Unfortunately, not all Americans are making smart healthcare choices like Taylor's. Nearly half of us skip needed drugs, treatments, and screenings to save money, according to a recent survey by the Kaiser Family Foundation. Those decisions can be risky. "Your most important asset is your health, not your money," says health economics expert Mark Fendrick, MD, of the University of Michigan in Ann Arbor.
Don't give up medications prescribed by a doctor, but review all your prescriptions with her or a pharmacist at least once a year.
Ways to save: Follow Maria Taylor's example and choose generic drugs over name brands. (Just make sure there are no questions about the generic's equivalence to your usual drug; see PeoplesPharmacy.com for more information.)
- Ask your doctor whether there are older, effective drugs you could take. Recent studies suggest that newer, pricier meds don't always work better than the less expensive treatments they were designed to replace. In one report, older diabetes drugs were as effective as newer types that cost eight to 11 times as much.
- Negotiate. Some health insurance companies are reducing or waiving co-pays on commonly prescribed drugs; call to see if your plan offers this program.
- Split your pills. Talk to your doctor about getting a higher-dose version of your drug and slicing the pills in half with a pill splitter. (Many statins can be split; the same is true of some pills for blood pressure, depression, and other conditions.) This can reduce prescription costs by as much as 50 percent.
- Look for discounts. NeedyMeds.org is a clearinghouse for hundreds of prescription-drug-assistance programs. Many of these programs are for the uninsured, but some provide discounts for insured patients who have high co-pays or who need expensive drugs.
Don't give up regular mammograms, Pap tests, and bone-density tests, as well as checks of your blood pressure, blood sugar, cholesterol, and triglycerides.
Ways to save: Ask your doctor's office, local hospitals, and women's health centers about free and low-priced mammograms, Pap smears, and other recommended tests. Several national chain drugstores offer free drop-in screenings for cholesterol, blood pressure, and blood sugar.
- If you have no health issues, cancel your annual physical. The U.S. Department of Health and Human Services recommends this practice. In 20 years of studying physicals, government researchers found that healthy people gain no benefit from annual visits. In fact, physicals can lead to unnecessary testing that has the potential to be both expensive and harmful.
- Slow down on Pap screens. Women over 30 who have had three consecutive healthy Pap smears can limit their tests to once every two to three years.
- Pass on unnecessary heart screens. Most people don't need heart disease tests for homocysteine, C-reactive protein, coronary calcium, and a blood fat called Lp(a), says Susan Bennett, MD, clinical director of the Women's Heart Program at George Washington University Hospital. These screens make sense only if you have a family history of early heart disease in the absence of the usual risk factors, such as smoking, high blood pressure, cholesterol, and triglycerides.
Don't give up yearly eye exams if you wear glasses or contact lenses or if you have a family history of eye disease, diabetes, or high blood pressure.
Ways to save: If you don't fit into the above categories and you're younger than 65, you don't need annual checkups. The American Academy of Ophthalmology recommends an eye exam once in your 20s, twice in your 30s, at age 40, and thereafter as needed.
Don't give up your first line of defense—brushing and flossing—which can save you big bucks by preventing gum disease and cavities. Studies show that professional teeth cleanings can't make up for neglect at home.
Ways to save: If you have no chronic dental conditions, try getting just one professional cleaning and scraping a year. A review of dental studies from researchers at the University of North Carolina and in the UK failed to establish an advantage in more frequent visits. Remarkably, the review couldn't detect a difference between getting a cleaning once every six months and once every two years.
- Ask your dentist about getting the old-fashioned, silver-colored amalgam for your fillings. These cost 20 to 30 percent less than newer, tooth-colored composite materials.
Don't give up going to the ER for allergic reactions, bone fractures, deep cuts or other injuries, heart attack and stroke symptoms, and anything else that seems life-threatening.
Ways to save: In noncritical situations where you can't wait until your doctor can see you—bladder infections, bronchitis, sinusitis, strep, and deer tick bites, for example—try one of the roughly 1,200 retail health clinics springing up in drugstores and at Walmart, Target, and other stores. The clinics are staffed by nurse practitioners, physician assistants, and in some cases MDs. Most insurers cover such visits (check with your plan before you need urgent care), and the co-pay will be less than you would shell out for an ER visit. Even if you don't have health insurance, the $40 to $70 fee may be less than your doctor's fee and is considerably cheaper than the typical cost of a trip to the emergency room.