With healthcare costs expected to rise, here are eight ways to save on healthcare costs:
1. Make A Plan Now - Don't Wait
Emergency rooms and illness are the worst places to make life-altering decisions. When a crisis hits, clear judgment disappears. Don't wait until you're overwhelmed to figure out your care—take control now. Use the steps below to build your plan while you have the clarity to do it right.
2. Choose the Best Option for Care You Need
Decide ahead of time exactly where you will go and under what circumstances for each level of care. This website from United Healthcare does a great job of breaking down care options. The chart below shows the differences in the cost of care for each type of visit. Selecting the right option for the level of care you need can save hundreds to thousands of dollars per visit.
| Type of Care | National Average | Range | Source |
|---|---|---|---|
| Virtual Visit | $65 | $40 - $90 | Recuro |
| Primary Care Visit | $171 | $150 - $300 | Mira |
| Urgent Care Visit | $280 | $160 - $300 | Forbes |
| Emergency Care | $2,750 | $1,200 - $4,500 | LatestCost |
3. Shop for the Best Prices with High Quality
You wouldn't buy a car without knowing the price and checking the quality of your purchase — why should the care you receive be any different? Higher prices do not alway equal higher quality.
How to Check Prices?
Healthcare providers are required to provide a transparent list of the cost for services. You can locate these by going to the provider's website and searching for transparency or for links to pricing under the billing department.
How Can I Compare Across Providers?
Many health insurance plans provide tools to help you compare costs and quality. Check with your insurance provider's site to see if they provide assistance. Medicare provides a tool that may also be helpful for comparison: Find Healthcare Providers: Compare Care Near You | Medicare
Can I Compare Costs Myself?
Yes, it can get a little complicated but there is a way to make it easier. Pricing tables from healthcare providers use Common Procedure Codes or CPT Codes. Sometimes there can be multiple codes for different services received during a single visit. Rather than spending time trying to determine the exact cost of the visit, pick a single common CPT code and compare across providers. While this will not give an exact cost, it shows how the provider is positioned either higher or lower in cost. Here are some common CPT codes you can use for comparison.
| Type of Care | CPT Code |
|---|---|
| New Patient | 99202-99205 |
| Existing Patient | 99211-99215 |
| New Patient Urgent Care | 99202-99205 |
| Emergency Care | 99281-99283 |
| Basic Blood Draw | 36415 |
Virtual visits and Urgent Care Facilities are much better about posting their prices directly on their website. They may use the same codes as a primary care visit or sometimes use codes for emergency care by the level of care and length of the visit. The prices listed will be for a specific insurance or self-pay, depending on your specifics, compare using the insurance you have or look at the self-pay price.
How to Check for Quality?
Check your insurance provider to see if they provide quality metrics and reviews, many do. Another great resource is HealthGrades.com.
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4. Choose In-Network Providers / Check for a Self-Pay Discounts
If You Have Insurance
Check that all of the physicians you will see are covered by your insurance provider and any labs or diagnostic imaging are in network as well. Be sure to check and re-check before visits because eligibility for coverages do change over time and can leave you with a hefty bill.
If You are Self Insuranced or Under-Insured
If you don't have insurance or are underinsured, check with the billing office to see if they provide a self-pay discount. Often times this is also listed on the billing pages for the provider.
5. Understand Your Insurance Plan
There are a variety of plan options out there. Be sure to check your insurance plan carefully for the amount you are responsible to pay. Some basics to be aware of:
Co-Pay — an amount you are responsible to pay for each visit (e.g. $25 co-pay)
Patient Liability/% Share — some plans pay only up to a certain amount per visit or require you to pay a percentage or both
Deductible — often this is an amount per individual or per family on an annual basis that you must pay before insurance will pay their part.
One area of significant savings is in the type of plan you choose, content for another article, significant savings can be found by shopping for an insurance provider and plan that meets you're specific health needs.
6. Use Your Health Savings Account (HSA)
If you are among the many americans with a High Deductible Plan and an HSA, take advantage of the triple tax savings by paying for all of your out-of-pocket medical expenses using your HSA.
7. Review Your Bill and Negotiate
Billing practices vary based on the provider and they are not always accurate. Here's what you can do:
- Be Patient. Billing can take some time.
- Wait to Pay. Wait until insurance is processed.
- Review your bill. Carefully review it for accuracy.
- Contact Insurance First. Contact your insurance first and seek to understand. Often times insurers will work on your behalf to resolve billing problems - ask them to help.
- Contact the Billing Office. Be nice. Ask for an explanation and compare to what your insurance payer stated.
- Negotiate. — if the price charged is different than the price submitted, ask why and if the price listed on their website can be used? Ask what the self-pay price would be — sometimes the price of self-pay would be less than you pay with insurance. Ask if there is a financial plan where you can pay part over time.
8. Improve Your Health
Ultimately poor health practices affect how you feel and impact your long term cost of care. Here are some common areas to improve your health:
- Nutrition. Replace your processed foods with raw and non-processed foods.
- Weight. Obesity is a huge factor in health. Seek help reducing your weight through exercise and nutrition.
- Stop or reduce smoking. Smoking and vaping have a long term impact on your health
- Schedule Preventative Visits. Many preventative checks are free, be sure to have your health checked regularly.
Frequently Asked Questions
How much can I save by choosing virtual visits?
Virtual visits average $65 compared to $171 for primary care and $280 for urgent care. That's hundreds of dollars in savings.
What is a Health Savings Account (HSA)?
An HSA is a tax-advantaged account that lets you pay for qualified medical expenses. It offers triple tax savings: contributions are tax-deductible, growth is tax-free, and withdrawals for medical expenses are tax-free.
How do I find healthcare price transparency information?
Healthcare providers are required to provide transparent pricing. Visit the provider's website and search for "transparency" or check the billing department section for links to pricing tables.
Should I negotiate my medical bills?
Yes. Review your bill carefully, contact your insurance first to understand charges, then contact the provider's billing office. Ask about the self-pay price, payment plans, and whether listed prices can apply if different charges were made.