10
ways to cut health-care costs before treatment | | |
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Even though your insurer's negotiated rates are likely
to be lower than the hospital's list price, be sure to understand
how your deductible and co-pay requirements affect your total out-of-pocket
expense.
"If you see that procedure is $2,000, and your insurer
pays 80 percent, you might assume that your 20 percent (out-of-pocket
expense) is $400," says Jason Beyrouty, a director with Benefit
Advisors, an employee benefit plan consulting firm in Salem, Ore.
"But I've seen cases where employees forget to factor in their $500
deductible," so they have to pay an extra hundred dollars.
Even worse, it's possible that the $2,000 charge listed
was in addition to the deductible, so the employee's total expense
would be $900, not $400. The lesson: Learn to ask how deductibles
and co-pays are calculated with respect to listed fees. Doing so
may not lower your expenses, but it might prevent those expenses
from being higher than you anticipated.
8. Ask for the
Medicare rates. If you have no insurance or are otherwise
faced with paying a hospital's list price, another negotiating strategy
is to inquire about your hospital's Medicare rates. The government-funded
Medicare program has prenegotiated fees that hospitals accept for
certain medical procedures. It's likely that these negotiated rates
are less than the hospital's listed rates, says Stewart. "Ask, 'What
would you get for doing this procedure if you were getting reimbursed
by Medicare?'" she says. "If you can get (the hospital) down to
those rates, you're doing pretty good."
9. Go generic.
Patients who are comfortable with their out-of-pocket deductible
and co-pay amounts might still be in for a shock later on when they
go to fill a prescription. "No one is going to be able to negotiate
(pharmaceutical costs). The best cost savings result when people
use generic (medicines) versus brand," says Cooper.
Cutler agrees. "Generic drugs are, in the vast majority
of cases, exactly the same as brand drugs. So, if your doctor prescribes
something for you, ask whether that drug is available as a generic,"
he says.
Another tip: "Make sure the drug your physician prescribes
for you is on (your insurer's) formulary," says Cooper. The formulary
is the list of drugs a health plan covers. If you don't have any
prescription drug coverage, contact the Partnership for Prescription
Assistance at (888) 4PPA-NOW to see if you qualify for an assistance
program. The PPA
serves as a national clearinghouse for programs that help patients
who lack prescription drug coverage.
10.
Sweat the small stuff. After you negotiate major services, pay attention
to incidental costs that might add up on your hospital bill. If there are any
toiletries that are not included in the price of your hospital room, bring them
yourself. Also ask about using your own prescription medicine if you already have
it on hand. Taking cost-reduction steps ahead of time can
eliminate unpleasant hospital bill surprises later. Nevertheless, remember that
it is nearly impossible to forecast what the final bill will be. If there is a
complication during your medical procedure, you'll obviously need more services
and your charges could be higher than expected. However, if you believe your charges
are erroneous, you will be in a better position to dispute them because of your
familiarity with the services you selected. As health plan
premiums and out-of-pocket payments continue to rise, consumers will have to do
more research and negotiating to get the medical care they need. Discussing costs
upfront can help ensure that both you and your wallet remain healthy. | 
