Five strategies to help you reduce the chance of painful financial surprises.
When you’re coping with the discomfort of symptoms or an injury, your primary focus should be getting the treatment you need. Yet, for all too many of us, the mounting costs of the care we’re receiving loom overhead, making a difficult time even more overwhelming. In fact, two-thirds of surveyed Americans rate receiving an unexpected bill as a significant financial worry†.
Fortunately, there are things you can do to help diminish both those concerns and costs.
Know your in-network healthcare providers and help protect yourself when authorizing care
Often, people seek physicians or hospitals in their healthcare plan’s network to help avoid unexpected bills. But, as care and perhaps hospitalization proceeds, additional healthcare providers, such as an anesthesiologist, radiologist, or specialist may be called upon for care.
These providers may “balance bill” you for amounts above what your insurance covers for in-network care, and some healthcare plans, such as health maintenance organizations (known as HMOs), may make you liable for the entire amount, warns Chuck Bell, programs director for Consumers Union, the advocacy division of Consumer Reports‡.
Be sure to ask your primary care provider to refer you to in-network healthcare professionals whenever possible and, once you have a referral, confirm the provider’s in-network status when you make your appointment.
In an emergency, of course, you may not have a choice. Learn more about how to help protect yourself here.
As a patient, you’ll be asked to sign consent forms. Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation§, advises patients to write on the form that permission is required before any out-of-network provider be involved in your care. “It isn’t legally binding, but any documentation that you tried to avoid out-of-network providers can be helpful during an appeal of those charges,” Donovan says.
Be price-aware before you go in for a planned procedure
Physicians and hospitals can often charge different fees, even within the same city, for the same procedures and tests. An MRI, for example, can be considerably less expensive at a standalone diagnostic facility than at a hospital‡.
Many insurers have online tools that can help you estimate your portion of the payment related to specific procedures, tests, or surgeries. This can help you compare prices charged by doctors, hospitals, and diagnostic testing facilities‡. If your insurer doesn’t have a cost estimator, sites such as Healthcare Bluebook or FAIR Health can help you compare prices.
Ask about alternative treatment or prescription options
Generic drugs are often cheaper than brand-name versions. It often falls on the patient to ask about less expensive alternatives. “Ask your healthcare providers for more affordable alternatives in the medications they prescribe or the tests and treatment they order,” advises Bell‡.
Ask about billing costs for routine procedures
Hospital and health insurance organizations have published a detailed guide to help avoid medical bill “surprises”; it includes questions to ask about specific procedures like colonoscopies and childbirth, and forms to help you plan.
