Nurse practitioner offers three easy ways to save more money in healthcare

Seven out of ten Americans believe the healthcare system is in crisis or has major problems, according to a November 2024 Gallup poll on American healthcare. Americans’ ratings of healthcare quality have been declining for the past 24 years. Increasingly, Americans find themselves spending too much on insurance for inadequate coverage. 

“When it comes to healthcare, especially health insurance, the deck is definitely stacked against a lot of people. Healthcare has changed from being patient-specific to insurance-specific,” said Jessica Knapp, a nurse practitioner at IU Health Ball Memorial Hospital. 

Knapp has worked in healthcare for 17 years in eight different labs. She has observed changes in the field since she was a girl. 

“I was sick a lot as a kid, in and out of the emergency room a lot. I have fond memories of people who have worked in healthcare, which gave me a drive to work as a caretaker,” Knapp said. 

Knapp shared three ways Hoosier patients can ‘beat the system’ without too much work. 

Tip #1 - Find an affordable insurance plan 

Knapp does not recommend that they go uninsured if they can afford it. 

“I am a cancer survivor. You never know when something like that is going to come up. If you don’t have insurance, it’s too late to get it,” Knapp said. It’s hard to sign up for insurance if it isn’t during the open enrollment period, which typically runs from early November to late January. 

Knapp defines health insurance as ‘an investment in your health and yourself.’ While it might seem counterintuitive to pay monthly premiums, emergency hospital visits can amount to thousands of dollars. A survey by U.S. News revealed that 40% of Americans cannot afford a $1,000 emergency expense. Health insurance can take care of the most expensive bills with the right coverage. 

Because of the Affordable Care Act (ACA), dependents under 26 are allowed to remain on their parent’s healthcare plan. Otherwise, they’ll need to get it through their employer, the ACA marketplace, or apply for a public healthcare plan like Medicaid. 

“Most of our issues locally are not related to governmental changes but instead employment changes,” Knapp said. According to a survey by Statistica, 53% of Americans receive health insurance from their employer. In Muncie, this number is potentially lower. 

According to the U.S. Bureau of Labor Statistics, Muncie’s unemployment rate in 2024 was around 5.4%. Nationally, this number is around 4%. 

If employers don’t offer health insurance or don’t offer good coverage with their plans, patients have to find healthcare in other places. They can apply for coverage in the Health Insurance Marketplace. Healthy patients who expect to visit the hospital less should consider a High Deductible Health Plan, which has lower monthly payments but higher out-of-pocket costs when patients visit the hospital. Preferred Provider Organizations and Health Maintenance Organizations are the opposite, with lower out-of-pocket costs and higher monthly premiums. 

If the plans on the ACA marketplace are unaffordable, patients can apply for Medicaid anytime. To qualify, single patients without children must make less than $1,670 per month. More qualifications can be checked on Indiana Medicaid. 

“Added barriers to receiving benefits only increase the likelihood of an eligible person going without care, simply because the system is too difficult to navigate,” said Jessica Rosales, a Community Health Worker who helps patients navigate expenses at Open Door. Because of these restrictions, it’s best to get private insurance when it’s affordable. 

Tip #2 - Utilize preventative healthcare services 

Markie Oliver, who worked as a paramedic for over a decade, said many people use the emergency room as their only way of receiving healthcare.  

“If you’re uninsured, don’t avoid getting healthcare (when you need it). It’ll cost you a whole lot more later, or your life,” Oliver said. If a patient sees a physician before a problem becomes critical, it can save money in the long run. 

Knapp agrees with Oliver. She describes Ball Memorial’s emergency room as incredibly busy and lacking sufficient staff to keep up. She suggests seeing a primary care physician or visiting urgent care as alternative options, even for uninsured patients, since these can be more affordable, especially if issues are addressed before they escalate into emergencies. 

If a patient cannot afford healthcare elsewhere, Federally Qualified Health Centers like Open Door and Meridian Health Services can help reduce costs. 

“We offer discounts/payment options as well as an array of support services to help find creative solutions to barriers to care,” Rosales said. 

WellNow Urgent Care is located at 1313 W. McGalliard Road, IU Health Urgent Care is at 2598 W. White River Blvd. and Open Door Urgent Care is at 1651 E. 29th St. 

“Eat healthier. Don’t smoke. Go to the gym. Try to live a healthier life to be less reliant on the healthcare industry,” Knapp said. She also recommends coming to Ball Memorial's health fairs, where services can be provided at a free or reduced price. 

Deciding whether to go to urgent care or the emergency room can be difficult. Oliver recommended calling Blue Cross Blue Shield’s toll-free 24/7 Nurse Hotline to make the decision. Generally, if symptoms include chest pains, trouble breathing, heavy bleeding or dangerous intrusive thoughts, the emergency room is the right choice. 

Tip #3 - Be your health advocate 

“It is impossible to meet a need that is not spoken. If a suggested resource or treatment doesn’t work for your situation, share that with your provider or support staff,” Rosales said. While physicians are experts, sometimes there are other options than the first suggested treatment. Rosales stressed the importance of taking charge of your health. 

Knapp stressed the importance of every patient understanding their health history. 

“I understand some people have a hard time with all the diagnoses,” Knapp said, recommending writing diagnoses, medications and allergies down on a piece of paper and bringing it with you. She says the most important thing you can do is “try to educate yourself and be your own advocate for your health.” 

Oliver stressed the importance of understanding your health insurance plan and what it covers. Different plans will have different physicians be cheaper than others - people known as in-network physicians. 

“Insurance companies make plans very complicated,” Oliver said. It can be difficult to know what procedures are covered and what aren’t. Researching what exactly is covered is important. 

It’s also important to try to reduce costs. Oliver says, “the healthcare system in this country is broken.” Private insurance companies are not being a part of the solution. 

Physicians have to change what they’ll do for patients based on what insurance is willing to cover. Knapp says this is ‘not in the best interest of patients.’ 

“You’ve got patients that need medications and they aren’t able to afford them because their insurance won’t pay for it. Then, you’ve got those same patients utilizing the emergency room heavily because they don’t have their necessary medications,” Knapp continued. “Are we really taking care of our patients and providing them with the services they need? It’s a difficult space to be in as a provider.” 

Even with physicians resisting unexpected changes in coverage, the outcome is not always ideal. 

“Sometimes that whole process can take weeks and weeks, and then you’ve got a patient with these ongoing complaints. It’s very frustrating,” Knapp said. Sometimes, physicians lose the fight with insurance. 

“Do not be afraid to advocate for the care you deserve. Lacking health insurance or the means to pay high medical bills should not keep people from accessing preventative services that would drastically improve their quality of life,” Rosales said. 

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