Mr. Tightwad’s tips to trim your health care expenses

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Mr. Tightwad isn't a doctor, nor did he stay at a Holiday Inn Express last night, but he does know how to save money on medical expenses.

Updated: February 28, 2012 8:00AM

Health insurance can be crazy expensive, but you don’t have to get caught with your pants down.

Between insurance premiums, doctor co-pays and prescriptions, more and more of your hard-earned money is going toward keeping that ticker ticking and that blood pressure down. And it’s only going to get worse.

A White House report states that from 2009 to 2010, the percentage of family income devoted to health care costs rose from 5.3 percent to 5.9 percent.

And if you’re an old Tightwad, the news is even worse. In the next 30 years, the median annual real out-of-pocket costs for Americans age 65 and older will more than double in constant 2008 dollars, from about $2,600 to about $6,200, according to a report from the Urban Institute, a nonprofit, nonpartisan policy and research group. On top of that, nearly 1 in 10 older adults will spend more than $14,000 per year on health care in 2040.

So that’s the bad news.

The good news is there are a few ways you can cut down your out-of-pocket expenses without having to drive to Mexico to get your prescriptions filled on the cheap en la farmacia.

Get a free discount prescription card from Coast2CoastRx.com.

While these are intended for people without insurance, you still can get one if you have insurance, which is good if it’ll get you prescriptions cheaper than it would otherwise with your current plan. The card works at more than 59,000 pharmacies and it claims to get you a discount up to 95 percent ... but it’ll most likely be less than that. While you do have to register under one of the cities, states or townships listed, you don’t have to live in one of them to actually use the card. Yes, it sounds too good to be true, but our own Phil Kadner looked into it awhile ago, and it’s legit.

Negotiate, negotiate, negotiate.

You might feel a bit awkward negotiating with a doctor the same way you do at the flea market, but if you don’t have insurance, it’s the way to go. Ask the doctor or hospital to only charge you the insurance reimbursement rate — what they actually get paid from insurance providers — and is only a percentage of their standard billing rate. This actually works. A few years back, Mr. T had a short span where he was uninsured because of a job change and there was a mandatory waiting period before he could get on the company insurance. And of course that’s when he had a nasty bout with kidney stones.

All he had to do was ask the doc for the discounted rate and magically, he got it.

Don’t be afraid to go to the doctor.

Medicaid and most private health insurance companies offer free annual wellness checkups.

Yes, you might get bad news. But catching a serious problem sooner can save you a whole bunch of money later in the form of a quicker cure.

Ditch the standard health insurance.

OK, this takes some risk assessment on your part. But the payoff can be huge.

If you rarely, if ever, go to the doctor, are in good health and have a clean family history, you can consider dropping your standard health insurance and instead purchase a catastrophic policy. These are significantly cheaper because they have very high deductibles and only get used in the case of a serious and costly illness.

You’ll have to pay for regular doctor visits and prescriptions out of your pocket. Take the money you’re saving on insurance premiums and set it aside for these expenses. And you can also use tips No. 1 and No. 2 to reduce your personal outlay.

Ask your doctor for free samples.

They get drug samples all the time from their medical suppliers. Especially if you’re going on a new drug that has side effects, it’s a good way to try it and not be left paying for a prescription your body can’t handle. Mr. T’s Teenie Tightwads had a handful of issues as babies, and our pediatrician was great about loading us up on samples, saving us a ton of cash. Again, if you ask, they’ll try to help you.

Cut your pills to cut your bills.

If you’re on a maintenance drug, ask your doctor if it’s a pill that can safely be cut in half and then taken.

By doing this, they can double the dosage and you can cut it in half to double the life of that one prescription.

This is great because on most drugs, the higher dosage versions are only marginally more expensive.

Mr. T cannot stress this enough ... only do this after talking to your doctor or pharmacist, because cutting some pills can be harmful to your health.

The somewhat extreme, but yet big money-saving tip.

Need to have major surgery but can’t afford to have it done locally?

Whether you need heart surgery, major dental work or are looking to tuck some of your parts back to their original positions, traveling abroad to get it done can save some serious cash.

A report from Reuters indicated Americans can save an average of 40 percent to 50 percent. It’s hard to argue with the numbers in some of these situations: An average heart bypass here costs $144,000, but only $25,000 in Costa Rica and $5,200 in India. And a hip replacement here will set you back $50,000 vs. $6,200 in India. Best of all, some insurance carriers will provide coverage for these out-of-country surgeries, cutting their costs in addition to yours.

Order your maintenance drugs through the mail.

If your insurance provider allows you to use mail-order pharmacies, you can often get a three-month supply for the same amount of money you’d fork over for a one-month supply at your local pharmacy. And the savings add up. According to a Kiplinger report, if you’re on Crestor, doing it this way would save you more than $1,000 a year — $1,000 you can apply to that $5,200 heart bypass surgery you might be having down the road ­— and across the world in India.