Getting affordable health care is often challenging. Health insurance is complicated, and medical costs seem completely unpredictable. But while health insurance may be difficult to understand, knowing how yours works and how to shop around could save you hundreds — or even thousands — of dollars per year. Here are some of the best ways to save on medical costs.
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1. Know Your Health Insurance
It seems as though my wife’s health insurance through work changes in one form or another every year. It’s hard to keep up with, but it's essential that we understand it.
The worst part is, my wife works for a hospital. You would think its insurance would be the best and the least complicated. Unfortunately, that’s far from the truth, as we’ve found out.
In our particular situation, my wife has multiple tiers of service providers, each of which costs us different amounts of money to use. During my wife’s pregnancy, she was required to get ultrasounds.
You would expect an ultrasound to cost the same, no matter where you get it done, right? That couldn’t be further from the truth.
When we got an ultrasound done at the doctor’s office, it cost us $150 out of pocket. But if my wife were to get the same ultrasound done at her hospital, it would be completely free. Crazy, right?
Understanding how your health insurance works is super important. If you don’t understand the basics — as we clearly didn’t — there is no shame in asking for help. If you work for a company, your human resources department may be able to help. However, the best resource is usually the insurance company itself.
Give the company a call and ask questions until you understand how to get the best value from your plan. If you hate talking on the phone, some insurance providers — like my wife’s — have a live web chat feature.
Web chat is extremely helpful because everything you talk about is in writing, so you can refer back to it later. If we had done the research and kept up with her health insurance, we could have saved $300 by getting the first two ultrasounds done at the hospital instead of the doctor’s office.
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2. Shop Around for Services
Shopping around for services can save you a decent amount of money. Many insurance providers now offer cost estimator tools on their websites. While they aren’t always accurate, they’re a good starting point to find out how to get the best price for a medical service.
Generally, you enter your location and the particular service you are shopping for, and the insurance company will give you a list of medical providers, along with an estimated cost for service.
3. In-Network Providers
Another option is to call in-network providers and ask them for their rates. This is probably the most difficult step, but it’s possible if you're really persistent. If you just talk to receptionists, they’ll probably think you’re crazy. Receptionists, for the most part, have no clue how medical items are billed.
Sadly, most doctors don’t know, either. So instead, ask to speak to the billing or insurance clerk. You’ll need to have the medical billing code for the procedure you’re considering and ask for the cost of that particular procedure. If you don’t know the billing code, you may be able to call your health insurance for help.
Of course, there's no guarantee the medical provider will bill your visit using the same code that you’re asking about.
You could end up getting different services than you'd shopped for. Or the doctor might add more codes and services without asking permission first.
The best advice I can give is to be proactive. Make the provider aware that you’re trying to keep your costs down and only want necessary services.
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4. Ask About Options
You might not understand every procedure that ends up coming your way. As such, don’t be afraid to ask your doctor if those procedures are necessary, especially when there’s a high out-of-pocket copay or deductible. There might be a low-cost way of dealing with your issue that won’t require huge medical bills to boot.
If You’re Billed Incorrectly
It can happen to anyone, but here are some sure-fire ways to correct the mistakes if they happen. Ted Chan, the CEO of CareDash, a health care provider directory, offered a guide to follow in such a situation:
Medical billing is rife with errors, and everyone should scrutinize their bills before they pay them. You should review all bills immediately upon receipt and deal with any issues right away since memories tend to fade. This includes doctors or nurses who might be able to verify what type of care you received or, in many cases, didn’t receive.
- The first step is to keep all documentation.
- Then call your insurance provider’s billing support number (typically on the bill itself).
- The key document is the required “explanation of benefits” document. Make sure you have this handy, along with documentation of why it doesn’t match your care.
- Make sure you fully understand your health insurance plan before getting on the phone.
- If your claim isn’t resolved, first escalate to a manager at your health insurer. Then you will need to go back to the provider.
- If that doesn’t work, you may need to engage a health care billing advocate or attorney. Unfortunately, this is both costly and time consuming, but some bills can be so large that it becomes a necessity.
5. Negotiate to Save on Medical Costs
It might sound silly, but you would be surprised at what you can achieve.
It’s possible to negotiate a discount price for a procedure or health care services with your provider, especially if there are many other providers in the area that offer the same service.
6. Cash Is King
Yep, that’s right. Paying in cash might actually save you money.
Using cash means that doctors don’t have to fill out insurance claims or pay credit transaction fees. In turn, they will be more likely to give you a discount just because you’re saving them time and money.
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7. Be Smarter About Buying Drugs
Ditch the name brand and pick up some of the generic stuff. It does the same job and usually costs a fraction of the price.
Even Sam’s Club and other big warehouse club stores can save you money on prescription drugs by ordering them in bulk. You can also get discounts from these large chains without health insurance.
Ask your doctor about mail order pharmacies that stock the drugs you need, too.
8. Check Your Bills
Make sure you get itemized bills and review them line by line for any errors or discrepancies. You're within your rights to question items on the list that you don’t recognize or understand.
Your health care provider’s billing office can also help you review your bill. Having a professional set of eyes look it over could save you money.
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9. Payment Plan
Sometimes, no matter how hard we try to save on medical costs, they still build up. If you cannot afford to pay your bill up front, ask the billing office if it can provide a payment plan that will help you manage the payment in smaller sums over a longer period of time.
Medical Emergencies Are a Different Beast
Keep in mind, shopping for health care services should be done only for planned procedures. If you’re having a medical emergency — such as a heart attack or a broken bone — you should be more focused on getting your problem fixed.
However, if you understand your health insurance prior to an emergency, you can at least make an educated guess about what type of facility will be able to give you service at the most reasonable price.
Additional reporting by Kelly Meehan Brown.