How to spend less on health care

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Fuel isnt the only staggering expense chomping at your income.Health care spending in America jumped 7 percent in 2007  twicethe rate of inflation  to $2.3 trillion, according to preliminaryfigures from the nonprofit, nonpartisan National Coalition onHealth Care. Thats $7,600 per person.

Small wonder that health is the third core reason whyowner-operators fail, behind only poor truck maintenance and a lackof business skills. A truck driver can find a way to pay a $3,000bill. They can set up a payment plan, says Dennis Carter, aninsurance consultant with Adrian & Associates who works closelywith trucking financial services company ATBS. But a $30,000 billwill kick them off the road.

For health care costs, as with fuel costs, truckers seem to have abulls-eye painted on their chests. Theyre surefire targets forobesity and therefore sleep apnea, high blood pressure, diabetes,high cholesterol and heart disease, says Dr. John McElligott,medical director and CEO of Knoxville, Tenn.-based ProfessionalDrivers Medical Depots. Thats because of the nature of theprofession: long hours sitting behind the wheel, lack of exerciseand the unhealthy nature of most foods available to on-the-godrivers. The Occupational Safety and Health Administration has putthe average life expectancy of a trucker at 61, or 15 years lessthan the average American male.

Most over-the-road drivers rarely have the time even to see afamily physician at home, much less a doctor while on the road,says McElligott. Most also lack the desire for a disciplinedapproach to diet and exercise.

Not so with owner-operator Juan Astudillo of Laredo, Texas, a truckdriver for 12 years. He walks laps around his truck whenever itsparked and opts for the rear of the parking lot to allow himselfsome more time on his feet. I try to eat healthy, he says,choosing salads when the option is available. He also storesnutritious food in his sleeper.

Richard Adam Jr. of New Hampshire, a company driver who haulslumber regionally, gets home nightly and hits the gym equipment inhis cellar. If truck stops had workout facilities, Adam says, Ican guarantee you Id use them.

Complicating this health picture for many owner-operators isinadequate health insurance coverage. Matt Amen of ATBS says thatonly 25 percent of owner-operator truck drivers have worthwhilemedical insurance. In 2007, the average owner-operator who spentmoney on health, dental and vision insurance paid $3,909, or 3.4cents per mile, Amen says. Thats 7.5 percent of the average netincome.

TIPS FOR THE SHORT HAUL
Caring for your body is like caring for your truck in that bothinvolve products and services. The informed consumer knows how toget the best value for both. Here are ways to spend your healthdollars wisely.

Shop for medical and dental services. Ask different offices howmuch they charge for similar services. While the cheapest may notalways be the best, three or four contacts should give you a goodestimate.

Compare pharmacy pricing. Consumersunion.org reports that stores inthe same city often have widely different prices for the samemedications. You also can buy your meds online.

Buy generic drugs. By law, U.S.-made generic medicines are requiredto meet the same standards as their brand-name inspirations, buttheyre far cheaper.

Check your medical bills. Even a simple visit to the doctor canproduce multiple charges from a lab or X-ray technician, and anemergency room visit or surgery can produce a stream of bills formonths. Carefully review any medical bill before paying it. Ifitems are listed as miscellaneous or coded, ask for details.Scrutinize statements from your insurer just as carefully.

Negotiate rates. The National Insurance Resource Centers websitesuggests that negotiation may work (thats a strong may) for peoplewithout insurance in getting medical expenses reduced before theservice is rendered. It never hurts to ask.

Get a second opinion. If your doctor or dentist suggests a majoroperation or procedure, get another opinion. Some insurancepolicies require a second opinion for certain major procedures, soyou could be liable for a big bill if you fail to do so.

Verify coverage. If youre insured, check with your provider tomake sure any procedure thats new for you, especially with aspecialist you havent used before, is covered.

Appeal insurance rejections. Most insurance companies have anappeals process in the event an expense is denied. Dont fret yet.Most insurance companies allow for three appeals on a single issue.A bonus tip: Have your doctor or dentist provide a writtenexplanation of why the procedure was necessary.

Avoid hospital emergency rooms. If youre suffering a heart attackor serious injury, use a hospital emergency room. Otherwise,theyre too expensive and often have long waits. Many communitieshave walk-in clinics that treat common problems such as colds, flu,broken limbs and cuts. There also are a small but growing number oftruck stop clinics that serve drivers on the road who fall ill,including Highway Health Care in Texarkana, Texas, and severallocations run by Professional Drivers Medical Depots and RoadsideMedical Services.

Keep up with tax-deductible expenses. Many medical-related itemsare tax deductible, including doctor and dentist fees, false teeth,prescription eyeglasses, hearing aids and crutches. Suchexpenditures are only deductible in excess of 7.5 percent of thetaxpayers adjusted gross income, says Mark Miller, a tax managerat ATBS. Unless a taxpayer has a lot of expenses, it is difficultfor the taxpayer to see a real advantage in medical expensedeductions. And dont create headaches for your tax preparer bymixing in receipts for drugs or medical services for which youvealready been reimbursed through your insurer. Check with your taxpreparer or visit www.irs.gov/taxtopics and go to topic 502 formore details.

TIPS FOR THE LONG HAUL
Preventive maintenance works. The more you keep your body in shape,the less downtime youll experience, and the less youll spendgetting yourself fixed. These best practices will, over time,prevent you from spinning your wheels in the doctors waiting roominstead of keeping them turning on the road.

Get regular exercise. When youre taking a rest period, instead ofwatching TV or other passive activities, exercise. Some things youcan do in your cab, such as sit-ups, jumping jacks and stretches.Walk  or jog, if you can  around the truck stop lot. Whateverlevel youre capable of, try to exercise four or five times a week.

Eat healthful foods. Stay away from the fast food and grease commonon truck stop diner and fast food menus. While an occasionalmoderate indulgence is OK, try to mix in more low-fat meals  heavyon salads, vegetables and fruits. Most truck stops now offer suchchoices. Bob Perry of Roadside Medical Clinics, which caters totruckers, advocates a total ban on fast food and processed foods,which includes anything with instant on the label or marketed asa quick microwave or stovetop meal: TV dinners, boxed oatmeal,canned pasta.

Drink more water. Too many people reach for a Mountain Dew or aDiet Coke when they become dehydrated, Perry says. But all thesedrinks, as well as beer and other alcoholic beverages, can furtherdehydrate you. Instead, reach for a large glass of water just afteryou wake up and just before you go to bed, Perry says. Watercleans out toxins, kicks your metabolism into gear, he says.

Avoid diet fads and energy drinks. They run your body out ofenergy, PDMDs McElligott says of energy drinks. Youre expendingenergy you will never catch up on.

Shun tobacco products. Use of cigarettes or smokeless tobacco islife-threatening. The sooner you quit, the better.

Dont be a substance abuser. Trucking is a hard job, but if yourerelying on heavy drinking to unwind, youre kidding yourself. Thesame goes for using illegal drugs or abusing prescriptionmedication.

Get an annual physical. Theres no substitute for the familyphysician, McElligott says. ATBS Amen adds that its critical fordrivers to be checked out at least annually: Your DOT physicaldoes not serve as an annual physical from a doctor. You should bescreened for eye disease, excess cholesterol and other conditions(see page 30). Testing for sleep apnea, a condition that is morecommon among truckers, is now available at some carriers throughSleep Pointes outfitted trailers and the companys otherfacilities.

Ensure your records are accessible. If you get sick on the road andare able to, call your physician (or dentist) to have medical filesand X-rays forwarded to an on-the-road clinic. Also, companies suchas MedicAlert and American Medical ID offer services that storeyour medical information on USB jump drives or scrolls that can becarried on a key chain. Wallet medical cards are good for listingblood type or conditions such as diabetes.

Follow doctors orders. Whether it relates to special diet, dailyexercise, sleep or medication, its critical to stick with aprescribed regimen. For example, truckers often take medication fora brief period, then stop, Perry says. Doing so without a doctorsauthorization can undo any efforts to correct or control yourillness.

Get insured  at least a little. McElligott and Perry urge havingat least catastrophic insurance in the event of an accident. Thecoverage is relatively cheap because less expensive health careneeds are not covered. The earlier you get any coverage, thebetter, because many insurers wont take on non-insured clients whohave certain pre-existing conditions. Many insurers post onlinecalculators for you to gauge prices.

Avoid paying by credit card. Unless youre paying off your entirebalance every month and know that you can do the same withadditional medical costs, stay away from credit. If your accountcharges 18 percent to 20 percent, even a $2,000 bill that takesmonths to pay could cost hundreds of dollars more before its overwith. Instead pay in cash, use savings, or set up a payment planwith the providers office.

Dont forget your teeth. Brush and floss regularly. Lay offartificial sweeteners and sodas, says Perry. When schedulingregular check-ups with your doctor, also make an appointment withyour dentist. Small dental problems can grow into major ones intime.

Know your bodys limits. Dont injure yourself with a pulledmuscle, joint, or other injury by lifting or reaching for an itemthat is out of your range. This rule applies not only to securing aflatbed load or wrestling cargo out of your van, it also applies tohome projects, such as climbing ladders.

Listen to your body. If you have any unexplained symptoms, see adoctor  now. If you do a better job of taking care of yourself,you wont be hit with these medical issues and bills, and themedication, and the regular checkups, Perry says.

Know your parents medical histories. If your fathers side of thefamily has heart problems, for example, pay careful attention tothe way you treat your heart. Attend likewise to family historiesof high blood pressure, diabetes, cancer, allergies, etc.



High-deductible insurance
A traditional health insurance policy might be too expensive, butthat doesnt mean you have to go without any coverage at all. Oneoption is to have a high-deductible medical insurance plan, whichcan then be associated with a Health Savings Account, says MarkMiller, a tax consultant with financial services provider ATBS.

Set up properly, such a plan can give an owner-operator theadvantage of paying all medical expenses with pre-tax dollars,meaning a lower tax bill. The list of expenses that qualify forpayment with pre-tax dollars is also much more liberal than whatwould be otherwise deductible as an itemized deduction, Millersays.

Thats why ATBS launched its own major medical insurance program,Truckers Health and Income Security Plan, with partners Aetna,Beta Health Association and Colonial Life. The insurers offer,respectively, health insurance with a $3,000 embedded individualdeductible, dental and vision coverage and life, accident anddisability coverage. Launched in February, the program is designedto get owner-operators needed health care coverage for themselvesand their families.

Families within the plan commonly pay $350 per month in healthinsurance premiums with an $6,000 deductible, says Dennis Carter,an insurance consultant with Adrian & Associates Inc., who helpedlaunch the program. One added bonus: Even if the driver is deniedhealth coverage because he has, say, diabetes and is a smoker, hisfamily still can obtain coverage.

The Owner-Operator Independent Drivers Association offers itsmembers programs including prescription drug discounts andaccidental death and dismemberment. Professional Drivers MedicalDepots also has launched Professional Drivers Insurance Program,with limited medical programs, dental and vision coverage andshort-term disability.



Heading off problems
In addition to a complete physical every year or two, screeningssuch as these can help keep health care expenses down:

PROSTATE CANCER. This test should be done yearly through a digitalrectal exam and blood test, starting at age 50.

COLORECTAL CANCER. Starting at age 50, various tests arerecommended anywhere from a blood test annually to a colonoscopyevery 10 years.

SKIN CANCER. A doctor may do a full body exam annually to detectprecancerous or cancerous growths, starting at age 50.

BLOOD PRESSURE. Because blood pressure at high levels can indicatea heart risk, it should be measured at least every two years.

CHOLESTEROL. You should be tested for total cholesterol as well asgood and bad cholesterol, which can be an indicator of heartdisease, at least every five years.

DIABETES. If you have high cholesterol, high blood pressure,obesity or a family history of the condition, get tested fordiabetes.

SEXUALLY TRANSMITTED DISEASES. If you have had more than one sexualpartner or notice unusual symptoms, talk with your doctor about STDscreenings.

EYE DISEASE. Routine eye exams are recommended every two to fouryears, especially past age 40. An annual glaucoma test can checkeye pressure and eye health.

SLEEP APNEA. If you have symptoms such as waking up choking or witha sore or dry throat, see your doctor.



RESOURCES
Association of Health Insurance Advisers
(703) 770-8200
www.ahia.net

Health Insurance Finders
(909) 335-9703
healthinsurancefinders.com

Health Insurance Resource Center
www.healthinsurance.org

Insurance Information Institute
(212) 346-5500
www.iii.org

Insure.com
(800) 324-6370
www.insure.com

OOIDA
(800) 715-9369
www.ooida.com

Professional Drivers
Medical Depots
www.pd-md.com

Professional Drivers
Insurance Program
(866) 817-9674
www.pd-ip.com

Roadside Medical Clinics
www.roadsidemed.com

Sleep Point
(316) 425-4019
www.sleeppointe.com

Truckers Health and Income Security (ATBS)
(800) WHY-THIS
www.whythisplan.com