintain what I had had through my employer. That did not include co-pays. As Medicare coverage loomed, there was a great ombudsman through the county's Area Agency on Aging, who guided me in making decisions, using spreadsheets for comparisons and "talking turkey". She wisely said "you don't know what may happen in the future, so look ahead now and get your coverage lined up". So right! I have kept with my same coverage for over 4 years now, and it remains the best for me, even with the increase in specialists and different scans/procedures. My prescription costs are manageable.

Going onto chemo earlier this year, I researched and found a grant to assist me to cover the co-pay, which is $3,000 per month! I just sent in the paperwork to renew for 2022.

My husband created a spreadsheet for himself this enrollment period, to look up different plans available, co-pays/premiums, and out-of-pocket costs for his meds. If you have it available to you, a mail order 90 day supply may be the best for your situation, or a local brick-and-mortar store that offers discounts.

It takes time to shop around, but it sure can save a lot of headache, heartache, and money. For over-the-counter health needs, using the store brand versus name brand may be a good option. Take advantage of sales and coupons. Partner with a neighbor or friend who might split supplies up with you, if buying in bulk. Some things do not have expiration dates [thinking soap, shampoo, etc here].
Ginger

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Ginger – The ombudsman is a great option.
Last week a group in our Texas community had this very discussion, and the range of responses was astonishing. Everything from "I don't bother" (total denial) to elaborate analysis each year to pick the best plan. We are fortunate to have access to continuing my former employer's plan in tandem with Medicare Parts A & B – not cheap – about $8400/year for the premiums, but it covers most copays except medications. I always make sure to ask whether the generic meds will work, and by doing so have kept our prescriptions under $3000/year. I have done the math a few times to see if there was a better option, but with recurring medical issues for both of us, paying the premium to minimize out of pocket costs is the best way for us.
One of my friends bought the top tier Medicare C supplement for the same reason – nearly no out of pocket copays – she felt it was a better choice on her fixed income to KNOW what her costs would be each year instead of having surprise bills for emergencies. Her son analyzed it and agreed she is actually saving money with the higher plan, maybe not every year, but overall.
Sue

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@sueinmn

Ginger – The ombudsman is a great option.
Last week a group in our Texas community had this very discussion, and the range of responses was astonishing. Everything from "I don't bother" (total denial) to elaborate analysis each year to pick the best plan. We are fortunate to have access to continuing my former employer's plan in tandem with Medicare Parts A & B – not cheap – about $8400/year for the premiums, but it covers most copays except medications. I always make sure to ask whether the generic meds will work, and by doing so have kept our prescriptions under $3000/year. I have done the math a few times to see if there was a better option, but with recurring medical issues for both of us, paying the premium to minimize out of pocket costs is the best way for us.
One of my friends bought the top tier Medicare C supplement for the same reason – nearly no out of pocket copays – she felt it was a better choice on her fixed income to KNOW what her costs would be each year instead of having surprise bills for emergencies. Her son analyzed it and agreed she is actually saving money with the higher plan, maybe not every year, but overall.
Sue

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@sueinmn, @gingerw, @debguide, @roch, and all…I retired at 62, so I've used my savings through the last 23 years to pay for a top supplemental insurance plan, close to $300/month, plus have a dental discount plan and pay for an RX plan. This year I researched and decided I have the best supplemental possible for me and dare not change. I walk in and out of the Mayo ED or hospital stay and pay very little, few co-pays, no doc visit co-pays. I am so blessed-this supplemental allowed me to find the Mayo healing that is ongoing.

Sue, I agree with your friend. I am better with a fixed premium so I can budget, etc. and the no co-pays are excellent. There are months I may not have had much more medical cost than premiums, but not anymore. My medical expenses are so high and constant now, I can't possibly do with different supplemental.

Until this year, my prescriptions reached the donut hole in March each year and I paid almost nothing the rest of the year. This year, I was able to stop taking a lot of heavy and expensive meds, so I didn't stop paying a co-pay until a month ago! Good and ….just good!

I've come to the end of my savings now, so I don't know what I'm heading into. I've had several discussions with folks and I'm meeting with the bank tomorrow for a loan. I think that will get me through the next years. I plan to keep my insurance in all areas the same if I'm able.

I know many pharmaceutical companies have patient assistance programs and will provide medications to patients whose meds are out of reach. These can be very helpful. I helped a friend find and apply for several years ago when she was without insurance. I suppose they still have these programs. It requires a lot of research but then they were called patient assistance programs. She said it saved her tremendously. There were some income requirements but you never know.

Wish me luck re my hunt for funds. Have to hurry before interest rates change or I fall or whatever….blessings to you all. elizabeth

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@ess77

@sueinmn, @gingerw, @debguide, @roch, and all…I retired at 62, so I've used my savings through the last 23 years to pay for a top supplemental insurance plan, close to $300/month, plus have a dental discount plan and pay for an RX plan. This year I researched and decided I have the best supplemental possible for me and dare not change. I walk in and out of the Mayo ED or hospital stay and pay very little, few co-pays, no doc visit co-pays. I am so blessed-this supplemental allowed me to find the Mayo healing that is ongoing.

Sue, I agree with your friend. I am better with a fixed premium so I can budget, etc. and the no co-pays are excellent. There are months I may not have had much more medical cost than premiums, but not anymore. My medical expenses are so high and constant now, I can't possibly do with different supplemental.

Until this year, my prescriptions reached the donut hole in March each year and I paid almost nothing the rest of the year. This year, I was able to stop taking a lot of heavy and expensive meds, so I didn't stop paying a co-pay until a month ago! Good and ….just good!

I've come to the end of my savings now, so I don't know what I'm heading into. I've had several discussions with folks and I'm meeting with the bank tomorrow for a loan. I think that will get me through the next years. I plan to keep my insurance in all areas the same if I'm able.

I know many pharmaceutical companies have patient assistance programs and will provide medications to patients whose meds are out of reach. These can be very helpful. I helped a friend find and apply for several years ago when she was without insurance. I suppose they still have these programs. It requires a lot of research but then they were called patient assistance programs. She said it saved her tremendously. There were some income requirements but you never know.

Wish me luck re my hunt for funds. Have to hurry before interest rates change or I fall or whatever….blessings to you all. elizabeth

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@ess77 Yes, Patient Assistance Programs are often associated with the manufacturers of medications. I am working on re-upping one right now, for 2022, for my chemo medication. Without assistance, my co-pay is $3000 a month! Even reaching the donut hole, my cost would be over $1000 a month.

From the Allergy and Asthma Foundation, here is a page that offers you several options to look at for patient funding, and you may find help here. It goes way beyond medications for allergies and asthma: https://www.aafa.org/patient-assistance-medicine-drug-programs

The PAN Foundation was given to me to resource by my patient navigator from the cancer center, and may offer you some information, also. https://www.panfoundation.org/find-disease-fund/

Let me know what you decide to do, please!
Ginger

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@gingerw

@ess77 Yes, Patient Assistance Programs are often associated with the manufacturers of medications. I am working on re-upping one right now, for 2022, for my chemo medication. Without assistance, my co-pay is $3000 a month! Even reaching the donut hole, my cost would be over $1000 a month.

From the Allergy and Asthma Foundation, here is a page that offers you several options to look at for patient funding, and you may find help here. It goes way beyond medications for allergies and asthma: https://www.aafa.org/patient-assistance-medicine-drug-programs

The PAN Foundation was given to me to resource by my patient navigator from the cancer center, and may offer you some information, also. https://www.panfoundation.org/find-disease-fund/

Let me know what you decide to do, please!
Ginger

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@gingerw, @sueinmn, and all…Those are great resources. GINGER. THANK YOU SO MUCH…This will help so many. You're an angel…
I heading to bed. Yes, it's 5:37pm, east coast, but I'm beat.
Blessings and goodnight.
Elizabeth

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@ess77

@gingerw, @sueinmn, and all…Those are great resources. GINGER. THANK YOU SO MUCH…This will help so many. You're an angel…
I heading to bed. Yes, it's 5:37pm, east coast, but I'm beat.
Blessings and goodnight.
Elizabeth

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I can relate!

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@dg0797

Had to dip into savings to pay for out-of-pocket costs when my husband passed this year. A few vendors waived the balance after I provided a Death Certificate, but the majority expected payment in full. Fortunately, I am able to use payment plans with my employer for my healthcare. I'll be paying off my expenses through next year.

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Deb, this must be particularly challenging to handle in his absence over a sustained period of time. I can imagine with the holidays approaching, his absence will feel stronger. I'd like to invite you to share in this discussion:
– Grief in Times of Celebration: The Empty Spot https://connect.mayoclinic.org/discussion/grief-in-times-of-celebration-the-empty-spot/

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@roch

I have Medicare, supplemental policy and Medicare D insurance for prescriptions. Unfortunately, my Medicare Plan D does not cover many of my prescription drugs.

I use GoodRx coupons to reduce the cost of my prescription drugs that are not Tier 1. It can save me over $100 on some prescriptions. There are other programs that do similar coupons.

It takes time to research costs, what pharmacy accept coupons, etc., but worth the time to save money.

I have friends who get their prescription drugs from Canada. I have not researched that yet.

Laurie

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Laurie, you're wise to do your research on the specific pharmacy you use when it comes to ordering online. Several members have posted links to services they use. I offer these articles to help you vet reliable online services.

— Choosing a safe online pharmacy: https://www.canada.ca/en/health-canada/topics/buying-using-drug-health-products-safely/safe-use-online-pharmacies.html
— So-Called “Canadian” Pharmacies are a Danger to Consumers, NABP Reports: https://nabp.pharmacy/news/news-releases/called-canadian-pharmacies-danger-consumers-nabp-reports/

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