Health insurance deductibles are rising in 2017, with average deductible costs expected to top $6,000 for those with coverage through the Obamacare marketplaces and $1,500 for those with employer plans. Paying thousands before insurance starts picking up the tab is enough to strain any budget -- especially if you have multiple family members who need medical services and have individual deductibles to meet. 

Going to the doctor for annual exams and health problems is not an optional expense, so finding a way to keep costs down is vital. Here are five ways to make your medical service as affordable as possible -- even if you are stuck with a high-deductible plan. 

Doctor holding a miniature heart

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1. Know if you have any covered benefits 

If you have a high-deductible plan, you may assume you'll have to pay for all your costs until you meet the deductible. This is not necessarily the case. The Affordable Care Act, popularly known as Obamacare, requires insurers to cover certain preventive-care services, even if your deductible is not met. These services -- which include vaccines, birth control, and screenings for cancer, HIV, and other conditions -- are provided at no cost. 

To take advantage of free services, know the caveats. Free services are only free if you visit an in-network doctor -- a doctor who participates with your insurer -- and receive only the preventive care. If you go for a flu shot and discuss a nasty cough on the visit, you're now getting "evaluation and monitoring services" -- which means you'll probably get a bill for your doctor's diagnostic services.

Any care that goes beyond the basic preventive service will trigger fees, so tell your care provider you don't want anything done that isn't covered unless you're told about extra charges and agree to pay. 

2. Shop around for lower-cost care

If you're having a serious medical emergency, get help right away. But if you need an exam or have a more minor health issue, it's worth shopping around among different providers. Retail clinics, for example, may cost less than pediatricians for a simple case of strep throat, while filling prescriptions online could be cheaper than your local pharmacy. Sites like Fair Health and Healthcare Bluebook provide a starting point for researching what a procedure should cost.

When shopping for care, it's often best to choose an in-network doctor, rather than an out-of-network doctor, as insurers will have negotiated rates with in-network doctors. You'll benefit from the discounted rate, even if you end up footing the whole bill because you haven't yet met your deductible.

3. Make sure care you get counts toward your deductible

When you pay for care, you want the costs to count toward your deductible. This means making sure you see the right doctor, that the doctor submits a claim to the insurer, and that the care is classified correctly so it is covered.

You may have a separate in-network and out-of-network deductible, and the out-of-network deductible is probably higher. If you see both in-network and out-of-network doctors, it will be harder for your total healthcare spending in either category to reach the deductible amount. 

Out-of-network doctors may also charge higher fees for services than the maximum the insurer will pay -- $500 for a service the insurer only pays $300 for, for example. You'll likely have to pay the extra $200, and that money will not count toward your deductible.  Ask up front about total fees and review your policy or call your insurer to find out what portion of your payment counts toward the deductible. 

4. Enlist the aid of your doctor

Researchers from Duke University analyzed 1,800 conversations patients had with their doctors and found that cost came up only 30% of the time. When patients and their doctors discuss costs of care, big savings can result from the conversation. "Almost half the time that costs come up in conversation, either the doctor or the patient [comes] up with some strategy to lower the patient's out-of-pocket cost," according to Duke's Professor Peter Ubel. "And it doesn't take long, usually less than a minute."

Doctors can often provide information on lower-cost prescriptions or help patients time procedures so the care can be provided after a deductible has already been met. The spacing of follow-up care can also be adjusted so patients have slightly fewer appoints and pay less in co-insurance and co-pay expenses. 

5. Use an HSA

One of the best ways to lower costs is to let the government subsidize your spending by giving you a tax break. You can open a Health Savings Account (HSA) at many financial institutions, including banks and brokerage firms, as long as you have a high-deductible health plan. As of 2017, you are considered to have a high-deductible health plan if your plan has a deductible of at least $1,300 for an individual and $2,600 for families

You can make tax-free contributions to an HSA of up to $3,400 for individuals or $6,750 for families. Catch-up contributions of $1,000 are available for those aged 55 and older. Qualifying health expenses may be paid out of your HSA. If you do not use the funds in the account, they may remain invested until you need them. You can pay deductibles, co-pays, medical-care costs, prescription expenses, and other care costs not covered by your insurance using pre-tax funds -- making your total costs cheaper and your care more affordable.

If you combine other cost saving techniques with the use of an HSA, managing your care costs is a lot easier -- even as your deductible creeps upward. The key is to look for ways to save at every step in the process so you can get high-quality care while keeping more cash in your pocket.

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