(Editor's Note: This is the second in a three-part series of articles on cutting your personal health care costs. The first article offers 11 tips on cutting prescription drug costs.)
Dec. 10, 2008 -- If you're watching your budget these days -- and who isn't -- you may be wondering if you can afford your doctor visits and medical tests.
Skipping those appointments could be risky. So here are 11 dos and don'ts from a cardiologist and family medicine doctor on ways to lighten the cost of your medical appointments without sacrificing your health.
1. Do follow through with preventive care.
"You've got to take care of your health, because it's your most important resource," Christie Ballantyne, MD, tells WebMD.
Preventive care is especially important in high-stress times because stress can take its toll on your health, says Ballantyne, who directs the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart and Vascular Center and is a professor of medicine at Baylor College of Medicine in Houston.
Ballantyne advises seeing your doctor to "make sure you're not having a worsening of your health due to the stress you're under."
2. Do exercise, eat right, lose even a little extra weight, and don't smoke.
A healthier lifestyle can pay off -- literally. For instance, you might need fewer prescription drugs, and you might be less likely to develop high-maintenance conditions such as heart disease, diabetes, and high blood pressure.
"It's a little bit like the saying 'An apple a day keeps the doctor away' ... a walk a day keeps the bills low," says Ballantyne, adding that you don't have to lose drastic amounts of extra weight because even modest weight loss makes a difference.
You needn't spend money on a gym; walking is free. "If you feel stressed, go out and take a walk," Ballantyne says. "You'll feel better and you will have helped lower your bill of health."
And if you quit smoking, not needing cigarette money is a financial bonus on top of better health.
3. Do negotiate with your doctor, or the financial counselor at your doctor's office, about medical test costs.
Scheduled for a costly medical test that you can't afford? Ballantyne suggests asking your doctor, "Do I have to have this test now? Could I have it next year?"
But don't skip the test without having that talk. "Discuss it with your doctor; don't make the decision yourself not to get it," Ballantyne says.
If the test is a must and you're going to have to pay for it out of pocket, Ballantyne suggests that you negotiate the test price and offer to pay the Medicare rate.
"The person without insurance or a person paying cash pays a price that no one else pays for it. The government doesn't pay it, the insurance companies don't pay it," Ballantyne says.
It's up to your doctor's office to decide whether they want to negotiate. "All they can do is say no, right? You lose nothing by asking," Ballantyne says.
4. Do maintain a medical "home."
That's your go-to place for your medical care and medical records.
A medical home isn't just convenient, says Adam Goldstein, MD, MPH, who is professor of family medicine at the University of North Carolina at Chapel Hill School of Medicine. He says that by working with providers who know you, you may be able to avoid unnecessary medical tests, which means more savings.
Getting people into a medical home "even in the face of these economic times saves so much money and resources, and it's good medicine," Goldstein says.
5. Do find out about local and state health resources.
Look into community health centers (which typically charge fees on a sliding scale), free clinics, and local or state programs for children.
Goldstein says at one of the large community centers in his area, the minimum payment is $20, which he says is far less than the $110 at an urgent care center or $120 at most doctor's offices.
If you have children and meet certain income standards, check with your state or local health department about insurance, pediatrician Andrew Racine, MD, PhD, tells WebMD.
"The first thing that I would advise people to do is to investigate what they may be eligible for, in terms of coverage, that they may not know about. ...There are many, many families eligible to be on that program who are not enrolled," says Racine, who directs the general pediatrics division at Albert Einstein College of Medicine and Children's Hospital at Montefiore in the Bronx, N.Y
6. Do pace your medical appointments.
If you see more than one doctor per year and you don't want a slew of medical bills all at once, Ballantyne suggests spreading your appointments throughout the year instead of clustering them together.
You may also be able to double up some appointments. "Having a single physician coordinating the care is going to be more cost-effective than having two or three physicians," Goldstein says.
For instance, "a woman going to an ob-gyn for a Pap smear and then going to a family doctor for monitoring her cholesterol and blood pressure -- that's just going to be twice the expense, and unnecessary," he says.
7. Do consider calling your doctor to see if you really need to come in.
"Contact your doctor if you have questions about whether or not you need to come in," Goldstein says.
But because it's just a phone call, your doctor may not feel comfortable giving you advice without seeing you.
"Most physicians are going to say if it's going to take them more than a few minutes of their time and/or they have any perception that the issue could be serious, they're going to say -- rightly so -- that the patient should come in," Goldstein says.
8. Don't dismiss your symptoms.
Of course, you should seek immediate care for possible heart attack symptoms or stroke symptoms. Time can also count for symptoms that don't seem immediately threatening, like new breast lumps or skin changes.
"I had a patient recently who noticed a mole changing and he decided to wait until he had other things going on [to see a doctor]. It turned out to be eight months, and he had large basal cell cancer above his nose next to his eye," Goldstein says.
Goldstein also knows of an elementary school teacher who didn't seek medical care for her headaches because she didn't have health insurance. "Two weeks later, she had a ruptured brain aneurysm and died in her 40s," he says. "That's just incredibly tragic."
9. Don't go to the emergency room for problems that aren't emergencies.
Because emergency rooms are overwhelmed, you may wait hours to be seen. And if you're paying out of pocket, you could wind up with "a bill of $400-$500, which you will be responsible for," Goldstein says.
Overcrowding in emergency rooms can also make it harder to deliver emergency care when it's truly needed, he says.
10. Don't skip your flu shot.
"That would be such a small cost compared to such a large potential benefit of not getting flu and the costs associated with those medicines," Goldstein says.
Of course, adults need other vaccines, too -- and as the saying goes, an ounce of prevention is worth a pound of cure.
11. Don't leave money in your flexible spending account (FSA).
Dec. 31 is right around the corner, so Joel Zive, PharmD, vice president of Zive Pharmacy in the Bronx, N.Y. and spokesman of the American Pharmacists Association, reminds you not to leave money in your FSA.
If you have an FSA to help cover your medical costs, it's "use it or lose it" -- you have to use that money by year's end or it's gone for good.