Negotiating Health Care Costs

Did you know that when it comes to your healthcare and the costs involved, it is important to shop around but negotiating also has its place?

It would make sense that every doctor or clinic would charge the same amount for a given service, but in reality, that is not the case. One of the top ways that I advise my clients when saving money on health care, is to shop around and negotiate. This comes into consideration particularly when the costs are out-of-pocket. I have previously explained that it is not always in your benefit to bill everything to your insurance and then you pay the out-of-pocket bill. Sometimes it can be more beneficial to you to not use your insurance, and treat the current circumstance on a cash patient basis. In my previous blog, we addressed that for healthy individuals with very high deductibles, where you do not expect to hit your deductible within the year (barring unexpected emergencies), that opting to pay for a procedure such as labs or an MRI, as a cash patient, will often result in you receiving a much smaller bill than if you had billed it through insurance. Check out last week’s blog for more information.

Having established that this given situation is now one that you should pay cash for (as a cash patient), it’s important to shop around. You are not bound to in-network doctors and facilities if you are paying cash and can find somewhere to receive your procedure at a good price.

I like to relate this to car shopping. Generally, when you go to buy a car, you are negotiating with the dealership. Negotiating your trade-in vehicle value is normal, as well as all the various items you could include or exclude with the new vehicle to ensure you are paying the price that you know is in your budget. People typically do not think to do this with their health care needs, because they have been trained not to. Generally speaking, this shopping around for prices applies to hospitals and facilities and not to primary care doctors.

The exorbitant charges that can come from a hospital or facility, generally do not come from primary care, and rarely from specialists. Your primary care will usually charge you a reasonable fee for what they’re doing. But hospitals, ERs, labs, and imaging places, for example, tend to charge exorbitantly. It’s worse than jewelry, the markup it really is. If you were to call some of these places and ask them what their cash price for uninsured patients is, you would be shocked to hear what they will accept for payment. You will also be shocked at the differing prices for the same procedures.

In summary, one way that you can really mitigate your health care cost is by understanding your coverage, your deductible, and your out-of-pocket costs.  You can call the insurance company if you don’t understand it all, or go onto your insurance company’s portal. Find out the medical code for the procedure you’re planning – such as a lab or MRI, and use that code to research and shop around what various facilities would charge you.

If you need any help or guidance in this area, please feel free to contact me by scheduling an appointment on my website.

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