Forty-seven million Americans have no health insurance, but there are also 50 million Americans including 30% of adults over age 65—who are said to be "underinsured." This means that their insurance does not sufficiently cover some key aspect of medical care, such as physical therapy, psychological counseling or prescription medication. If you don't have health insurance-or it's inadequate-it can be tempting to respond to those ubiquitous advertisements for "discount" medical cards. With come-ons like "Discounts of up to 60%" and "No deductibles or co-pays," these services sound like the answer to your prayers. But are they? What you should know…

  • Medical discount cards are not health insurance. Medical discount providers make arrangements with doctors, dentists, pharmacies, hospitals, chiropractors and other providers to offer a discount off their normal retail prices for services. But you still must pay the bill out of your own pocket. In addition, most medical discount cards charge a monthly fee ($9.99 to more than $50) for the use of their services.
  • Discounts may not be worth it. Over the years, several states, including New York and Florida, have investigated some of the companies providing medical discount cards and found that many offer only small-or no-savings.

Example: If the doctor you see offers a 10% discount, and his/her fee is $100 per visit, you save $10 per visit. But if the card fee is $10 per month, you won't save anything unless you see the doctor more than 12 times per year! The discounts also can vary widely from provider to provider, making it difficult for you to get the best use out of the service unless you invest considerable time in finding the best discounts. Eyeglasses, medical equipment and foot care are among the few instances in which a valid discount card may be worthwhile.

  • Provider lists are often out-of-date. Medical discount plans give clients a list of participating providers. But quite often, those lists are outdated, or the providers accept only a limited number of customers from one card sponsor. If you are considering signing up for a card, be sure that the providers or pharmacies that you want to use participate in the discount plan. Call each provider and ask if he accepts the card, what the discounts will be and the retail prices for the services that you are most likely to need.
  • You can negotiate discounts yourself. Most people don't realize this, but many doctors, dentists and other providers will offer a discount if you ask-particularly if you are a longtime patient. For example, a doctor may charge a discounted fee for a physical exam, while a dentist may discount fees for fillings and crowns. AARP and other organizations, including drug companies, have discount programs for medications that are worth checking out. Many pharmacies also have their own discount plans, with discounts ranging from 10% to 70%, depending on the drug and whether it's a brand-name or generic. By negotiating your own discounts with your health care providers, you cut out the middleman fee, which means you'll receive the greatest possible savings.

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