What you need to know to save on out-of-pocket health care costs

By Carla K. Johnson, AP
Friday, September 18, 2009

How to save on out-of-pocket health care costs

If you’re uninsured or in a health plan that requires you to pay a high annual deductible, you may be interested in learning more about the price of medical procedures. Here are some tips from the experts:

—Shop around because prices vary greatly. A colonoscopy can cost $1,300 at a hospital and $550 across town at an outpatient surgery center. That’s because different institutions are able to negotiate different prices from commercial insurers based on their position in the market.

—Uninsured? Look out. People without an insurance company negotiating for them end up being charged the highest prices. Still, uninsured patients who ask can sometimes get a discount of 20 percent, or possibly qualify for charity care.

—Ask your insurance company who’s in the network. Only certain facilities and doctors have signed agreements with your insurance company. If you go “out of network,” you’ll be charged more.

—Don’t expect your doctor’s office to alert you if they don’t accept your insurance. It’s your responsibility to ask your insurance company who’s in the network.

—Consider an HSA. Health Savings Accounts allow you to put pretax money aside that can be withdrawn to pay for certain medical expenses. The money typically can be used to pay for some things that aren’t covered by insurance, like co-payments, over-the-counter medicine and Lasik eye surgery. You must have a high-deductible health insurance plan to qualify for an HSA.

—Complications increase costs. When something goes wrong, that generally means more expense. You shouldn’t have to pay for outright medical errors or negligence, but if your doctor finds something unexpected during a procedure, you may have to pay for a more complicated procedure or lab tests you didn’t expect.

—Shop online. In some regions, commercial insurers and nonprofit groups have launched price comparison sites. New Hampshire and Maine have the best online cost comparison tools, based on claims data for all insurers and providers in those states. In the Northwest, Regence members can get network average costs for certain common treatments by using a tool on the member site. In the Midwest, HealthPartners members can find prices of common services at hospitals and clinics. Residents of Minnesota and Texas also have some online tools available.

—Need help quick? Urgent care centers generally cost more than a same-day appointment with a doctor. Many medical practices leave some space in the schedule for last-minute appointments, so ask your doctor first.

Sources: NewChoiceHealth Inc., Cigna Corp., Regence, eHealth Inc., HealthPartners, Texas Hospital Association, Minnesota HealthScores, Associated Press interviews.

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