Once a month, Jessica Jean of Shrewsbury, Mass., used to plan her grocery runs and errands around a stop at the pharmacy for her thyroid medication. She never questioned what it cost. “I just figured that must be what I had to pay,” she says.

Then a letter from her health plan, Blue Cross Blue Shield of Massachusetts, pointed out another option. Because Jean takes her medication daily for hypothyroidism, she was eligible for 90-day refills — and making the switch could help her save money.

“All I had to do was tell my provider that I wanted a 90-day refill and they were able to do it right away,” Jean says. “I think the medication was going to be about $35 for the 30-day refill, and $11 for the 90-day refill. So that’s a no brainer when you think about $105 vs. $11 for the same amount of meds and fewer trips to the pharmacy.”

Jean’s assumption, that the price is simply the price, is a common one when it comes to health care. But many of the decisions that shape your bill happen before it arrives, and knowing where you have a say can make a real difference.

“Every week in my clinic, I see how hard it is for families to struggle with high healthcare costs – it’s a heavy burden on so many people,” says Dr. Adam Licurse, a practicing primary care doctor and senior medical director at Blue Cross Blue Shield of Massachusetts. “To fix this, we all have to do our part. Health plans, doctors, employers, drug companies, and policymakers have to work together to bring costs down. And for our members, the best thing you can do is never hesitate to speak up and advocate for yourself when you’re at the doctor’s office.”

Like a quick check up for your health, a quick review of how you use your health care can help manage costs. Here are five common assumptions worth a second look.

Myth 1: “I’ve seen this doctor before, so I know they’re in-network”

Seeing an in-network provider usually means paying less because health plans negotiate lower rates with the doctors and hospitals in their networks. But networks change. A provider who was covered last year isn’t guaranteed to be covered this year, and switching plans or jobs can change the picture too.

Before your next appointment, create a MyBlue account and use the Find a Doctor & Estimate Costs tool in the MyBlue app to look up your providers. If you’re searching for someone new, you can filter by specialty and location, read patient reviews, and compare several providers at once.

Myth 2: “Medical services cost about the same everywhere.”

The price of the same service can vary widely depending on where you get it. The differences tend to be greatest for scheduled, nonemergency care, including diagnostic imaging tests, outpatient surgeries, preventive and routine lab work, therapies, and specialized care like physical therapy.

For certain services, the setting can make a difference, too. Freestanding labs and imaging centers, for example, tend to cost less than getting the same lab work, X-ray, or MRI in a hospital setting.

When your doctor orders a test or procedure, do your research before saying yes. If it’s an emergency, however, always go straight to the nearest emergency room.

“Sometimes that means asking the purpose of high-cost tests such as imaging, requesting generic or alternative medicines that are cheaper, and for referrals that are within network,” Licurse says. “Your doctor shouldn’t be offended, but often just doesn’t know the out-of-pocket cost differences between these options — and if you don’t, you can call us.”

Myth 3: “The prescription my doctor recommends is the only option.”

Often, it isn’t. Generic medications have the same active ingredients as their brand-name counterparts and must meet the same FDA standards, but they typically cost much less. Plans also place medications in tiers based on factors like cost and whether alternatives are available.

If cost is a concern, ask your doctor whether there are less expensive alternatives available. Depending on the medication, there may be options that work differently or carry different costs, so your doctor can help you understand the potential trade-offs and determine what makes sense for you. For medications like Jean’s that you take long-term, a 90-day supply through the mail service pharmacy can also cost you less. 

For Jean, the convenience has mattered as much as the savings. “I like having enough medication for three months so I’m not constantly having to think about it every month and figuring out when I’ll pick up my medication,” she says. 

Check whether your medication has a lower-cost alternative or even bring the list to review with your doctor. 

Myth 4: “I won’t know what I’ll pay until the bill arrives.”

Most people compare prices before a big purchase. With scheduled care, you can often do the same. Under federal price transparency rules, most health plans offer online tools that estimate your out-of-pocket costs for covered services before you get care. 

Blue Cross Blue Shield members can use the Find a Doctor & Estimate Costs tool within the MyBlue app to see estimates for more than 1,600 common services, from office visits to imaging to outpatient procedures. Seeing the numbers ahead of time can help you plan, avoid surprises, and choose the option that best fits your needs and budget. 

Look up the service before you book it. If your plan has a deductible, check how much of it you’ve already met, since that can change what you owe.

Myth 5: “Preventive care is just another expense.”

Most plans cover recommended preventive care, including annual checkups, many screenings, and immunizations, at no cost to you when you see an in-network provider. For Blue Cross Blue Shield members, that includes preventive services such as routine physicals, mammograms, colorectal cancer screenings, and flu shots. 

Regular preventive care pays off in the long-term. Screenings can catch conditions like cancer, high blood pressure, and diabetes early when they’re often easier to treat and have a better likelihood of positive outcomes. 

Book your annual checkup and ask which screenings are recommended for your age and family history.

Check, compare, ask

You don’t need to be a health insurance expert to make more informed decisions about your care. Before scheduled care, check that your providers are in-network, compare costs, get an estimate, and ask questions. After care, review your Explanation of Benefits letter to make sure it matches the services you received. 

That kind of attention is exactly what a not-for-profit plan is built to support. Blue Cross Blue Shield answers to its members, not stockholders. About 90 cents on every premium dollar goes directly to members’ medical and pharmacy coverage, with the rest covering taxes, employee pay, and technology. 

For Jean, one small change opened the door to more. “Combining three months into one trip and one lower cost gave me immediate control over my budget by saving on copays, while also cutting down on time and stress,” she says. “Perhaps most importantly, having that physical cushion in my medicine cabinet gave me the peace of mind that I wouldn’t run out of my daily meds and have to go without.”