It’s impossible to place a price on excellent health. You’ve heard the adage before, but it’s taken on new significance in the age of high deductibles, caveat-ridden coverage, hidden costs, and a healthcare system in turmoil.
Anyone who has ever gotten an unexpected medical bill has faced this dilemma.
According to a recent poll conducted by the Kaiser Family Foundation, 67% of the 1,100 adults polled were more concerned about unexpected medical expenditures than paying rent, food, power, or insurance premiums.
Pricing and choosing providers
According to the US Census Bureau, almost 86% of most Americans have health insurance coverage that pays for most healthcare services. However, even if you have health insurance, you may compare shop for healthcare in the same way you would for any other purchase.
Here are some pointers on picking a service and pricing before being surprised with higher-than-expected expenses.
Make use of in-network healthcare providers
Suppose you have a PPO (preferred provider option) health insurance plan. Your health insurance provider will cover most of the cost, minus your co-pay when you visit a doctor or hospital in the insurer’s preferred network.
However, you will be responsible for a higher fee if you see a doctor or hospital outside the provider network.
PPOs usually cover 70-80% of expenditures incurred outside the network.
Costs of services can be found online
Third-party health “infomediaries,” or groups that educate customers on treatment and provider alternatives, are emerging as Americans become more responsible for their healthcare bills.
Medical service rates may be found online from various sources, including consumer websites, particular hospitals, insurance providers, and even the federal government.
Therefore, when you obtain a diagnosis or a piece of procedure advice, conduct some internet research to become a more educated consumer.
Walk-in clinics vs. the emergency room
Walk-in clinics range in price from $99-$129 and are available at chain pharmacies like CVS for minor illnesses like sore throats, while urgent care centers, which may start at $150 without insurance, provide a broader range of treatments.
If your problem is potentially life-threatening, you should go to the emergency room, which generally costs a larger co-pay and charge.
When you’re feeling better, or even better, before you become sick, you can arm yourself with even more information on ER prices and what to anticipate over at Vox, where they’ve created a project targeted at uncovering the hidden costs of ER visits.
You may even contribute to their cause by splitting your bill with them.
Inquire about the price
You might be shocked to learn that you can ask your doctor to estimate the cost of a surgery or service before making an appointment.
Then, if the price is too exorbitant for you, you could try to haggle before your appointment or seek treatment elsewhere.
If the surgery or visit is regular, it may be simple to “shop about” with different area doctors. You might also request an installment payment plan.
Inquire about your options
If you have a sizeable out-of-pocket deductible or co-pay, ask your doctor if all recommended tests or treatments are medically essential.
Request a discount
It’s feasible to haggle a lower price for healthcare services, especially if you’re looking for a surgery or treatment available from several different providers in your region.
Seek the help of a local advocate to help choose a plan.
Professional healthcare advocates can advise you about local treatment alternatives, assist you in obtaining care, and help you address billing concerns with your insurance company or healthcare providers.
Pay in cash when possible
While physicians may earn large sums of money each year, their clinics are generally cash strapped.
Patients who pay cash get discounts from their doctors’ offices since they don’t have to file insurance claims or pay with credit card transaction fees.
Trim costs of prescription drugs
You may save money on prescription medicines in a variety of ways.
Using generic prescriptions
Since the FDA relaxed limits on pharmaceutical corporations’ ability to market directly to consumers (also known as DTC advertising) in 1997, Americans have been assaulted with multi million-dollar ad campaigns pushing name-brand prescriptions and treatments.
According to Consumer Reports, generic medications are as effective and safe as name-brand pharmaceuticals and typically cost less.
Drugs can be ordered through the mail or from big-box stores
Even if you aren’t a member, you may occasionally obtain prescription medications at a discount at warehouse clubs like Sam’s Club.
In addition, some big retail stores provide huge savings without health insurance, such as $4 for a 30-day supply and $10 for a 90-day supply on 300-400 common generic medications.
Ask your doctor for a recommendation for a mail-order pharmacy where you may acquire a larger prescription bundle. For example, you may get a three-month supply instead of a standard one-month supply for less.
Request an OTC (over-the-counter) substitute
Ask your doctor or local pharmacist if an OTC medicine can treat your problems for less money.
Keep an eye out for billing errors
According to supporters for transparent medical billing, such as the non-profit Medliminal, up to 80% to 90% of hospital invoices are erroneous.
Inquire about itemized bills
The explanation of benefits (EOB) statement that you get in the mail does not provide a complete breakdown of all charges for treatments or inpatient stays. Instead, request an itemized bill so you can see precisely what you’re being charged for.
Examine the bills for any mistakes
Verify that you got all the services, prescriptions, and others listed on your statement. Ask for copies of your medical chart or pharmacy ledger if you find a difference or inaccuracy so you may compare the doctor’s prescriptions for services on your bill.
Request an audit of your medical bills
Insurance claim processors might make errors even for services and prescriptions you got, resulting in improper invoicing. However, claim managers at your healthcare provider can go through your case and fix any billing problems.
Examine your insurance protection
According to your health insurance policy booklet, which costs are “covered” and which are “not covered” are listed.
The health insurance company should reimburse all covered charges. If a service were covered or not, it would be noted on the EOB document you get from your insurance carrier.
Form a working relationship with the billing office
Most doctors’ offices include a professional billing team or finance department that deals with all patient billing problems and concerns and insurance company interactions.
Make an appointment with your doctor’s billing office if you’re having trouble paying your medical expenses.
They should be able to go through your bills, explain your health insurance advantages, refer you to other resources to help you get the most out of your insurance, and assist you in finding less expensive medications and services.
Employ the services of a professional bill examiner
If you’re having trouble deciphering the codes and charges on your bills, hire a professional bill reviewer familiar with hospital diagnoses and procedure codes and can tell you if you were overcharged for the service you got.
Taking care of medical bills
Your payment plan can be straightforward if you’re ready to be proactive, lowering your medical costs or rearranging.
Be sure to make an agreement with your doctor’s office.
Simply asking for a discount on services will frequently result in a reduction. Keeping clients is a provider’s long-term interest in today’s more competitive healthcare business. You can always request a discount in exchange for your business services.
Make a payment schedule
If you cannot pay your account in full and on time, ask the billing office staff if they would work with you to develop a payment plan that allows you to make smaller, more manageable payments over time.
Consult your insurance provider
If you’re having difficulties paying your medical costs, you could be better off switching to a different health insurance plan. Co-pays, deductibles, yearly maximums, and other costs vary widely among programs.
Create a Health Savings Account (HSA)
If you have a high-deductible health insurance plan, you should start health savings account to put money down for things your insurance doesn’t cover. The money your employer puts into the account is tax-deductible, it grows tax-free, and you may withdraw cash from it tax-free if it’s used for a qualified medical cost.
Can urgent care help you save money on medical bills?
It depends on your insurance and how much an urgent care visit costs out of pocket. However, going to an urgent care center is generally less expensive than going to an emergency room.
Can you deduct medical expenses on your yearly tax return?
Suppose you itemize your deductions on Schedule A (Form 1040), Itemized Deductions, for a taxable year. In that case, you may be eligible to deduct medical and dental expenditures incurred for yourself, your spouse, and even your kids.
The Internal Revenue Service (IRS) claims that only the portion of your total medical costs that exceed 7.5% of your adjusted gross income is deductible. Schedule A (Form 1040) is where you determine how much you may deduct.
How much can a flexible spending account save you on medical bills?
Per the Federal Flexible Spending Account Program (FSAFEDS) website, an FSA allows you to utilize pre-tax money to pay for medical expenditures. As a result, you can save up to 30% on your out-of-pocket expenses.
Image by: Darko Stojanovic