Cost sharing is the amount of money you pay out of your own pocket for medical care or prescription drugs. Understanding how cost sharing works may help you save money. Your “cost share” may include:
- Your copayment – the flat amount you pay to a healthcare provider or pharmacy at the time of service, based on your plan and the services you receive
- Your deductible – the amount that you pay toward certain healthcare expenses before your plan starts paying a share of the costs
- Your coinsurance – a percentage of the charges you may owe for services you receive once you’ve met your plan’s deductible
One simple way to save on your cost share is by making sure you get care from providers who are in your plan’s network. With most plans, your cost share will be higher if you use an out-of-network provider. And remember that your doctor is just one of your care providers. If your doctor refers you to a specialist or other care provider, check to be sure that they are in your plan’s network, as well. You can do this online at Humana.com/PhysicianFinder, or call your doctor’s office directly to be sure they’ve referred you to someone in your plan’s network.
You may be able to save on your cost share at the pharmacy, as well. If your doctor prescribes a drug, ask if a generic version with a lower copayment is available.
Knowing where to go for care when your doctor isn’t available can help you save, as well. For example, a visit to an urgent care center will usually cost less than a visit to an emergency room. And an emergency room visit to a hospital in your plan’s network will cost less than a visit to an out-of-network hospital. So your share of the cost will be lower, as well, in both of those cases.
The best time to find an emergency room in your plan’s network is before you need one! Most plans cover emergency room care for true emergencies regardless of whether it’s in or out of your plan’s network. But if you need to be admitted to the hospital for further treatment or need after-treatment care, your share of the cost will be lower at a hospital in your plan’s network.
Finally, know your plan and what it covers. One of the easiest ways to do this is to register for a secure, online account at MyHumana.com. That way, you can access your personal plan information anytime you need it.