How to choose the best, cost-effective health insurance

The No. 1 cause for personal bankruptcy in America today is medical bills. Medical errors account for 250,000 fatalities a year and are the third leading cause of death in America. You don’t want to be a victim of these misfortunes.

Simple-to-implement strategies for obtaining high-quality medical care include:

◆ Choose as your physician or primary care physician someone you believe is truly invested in your health over the long term and assumes the critically important role as health care coordinator.

◆ When you are well and thinking clearly is the best time to plan what emergency department and hospital to use should misfortune strike. You don’t want an ambulance driver to be solely responsible. You may have some influence over the decision.

◆ Thirty percent of second medical opinions discover a correct diagnosis or a better treatment plan. Consider obtaining a second medical opinion from a medical specialist, which may save both your life and money when your diagnosis is still not determined; you are not recovering satisfactorily from an illness; or your intuition and family encourage you.

◆ Consider enlisting a knowledgeable family member or an agency to be the health care advocate (“guardian angel”) for an impaired family member or friend, especially if he/she lacks a good support system.

To reduce the cost of insurance and out-of-pocket medical expenses:

◆ Consider obtaining health insurance from the Affordable Care Act insurance exchange (beWellnm.com, healthcare. gov or insurance agent) if you don’t have insurance from your employer, government insurance (e.g., Medicare, Centennial Care) or are under your parent’s insurance (if you’re under age 26).

◆ If your yearly income is below a certain amount, you may qualify for a federal tax credit or subsidy, to pay a good portion of the cost of an ACA policy available on the insurance exchange (Check the internet for “The Premium Tax Credit — The Basics”). Medical clinics, like La Familia Medical Center, have specialized staff to help you apply for an ACA-approved policy and for Centennial Care.

◆ If you can’t afford an ACA plan, consider an inexpensive, insurance policy promoted by the Trump administration. But read all the fine print. They do not cover preexisting illnesses and have many limitations. Don’t confuse these inexpensive $99 or less per month policies, which are not available on government exchanges, with ACA-approved policies. But having an inferior policy may be better than having no insurance at all.

◆ Make certain the health professionals, hospitals and facilities you use are all “in-network” with your insurance; otherwise, you’ll be financially responsible and receive expensive “surprise” bills.

◆ Review your medical bills very carefully for errors (very common). Hold off paying your portion until your insurance has paid fully for the portion for which they are responsible.

◆ Consider insurance with a higher deductible (especially if you are healthy), which is usually less expensive and may qualify you for contribution into a health savings account, which is tax deductible. Money can be withdrawn tax-free if used for medical expenses.

Good luck in searching for the most cost-effective insurance and keeping down your out-of-pocket expenses.

Dr. Lawrence Lazarus is a practicing physician who lives in Santa Fe.

Dr. Lazarus and his co-author Dr. Jeff Foster published the recent best-seller, Insider’s Guide to Quality, Affordable Healthcare. Their 3-year-old, free, interactive website, www.qualityaffordablehealthcare.net, provides bimonthly, informative, health care updates and encourages questions from readers.