If you feel like you need an advance degree (and a sizable back account) to manage your health insurance, read on. Here are 7 tips to help you save money-and your sanity-while still getting the best possible care you can.
1. Shop for Tests Like you Shop for Shoes
Need an expensive test that's going to cost you a hefty out-of-pocket sum? It might be worthwhile to compare prices among different labs and clinics; fees can vary widely. To compare prices, you need to know the CPT (Current Procedural Terminology) code, a universally accepted number that corresponds to an MRI, a specific lab analysis, or any other billable service. The American Medical Association's Web site, ama-assn.org, has an easy-to-use CPT search engine. Once you have the code, you can get price quotes from several providers. You may be surprised at how well you'll do. "For a CT scan, the price could range between $500 and $1,500 at two different facilities," says Devon Herrick, PhD, a senior fellow at the National Center for Policy Analysis in Dallas.
Save: 20 to 66%
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2. Negotiate Your Hospital Bill
For patients with insurance, the hospital co-pay or deductible can represent a very large amount of money. Some insurance companies will deduct this amount from the hospital's contracted rate. The unpaid portion is then your responsibility. Here's a fact many hospitals won't openly admit: They're often willing to waive or reduce an account balance if a patient can demonstrate that the co-pay or deductible is a hardship. But you have to ask. "The patient can go back to an account administrator and say, 'This is really difficult for me. Is there anything you can do?' And we can," says Ruth Levin, vice president for managed care at Continuum Health Partners in New York City. "The number of payers, including patients and insurance plans, who pay hospitals 100% of our charges is probably less than 2%."
Save: 10 to 30%
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3. Question Follow-Up Appointments
"When a doctor tells you to come back, whether it's in 3 weeks, 6 months, or a year, ask why. A phone call might suffice," says Arthur Garson Jr., MD, dean and vice president of the University of Virginia School of Medicine and author of Health Care Half Truths: Too Many Myths, Not Enough Reality. When a specialist orders a test, such as an x-ray or MRI, ask your primary-care doctor if it's necessary. Seventeen percent of US adults say their doctors have ordered duplicates of medical tests, according to a recent survey by the Commonwealth Fund, a nonpartisan health care foundation in New York City. If you're going for a second opinion, sign out your x-rays or MRI scans from your doctor and bring them with you.
Save $20: (office visit) to $300 (your share of the average cost of an MRI under an insurance plan that reimburses only 80%)
4. Ask for Cheaper Drugs
Doctors aren't always aware of how much medication costs. "We don't know which drugs are covered and which aren't when we discuss them with patients," says Doug Farrago, MD, a family physician in Auburn, ME. Ask your physician if there's a less expensive but equally effective alternative to the drug you're prescribed.
Save: Up to 75% (the difference between a "preferred" drug and one not covered by insurance)
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5. Plead Your Case Directly with Your Doc
If you're experiencing serious hardship, talk directly to your doctor: They are in the profession because they want to do good and tend to be more forgiving of outstanding balances than many billing managers. "They are the ones who can direct their billing department to give the patient a break," says Levin.
Save: Up to 70%
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6. Arrange Independent Lab Work
Cut the cost of blood and urine analyses by using MyMedLab.com. Once your doctor gives you a prescription for a test, have blood drawn at one of 3,000 collection sites nationwide; the vials are then mailed to independent labs. "You can get more than 30 blood readings and analyses starting at about $95--around 75% less than getting the same tests at a hospital," says Herrick. The lab will mail the results to both you and your doctor. (State laws prohibit this service in California, New Jersey, New York, and Rhode Island, according to the site.)
Save: 50 to 80%
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7. Fill Prescriptions with Big Retailers
Mail-order pharmacies such as Drugstore.com, Drugs.com, and Costco.com typically beat the prices of neighborhood drugstores hands down. You can do your own price comparisons at Rxaminer.com, which was founded by a cardiologist and has the reputation for independence from special interest groups.
Save: 10 to 20% for name brands, 20 to 40% for generics
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