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Affordable Health Insurance - 15 Ways YOU can make your Health Care more Affordable

Employers and consumers alike are asking why the cost of health care coverage keeps increasing.

With millions of Americans without coverage, millions more who are struggling to maintain the coverage they have, and employers facing difficult choices over whether to reduce benefits or pass on higher costs to their employees, controlling the cost of health care coverage is one of the most important challenges we face in this country today.

Yet, this question is actually misplaced. Health care premiums are really a marker for the cost of care, and increasing premium rates are just a symptom of the real ailment—the rising cost of health care.

Many Factors Contribute to Rising Health Care Costs:

  • An increasing demand for health care services driven by better informed consumers, easier access to health care, an attitude of consumer entitlement and an aging population.
  • Advances in technology such as new surgical procedures, diagnostic equipment, as well as outpatient facilities and procedures.
  • Pharmaceutical advances and spending. Biologic agents to treat conditions such as rheumatoid arthritis, multiple sclerosis, and cancer are the fastest growing component of health care costs today.
  • The development of unhealthy lifestyles in America leading to obesity, lack of exercise, high tobacco usage rates, and other poor life choices which in turn increase the incidence of chronic diseases such as heart failure, coronary artery disease, diabetes and asthma.
  • Physician shortages and high medical malpractice insurance rates, causing physicians to practice “defensive medicine” as a result.

Some of these factors are difficult to influence, and one would certainly argue that medical advances are a good thing — improving the quality of our daily lives, and ultimately prolonging our lives in many cases. But these “good things” are becoming increasingly expensive, forcing us all to be more conscious of the care we receive and its cost to the system. We all need to be as informed as possible about the alternatives and costs of our health care. The responsibility of controlling your health care costs is in your hands.

What can YOU do?

1. Exercise Regularly
Studies have shown that consumers who exercise regularly use less health care. Join a health club, exercise with a friend, or develop a program of your own — but do something. Even low-intensity activities, performed for as little as thirty minutes a day, will promote healthy benefits. Exercise benefits exist even in pleasure walking, gardening, yard work, housework and dancing.

2. Diet and Nutrition
Eating a healthy diet can reduce body fat, cholesterol and high blood pressure — all indicators for chronic diseases such as diabetes, congestive heart failure and others. Obesity has become a national epidemic in America and heart disease has now become the leading killer of women in this country, causing more deaths each year than all forms of cancer combined. Ample information exists for consumers to follow regarding the importance of healthy diets and proper nutrition, including how to achieve results.

3. Preventive Health Services
Take advantage of benefits for periodic examinations, immunizations, screenings and routine tests. These benefits save money in the long run through the early detection of serious or chronic conditions which are more costly to treat. And more importantly, the early detection of a serious condition could save your life. Recommended screenings are listed within this brochure.

4. Stop Tobacco Usage
By now, the dangers of tobacco have been made abundantly clear to us all. If you don’t use tobacco, don’t start. If you do, quit now. Several effective programs exist to help you. Take advantage of them.

5. Prenatal Care
Expectant mothers need to receive proper prenatal care. Many pre-term labors, c-sections, and low birth weight babies, which are accompanied by higher medical costs, can be prevented. Take advantage of the prenatal care benefits of your DAKOTACARE group or individual plan and enroll in Prenatal Partners, a free* program offered to DAKOTACARE members which improves the probability of normal births and healthier babies.

6. Get Informed
Take responsibility for finding out about conditions that affect you. The availability of medical information today is like no other period in our history. Talk with your physician and be proactive about your care. Don’t be afraid to ask questions if you don’t understand your treatment or the options available to you. Ultimately, your care is your business.

7. Wear Seat Belts & Helmets
In addition to saving your life, the benefits of always wearing your seatbelt and wearing helmets when riding a bicycle or motorcycle are indisputable. Serious accidents result in serious medical costs, and much of these costs can be prevented by the use of these important safety devices.

8. Don’t Drink and Drive
Lives are lost and permanently affected by the tragic occurrence of drunk driving accidents. If you drink, drink responsibly and use designated drivers when necessary to avoid the terrible, yet avoidable consequences and costs associated with drunk driving.

9. Manage Stress
Studies continue to point out the health care costs associated with too much stress in our lives. Learn to manage stress through classes, techniques you can perform on your own, or other stress-reducing activities. Get 7-8 hours of sleep per day for optimum physical and mental health. Everyone responds to stress in their own way. Learn what works best for you, and use it consistently when you feel stress in your life.

10. Disease Management Programs
DAKOTACARE has developed several disease management programs designed to take a proactive approach to chronic health care problems. These programs are proven to reduce costs and increase the health of our members by identifying risk factors associated with increased cost, and aggressively addressing those factors before expensive problems develop. Free* programs for members of a DAKOTACARE group or individual plan include Heartline for cardiovascular disease, Diabetes Care, Asthma Care and Prenatal Partners. In the near future, programs will also be available for obesity, depression and congestive heart failure. Enroll in one of these programs today if you are at risk for one of these conditions and enjoy the benefits of improved health and lower health care costs.

11. Avoid the Emergency Room When Possible
Hospital emergency rooms are highly expensive and often unnecessary. During evenings and weekends when your physician is not available, the best alternative can be an “after-hours” or “urgent care” clinic (if available in your area). Save the emergency room for critical injuries and conditions where hospitalization is a possibility. Ask your family physician for the facility nearest to you.

12. Utilize Self-Help Resources and Medical Help Lines
DAKOTACARE’S Taking Care** program offers members an opportunity to save health care dollars by avoiding unnecessary medical expenses. Monthly newsletters offer useful health tips and information, and the Taking Care of Yourself guidebook provides a resource for home treatment of common ailments that may seem serious at first, but may just be a minor discomfort. Free medical help lines are also available in most areas. Double-checking with an expert can save time, money and hassle. Ask your employer how to access the Taking Care program.

13. Use Generic Drugs When Available
Use generic prescription drugs instead of brand names when possible. Generic drugs are much less costly in most cases and are usually just as effective as brand name drugs. A generic version of a brand name drug works like the brand name in dosage, strength, performance and use, and must meet the same quality and safety standards established by the FDA for brand name drugs. Pharmaceutical companies spend millions of dollars in research, development, marketing and advertising of brand name drugs. Generic manufacturers have much lower costs, and these savings are passed on to you. Copayment levels on all DAKOTACARE pharmacy plans reflect the lowest out-of-pocket costs to you if you purchase generic drugs. Ask your physician for available generics with every prescription.

14. Understand and Utilize the DAKOTACARE Drug Formulary
DAKOTACARE has produced (through a committee of physicians and pharmacists) a list of approved drugs called a formulary. The most up to date formulary is available on our website. Refer to the formulary to help you make informed choices about your pharmaceutical purchases. Discuss the formulary and your options with your physician during your appointments. The DAKOTACARE Drug Formulary*** is an important tool in controlling prescription drug costs.

DAKOTACARE’s website contains a multitude of information you can utilize to understand your benefits and get the most of your health care dollar. Links to health-related websites are available for you to research various aspects of your health, descriptions of plan benefits, interactive directories of participating providers, drug formularies, as well as drug cost comparison and drug interaction tools are all available to help you become a wiser health care consumer.

The responsibility for controlling health care costs is in your hands

Ultimately, the power to control health care spending lies with each of us as consumers. As employers shift more of the cost of premiums and out-of-pocket amounts to employees, individuals are becoming more aware of the true costs of health care. Individual education, therefore, is the key to making wise health care choices which will result in the greatest measure of control over the growth of health care expenditures now and in the future.

DAKOTACARE is committed to improving the health of its members by educating you about the choices that are necessary, and giving you the tools to help you make those decisions.

*Employer fee for DAS groups.
**Taking Care publications are copyrights of Optum.
***Formularies, if applicable, may vary based on line of business.

© 2008 DAKOTACARE — All Rights Reserved