Health Care Costs & How to Navigate Them
Health care in this country is expensive, and even if we think we are covered, medical debt is still very capable of appearing ,especially after an emergency. After reading I hope you are less likely to fall into medical debt and even learn ways to save money. There are resources out there to help even if you don’t know where to start, we are here to help.
In this blog you’ll find:
Where to get treatment (no matter your income)
Resources to find free/low cost health centers near you
Ways to negotiate medical bills and avoid paying interest.
My favorite way to save money for health costs—pre-tax!
Click buttons and links for definitions of terms and more resources.
Health care is the #1 reason behind bankruptcies in the U.S.
Health care is one of the biggest expenses in retirement,
and Health Care is currently ranked the top financial concern for Americans.
How do I make sure I can afford my healthcare?
There are ways to make sure we can afford health coverage. If its time to choose a health plan from your employer or a government program, please do a little research. Start here:
Get out a calculator add up the monthly premiums, plus deductible and any known costs like monthly prescriptions. You want to know that number and make sure it wont send you into debt if you do need to utilize your plan fully.
HMO’s are a great low-cost option for health insurance, if offered. They don’t offer as many choices once in the plan, but they’re budget friendly and will keep you covered in case you ever need it.
A High deductible HSA plan is a great option, especially if your company is subsidizing or if you are saving up for an upcoming expected healthcare cost, or even planning for retirement.
Okay, so you have coverage. Maybe it’s good, maybe it’s not the best. But You need medical care, and it is going to be pricey. What’s next?
Shop Around!
The first thing to do is to shop around for the right hospital/health care provider for you. Yup, you heard me; shop.
Sometimes services or devices are more expensive or less when they come directly from the provider or hospital. It depends on your insurance. One example I came across a lot in my practice was the varying price of an MRI. Some insurance companies have deals with different imaging centers or hospitals.
Let’s break it down on how you could possibly save in this situation:
Example 1: You need an MRI and the doctor writes the order or prescription. They recommend the place right down the road because they use them often. You have not yet met your deductible, so you will be paying either the entire cost of the MRI or the portion until your deductible is met. Say your deductible is $1000.
The imaging center down the road charges $900 for an MRI, but the hospital in your area also takes your insurance and only charges $400 for the same quality MRI. You can ask your doctor to send the order for the MRI to the hospital instead and save yourself $500.
Example 2: You have met your deductible, but you have a Co-Insurance of 10%. In the same situation with the Hospital charging less for the MRI, you would pay 10% of their fee of $400 which would be $40, as opposed to 10% of the center’s fee of $900 which would be $90.
Pro tip for medical devices such as crutches, walking boots, braces: If the quality is truly the same even the same brand and your insurance does not cover these devices, you can purchase them yourself from a medical supply store, amazon or here: ShopRx
I didn’t sign up for insurance (or my insurance is crap), and I definitely cannot afford to pay this upcoming medical bill. So what can I do?
If possible, choose which hospital you will receive care from.
There are two kinds of hospitals: for-profit, and nonprofit.
For-profit hospitals are owned privately and can choose their own prices for medical services. Nonprofit hospitals are run by charitable organizations or government agencies and have different rules and regulations. Mostly, they will provide discounted or free medical care if your income is below a certain amount.
A provision of the Affordable Care Act mandates nonprofit hospitals must provide a “financial assistance policy” that “must apply to all emergency and other medically necessary care provided by the hospital facility” in order for the hospital to maintain its tax-exempt status as a nonprofit.
That means that a nonprofit hospital cannot deny you health care because of your financial status, though there is an income limit maximum for most financial aid programs. This varies from state to state and from hospital to hospital, so make sure to check what your state’s regulations are.
Some nonprofit hospitals will require a referral to be seen by a doctor. For this, you can go to that hospital’s Urgent Care or Emergency Room and receive a referral after being evaluated there.
What if I’ve already gotten a bill?
Don’t stress! And don’t wait. The good news is in 2022, the time increased to 180 days from the date of medical service before the unpaid bill is sent to collections.
Always check your bill, ask for an itemized list if one wasn’t provided.
Strike a deal with the hospital or provider: If you have a large hospital expense or doctor’s bill, don’t charge it on a credit card to buy more time— the interest will add up and make matters worse. Strike a deal with the provider themselves. Most hospitals offer a zero interest payment plans. Even the private ones. They will have a minimum monthly, but you can negotiate a bit to make it work for you. Even private doctors offices are usually willing to work with their patients. In this case, be upfront with the office and tell them your situation. If you are expecting a large out of pocket cost, discuss this with the office manager prior and see if you can make installments—with zero interest!
Get a Quote: If you have a planned surgery coming up, say a knee replacement, ask your doctor’s front office to give you an estimate of your out of pocket costs prior to the surgery. If they can’t do that, ask for the procedure and diagnosis codes and call your health insurance to see what they will pay for that procedure and give that information to the office.
Trust me most doctors have limited knowledge of what each insurance plan’s reimbursement is for each procedure. Save your time with your doc for medical questions. Discuss all billing issues with the office or billing managers, as they will give you the best answer.
If you are lost and this is all too much, there are free patient services out there. We hope to be one of them some day! But for now…
Organizations such as dollarfor.org. will help you apply for financial assistance or medical debt forgiveness. They will do the heavy lifting and fill out any paperwork on your behalf.
For those who like to plan and save…
I personally favor health plans that offer the option for an HSA (Health Savings Account). These are usually plans with a high deductible (more money up front) and are nicknamed an HDHP (High Deductible Health Plan).
An HSA lets you set aside money from your paycheck pre-tax for qualified health expenses. Why does pre-tax matter? The money contributed to your HSA isn't counted in your taxable income, so you will pay less income tax on the income you take home. Win.
Plus, it’s sort of a way to automate your savings—especially if you know you have a big ticket health cost coming up, like a surgery, even if its elective, or anything involving children (they are expensive in all stages, from fertility treatments, to delivery, to braces and beyond)
FSA vs HSA — why HSA is better :)
The funds contributed to an HSA are yours for life, and there are some pretty interesting ways to use them. With an FSA if you don’t use the funds by Dec 31st of that year, they are lost.
KEY TAKEAWAYS
Unpaid medical bills can be detrimental to your credit score and financial security. Don’t ignore them.
Check all medical bills for errors and try to settle an unaffordable debt for less than the full amount.
There are organizations that will help you pay your medical bills if you are uninsured.
Be proactive. Discuss the costs prior if you can, plan for procedures when possible, save using an HSA.
If you currently do not have health insurance and do not qualify for any of the emergency special circumstances, there are free and charitable clinics and pharmacies that you can find here:
There is also this government run website for finding a free health center. I found it less useful, but results may be better in different cities. Worth a click if you are in need:
There’s always help out there. Follow along on social media to see more recommendations and tips on how to manage health care expenses.
Be well.
—Dr.D
References:
https://findahealthcenter.hrsa.gov/
http://www.hospitalinspections.org/state/or/
https://www.kff.org/womens-health-policy/fact-sheet/the-availability-and-use-of-medication-abortion/
https://nafcclinics.org/get-involved/get-care/
https://siepr.stanford.edu/news/americas-medical-debt-much-worse-we-think