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Avoid handing over heaps of cash for medical expenses when you don’t have to.

By Jennifer Chesak
March 16, 2021
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We don't typically enjoy the feeling of parting with our hard-earned money. But paying for a vacation is decidedly a different feeling than forking over funds for a trip to the doctor—where you'll inevitably suffer the cold stethoscope to the chest, or worse.

Medical appointments can add up fast and put anything from a small nick to a giant dent in your budget. Here are a few ways to save on those clinic visits—so you can still go on that vaycay. And/or put groceries in your pantry and pay your rent.

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Credit: Getty Images

1. Access free or sliding-scale services

First, it should be noted that nearly 30 million people in the United States don't have health insurance because of a lack of affordable options, according to the Kaiser Family Foundation. And even when they do have coverage, not all folks can pay for basic services. Those out-of-pocket expenses can still be steep. If you don't have health insurance or can't afford copays, you still have options.

The U.S. Health and Human Services Health Resources Administration has a directory of health centers that offer care on a sliding-fee scale. You can get care without insurance and even if you cannot pay. Additionally, Freeclinics.com has location-based search options for finding free and sliding-fee scale clinics in your area.

Many state, territorial, and local health departments also offer free services, such as vaccination, STI testing, birth control and other family planning, and assistance for those who are pregnant or nursing (along with care for their infants). And the Centers for Disease Control and Prevention (CDC) offers a list of LGBTQ+ resources, with links to several free LGBTQ-friendly clinics and services around the country.

If you are an American Indian or Alaska Native, Indian Health Services (IHS) has Tribal and Urban Indian Health Programs offering a range of health care options. You won't have to pay for services under IHS or when IHS refers you to a provider under its referral program.

Sliding-scale fees are also often available for many services at private clinics, including those for mental health and integrative medicine. If you're interested in seeking services from any clinic, but you're not sure about affordability, just ask.

2. Avoid the ER if it's not an emergency

Some health events absolutely require a trip to the emergency room. If you are experiencing a medical emergency, never hesitate to go. Under the Emergency Medical Treatment and Labor Act, you cannot be refused emergency medical treatment even if you do not have insurance or cannot pay.

If you're not experiencing an emergency and you're dealing with an uncomfortable situation that's occurring after hours, urgent care will generally be the cheaper option by far, according to a study in the Annals of Emergency Medicine. A walk-in clinic might also provide a source of relief that won't break the bank.

As long as you're not experiencing an emergency and you can wait it out until you can see your primary care doctor, that will likely be your cheapest bet. But some things can't wait, so don't hesitate to get the care you need when you need it.

3. Try telehealth options

Telehealth apps were gaining some steam well before the COVID-19 pandemic, but that business is now beyond booming. And part of the reason is because patients are liking the convenience and cost savings.

"Telehealth is often more affordable than in-person visits," says Benjamin Lefever, CEO and founder of Certintell, a telehealth company that partners with community-based organizations. "Many health care providers simply charge one flat fee. Telehealth can also save you time. The average telehealth visit only takes about 15 minutes. An in-person visit takes an average of 2 hours, even though you only spend 20 minutes with the doctor."

That time-saving aspect of telehealth provides its own value. "For example," says Eric Bacon, president of AMD Global Telemedicine, "not having to use 2 to 4 hours of vacation time for your own—or a loved one's—in-person doctor's appointment."

So which telehealth options should you try? Here are a few to consider. Teledoc is a free app, and appointment fees are based on your health insurance plan. You can opt for video or just voice chat and access a variety of medical specialists. If you tend to use telehealth a lot, K Health offers a membership option at just $9 a month. Or you can pay a one-time $19 fee, which is usually lower than many insurance copays.

K Health focuses on concerns you'd tend to see your primary care physician for but also some mental health issues, such as anxiety and depression. The app just launched a version for parents who are looking for quick access to a pediatrician for their kiddos age 3 and up.

Nowadays, there are also specialty telehealth apps that can customize treatments for several issues. Examples include Apostrophe for some dermatology needs, Cove for help with migraines, and Evernow for managing menopause. "Evernow is building medicine for women on their terms," says Dr. Alicia Jackson, Evernow's founder and CEO, "for their goals and needs when they need it, where they are, how they want it delivered."

Apps that home in on specific issues rather than focusing on all areas of health can help patients get fast, efficient care. "We are now living in a time where turning to telehealth for specialty care is going to not only save money but time and headaches as well," Jackson explains. "We're seeing multiple ways that women nationwide are able to get more personal and streamlined care to critical health moments such as menopause."

A big benefit of using a specialty telehealth app is saving money on repeat in-person appointments. "If you have side effects or misunderstood a dosing instruction," Jackson says, "you shouldn't have to worry about the extra spend it will require to reconnect with your doctor for a follow-up consultation."

4. Put your pre-tax dollars toward health care.

You can also save money by leveraging some tax advantages. If you have employer-sponsored health insurance, you can use a Flexible Spending Account (FSA) to pay for qualifying health care costs, such as copays and deductibles. "Funding an FSA is done through a salary deferral, which reduces your overall taxable wages," says Brian Wainscoat, CPA, senior tax specialist at Personal Capital, an Empower Company.

You read that right. You do not pay income tax on the money that you contribute to your FSA. Your employer may also make contributions. An FSA has a $2,750 contribution limit per year per employer. The FSA money does not roll over to the next year, so you want to make sure you fund it carefully and spend it. But employers often offer a grace period into the next year or partial amount carryover options.

5. Plan ahead for health expenses.

Health Savings Accounts (HSAs) also allow you to use tax advantages to pay for qualifying health care expenses. In a nutshell, they reduce how much you owe on income tax by directing funds toward your health—a win-win.

"HSAs actually are a great tool to help save money on routine health care costs while also preparing for unexpected medical emergencies," says Sherry Olson, vice president of HR of WEX's benefits division.

You can contribute to an HSA only if you have an HSA-eligible high-deductible health care plan. HDHCPs often have lower premiums at the expense of high deductibles, meaning you're stuck paying the bulk of your medical expenses until your high deductible is met. But if you contribute to an HSA, you can use that account to pay for your copayments, your medical bills that count toward your deductible, and your coinsurance (the percentage of health care costs you're responsible for after your deductible is met).

Olson offers a whole list on Wex of HSA-eligible expenses—from acupuncture to X-rays. "Telehealth is a recent addition to the list of HSA-qualified medical expenses," she explains. "And many people don't realize that things like mental health services, stop-smoking programs, and telephone equipment for people with hearing and speech disabilities are also covered by an HSA. The more people know about HSAs, the more they will find ways they can use one to save on health care expenses and prepare for the unexpected."

The IRS sets contribution limits, but it pays to fully fund your HSA each year if you can. "The biggest mistake employees make with their HSA," Wainscoat says, "is not funding it enough. If you're in a high-deductible health plan, it makes sense to open an account, since your money is carried forward and accumulates. Your contributions can be invested and withdrawn when you need them for medical expenses." And your contributions are deductible when you file your taxes, even if you claim the standard deduction.

"Your health is priceless," says Colleen McCreary, Credit Karma's chief people officer and financial advocate, "whether it's your physical, mental or emotional health. Investing in your health can actually end up saving you money down the road if you put a strategy in place that works for your finances."