Shop around
If you have the opportunity, shop around to find the best prices on medical care. This has become easier since federal rules in 2021 required hospitals to show their prices. You can look for prices on their website, you can call in, or you may even be able to get some help from a case manager if your insurance has one. While you’re looking for prices, also compare the self-pay price vs what you would pay with your insurance.
Of course if you are having an emergency, you can’t shop around. You get the care you need and take care of your health. One thing you can do is to ask that, if you need a consulting physician or specialist, that they are in-network.
Some services that you can shop around for are prescriptions, outpatient diagnostic procedures, or lab work. For prescriptions, many people have heard of GoodRx due to their advertising. I actually useCleverRx, which has helped me save $46 on my new prescription. For lab work, even if your doctor does the blood draw at your appointment, make sure it goes to an in-network laboratory. My family doctor’s office sends blood work to the hospital lab, if I don’t say otherwise. That results in 3-4x higher costs for me.
Talk to your provider
If your insurance coverage for a procedure or treatment is poor, discuss it with your provider. They know their field the best and may have resources that can help you. The facility may have charity care they can offer. They may be able to adjust your treatment schedule. Perhaps they have samples of a prescription or can change the type of drug to a lower cost option or one covered by your insurance.
In outpatient physical therapy, I would sometimes work with patients whose copay for the visit was higher than what I would actually be reimbursed by the insurance company. Yep, basically the patient paid me and paid the insurance company extra in order to be seen for treatment. In that case, we offered the patient some options. First, the patient could self-pay for their session – they would pay less but it wouldn’t count towards insurance deductibles. Second, we could do longer sessions, but less frequently, loading the patient up with information and exercises that they could complete independently at home in between.
Your provider likely went into healthcare in part to help others. They will want to work with you and ease the financial burden as well if possible.
Self-pay
For self-pay, providers will nearly always give a discount. Insurance companies never pay in full what a medical facility or provider bills them. So providers can offer a discount to those who are private pay as well. Some providers will give discounts automatically if you are listed as self-pay, but you will likely have to ask or call.
Sometimes, the self-pay price with discount is actually cheaper than what you might pay with insurance. This is worth considering. Weigh your expected healthcare costs and decide if it is better to go through insurance vs self-pay. Most years, our family did not meet our insurance deductible so when self-pay was cheaper, it was better for us.
Always ask for a discount!
It may be quick and easy to just go online and pay whatever they bill you. However, you can miss out on big savings. I was taught by my mother that you always call in to pay your bill. When you do, as if they will give a discount if you pay in full or if you pay in cash.
My family physician’s practice is part of a large healthcare organization, and they provide 25% discounts for any medical bills $100 or more if you pay in full. And it doesn’t matter if you are self-pay or have insurance. Our local hospital has a similar policy, with discounts varying depending on the cost. This helped us when we had insurance and had some large bills before our deductible had been met. We saved hundreds on our medical expenses just by calling in and asking.
Medical cost sharing
If you are not happy with your insurance and you have high medical expenses, you should consider medical cost sharing. Medical cost sharing may also be the solution if you can’t afford health insurance. As of the writing of this article, sharing levels at Christian Healthcare Ministries (CHM) start at $92 per month, and protect you from large healthcare costs. If you want to learn more about medical cost sharing, check out my article about our experience with CHM and how they’ve saved us money. The article is about my experience during pregnancy, but it will give you a good understanding of how medical cost sharing works.
Heath Savings Account
If you are eligible for a Health Savings Account (HSA), this can be a good way to save on medical expenses. Not everyone is eligible for an HSA. You can qualify for an HSA if you have a high-deductible health insurance plan.
What is an HSA?
An HSA is a tax-advantaged account that you or your employer can contribute to, that is used to pay medical expenses. Medical expenses include more than just copays and money paid out of pocket until the deductible is met. Many things not covered by insurance are eligible to be paid from your HSA, like acupuncture, bandages, or home improvements needed for medical reasons. For a full and up-to-date list, go to the IRS website. Insurance premiums are not included as an eligible medical expense.
How does an HSA save me money?
Because an HSA is a tax-advantaged account, any money contributed by you or your employer can be deducted. That means it is not counted as income, and so your contributions are deducted from your taxable income. Any interest earned by the funds in your HSA is also not taxable. As long as you spend the HSA funds on qualified medical expenses, it will be tax-free. A high-deductible insurance plan usually has lower premiums, but you will spend more at the time you receive care. But, with an HSA, it minimizes the impact of that high-deductible.
HSA and retirement
An HSA’s primary purpose is for healthcare costs. However, the HSA is also considered part of a retirement strategy by some. The reason for this is that money in an HSA is fully yours. These funds will stay in your HSA from year to year and even when you change jobs. Money in the HSA can be invested and money grows tax-free. Withdrawals from an HSA are tax-free if used for medical expenses, but you will pay fees if withdrawing money for other purposes. Once you turn 65, you can withdraw funds for any purpose without fees, but you will need to claim the withdrawn funds as income tax.
While I didn’t include my HSA as a part of my retirement planning, I like that the funds will continue to be available and to be invested while in the HSA. Funds contributed to an HSA are never a waste!
Medicaid
Medicaid is available to low-income families and individuals. If you are struggling to make ends meet and to pay your healthcare costs, you should look into whether or not you qualify. Medicaid is an insurance provided by the federal and state governments in US, with each state setting their own income thresholds and coverage. The income threshold is generally above the Federal Poverty Level, so don’t think you can’t be covered just because you are not below the poverty level.
Do you have any other ideas for saving on medical expenses? Comment below or email me at[emailprotected].I would love to hear from you!
