9 tips for cutting out-of-pocket medical expenses

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9 tips for cutting out-of-pocket medical expenses

Out-of-pocket medical expenses can make you feel sick. For Americans, these expenses—what you have to pay when insurance doesn’t fully cover a surgical procedure, for instance—can run into the hundreds or thousands of dollars in a year’s time. That, in turn, can plunge you and your family into debt.

You can ease the headache of out-of-pocket medical expenses, though, by following these nine tips.

1. Shop around

Did you know you can comparison shop for health care, just like you can when you’re buying a car? For starters, use a tool like PolicyGenius to compare quotes and buy the health insurance in your area best suited to your needs. But once you have insurance you should also comparison shop any procedure you need to have.

If you’re facing a medical expense, especially an expensive procedure, find out what it’ll cost beforehand, says Kevin Gallegos, vice president of Phoenix operations at Freedom Financial Network, a financial services company. You can call doctors’ offices or hospitals and ask for the billing department, then inquire about what you’d be charged for the procedure. That can help you decide where to get medical care.

"This one is one of the most overlooked aspects of using the health care system. We rarely make purchases without knowing how much something will cost, and we shouldn’t do that with medical care, either," says Garrett Ball, a Medicare insurance agent.

Keep in mind, though, that the place offering the cheapest procedure may not be the best place. Don’t sacrifice quality to save a few bucks. Check online reviews and ask relatives, friends and co-workers for their recommendations before scheduling that procedure.

You can research prices for medical procedures and prescriptions at Amino.

2. Inquire about a discount

You’re not likely to come across a Groupon for knee surgery, but you might be able to score another type of discount. If you pay with cash rather than filing an insurance claim, ask the health care provider whether you can secure a discount as a "self-pay patient," Gallegos recommends.

3. Go to school

In some areas, dental schools offer care — at a reduced cost — that’s provided by students but supervised by experienced dentists.

"You’ll help train the next generation and keep money in your pocket," Gallegos says.

Of course, you’ll have to confront a student-in-training coming at your teeth with a drill—but the savings may well be worth it.

4. Stay in your network

If you’ve got health insurance (and thanks to the ACA you probably do), your insurance company has negotiated special rates with a network of health care providers. When you remain within that network, you’ll typically pay less for care, such as copays. But when you go to a provider outside that network, you’ll normally pay more. (Remember: PPO plans offer some coverage outside the network. However, HMOs don’t. If you have an HMO and stray outside the network for care, you’ll have to pay 100% out of pocket.)

Unsure whether a health care provider is inside or outside the network? Ask your insurance company.

5. Avoid the ER

For treatment of life-threatening conditions, head to an ER. But if you’ve got the flu, a sprained ankle or a broken wrist and need treatment right away, visit an urgent care clinic, Gallegos says. ERs tend to charge a lot more for care than urgent care clinics do; and many of these clinics take health insurance.

6. Read your medical bills

Going over a medical bill isn’t fun, but it can save money.

Many medical bills contain errors or overcharges; one estimate puts the number at 80 percent. Ball says that if something on your bill looks wrong, don’t automatically pay it.

"Ask for an itemized bill and read it carefully, and call the billing office with any questions or concerns. Protest any erroneous charges to negotiate a lower fee," Gallegos says.

7. Seek assistance from a pro

Are you trying to make sense of a huge medical bill after a hospital stay? Then it might be worth paying a medical billing advocate to review the charges. A medical billing advocate won’t charge you if everything’s in order, health advocate Ruth Linden says.

"On the other hand, if errors or a questionable charge is found, the typical billing advocate may charge you one-third to one-half of the amount they save you. Your cost savings could run into thousands of dollars," Linden says.

8. Ask for financial help

Struggling to pay medical expenses can make you feel ashamed, but you never should hesitate to pursue assistance if you’re hurting financially. Linden says a cash-strapped patient might qualify for financial help from a hospital or other health care provider in the form of a lower bill or a manageable payment plan.

Health educator VJ Sleight notes that if you have a specific medical condition, such as cancer, a local community foundation or the local chapter of a national nonprofit organization might be able to cover some of your expenses.

9. Go generic

Whenever possible, request the generic version of a prescription drug. The price difference between a generic drug and a brand-name drug is "enormous," Ball says. According to the U.S. Food and Drug Administration (FDA), a generic drug costs 80 percent to 85 percent less than its brand-name counterpart.

The FDA emphasizes that a generic drug is supposed to be just as effective as the brand-name equivalent.

Other ways to save money on prescriptions include:

  • Signing up for a prescription discount program, such as the one offered through AARP.

  • Hunting for coupons or cards that will help cover the copay for a prescription. For more information, head to NeedyMeds.org.

  • Comparing drug prices. Visit GoodRx.com to look up prescription costs in your area.