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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Summary

Even if you have great medical insurance, you probably have some out-of-pocket costs.

The first thing to do to help save money is to let your doctor and other medical provider know that money is an issue for you and that you would like to spend as little out-of-pocket as you can. The sooner you bring up the subject, the more the doctor or other provider can do to help you save money. For instance, order a less expensive drug, or a less expensive test or reconsider whether the test is even necessary.

Next is to keep in mind that medical costs are not set in stone. You can:

  • Negotiate health care costs with providers
  • Shop for cheaper providers
  • If you qualify, take advantage of special health care programs.

Consider skimming through the various sections of this article to get an idea of different ways you can save money on medical care. If time is short, go directly to the subject of immediate interest. ï»¿ï»¿is document whenyou have time. A reminder on your calendar may be helpful.

If If you do not have health insurance, in addition to reading this article, learn how to get the health care you need as an uninsured person. 

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How To Deal With A Financial Crunch

When You Need Routine Medical Care

For routine problems such as cuts, broken bones, sore throats and ear aches, you can save money by going to one of the following instead of an Emergency Room:

  • A general practitioner rather than a specialist. Primary-care doctors  are able to treat the vast majority of illnesses at a more affordable rate than specialists. They can always refer you to a specialist if necessary.
  • A clinic in a retail store clinic or a company clinic for routine problems such as cuts, sore t hroats and ear aches
  • An urgent care center for routine matters and for more serious matters such as a broken bone.

Compare the cost of medical services. Please keep in mind that it can't hurt to try to negotiate price. If you can't get a reduction in price, perhaps you can get payment terms. For more information, click here.  Also consider the following ideas:

  • Request bids for your medical care through such websites as MediBid.com offsite link
  • Check to see if your state collects information about medical costs and makes it available online. State sites are listed at the web site of the All-Payer Claims Databases Council at www.APCDCouncil.org offsite link
  • www.FairHealthConsumer.org offsite link lists typical costs for medical procedures for different locations
  • www.HealthcareBlueBook.com offsite link provides what it refers to as fair prices by area
  • American Medical Association lists what Medicare pays for services by area at www.AMACodingOnline.com offsite link

NOTE: Learn how to prepare for a medical emergency by clicking here.

When You Receive A Medical Bill

Check for errors in the bill

  • According to Money Magazine, auditors have found that about 80% of medical bills contain at least one error. Errors can cost you thousands of dollars. This is particularly true of hospital bills. To learn more, see Hospitals 101.
  • If the task is too complicated for you, hire a professional.

Negotiate what you owe

  • A bill for health care services is no different than other bills for services you need. Bills are negotiable. 
  • Learn the price others charge in your area before negotiating. It is helpful to your cause if others in your area charge less for the service.
  • If you can offer to pay cash, you can generally negotiate a lower price.

NOTE: Consider hiring a professional who negotiates medical debt.  These provessionals generally do not get paid if they do not save you money. They work for a percentage of the amount you are saved. To learn more, click here.

When You Have A Hospital Bill

To save money: 

  • Start by looking for errors. Studies have shown that most hospitals make billing errors on a staggeringly high percentage of bills. Even if you only have to pay 10% of a hospital bill, you could save $100 if you are overcharged by $1,000.
  • Then compare prices charged by other local hospitals. Hospitals 101 explains how.
  • Then negotiate the bill. The success rate for negotiated bills is high. 
    • To learn how to negotiate a hospital bill, click here.
    • For companies that will negotiate the bill for you for a percentage of what you save, click here.


When You Have To Pay A Doctor

Doctor's fees are not fixed. In order to reduce the amount you have to pay:

  • Check fees for similar services in your area.
  • If you have a co-payment or coinsurance, your doctor might be willing to waive your share of payment. This concept is so common that it even has a name: it is referred to as "accepting assignment of insurance."
  • You can negotiate the charge itself with doctors. 
    • The more cash now you can pay, the more likely you are to get a lower bill. 
    • Installment payments to your doctor are better than running up credit card debt. You may not have to pay interest. If you do, it won't be as high as your credit card and the doctor is not as likely to report the situation to the credit bureaus. 
    • For more information, see our article about negotiating a doctor's fees.
    • If you would prefer,  you can hire a professional to negotiate the bill for you. Such professionals generally receive a percentage of your savings as their fee. To learn more, click here
  • You can also ask the doctor if he or she has an arrangement with a lender who can provide a loan to pay medical bills. Many do.

If you owe money to a doctor you want to continue to use:

  • Try to work out a modified payment schedule. 
  • If money becomes a stumbling block and the doctor won't provide care without further payment, look for another doctor. At least this way you'll be starting fresh and your medical services won't be cut off. Try to get on a repayment schedule with your old providers.

When You Need Lab Tests

There is not really much negotiating with respect to fees for lab tests. With the exception of the most basic testing (such as urine dip stick or glucose blood strips), the doctor generally refers lab tests to commercial labs he or she works with regularly.

The best way to save money with respect to lab tests is to avoid unnecessary tests. When the doctor recommends a test, ask whether the test is necessary -- particularly if you had the same test recently. Many doctors practice "defensive medicine" (they order more tests than necessary in order to avoid law suits), or because it is local custom.

If the test is necessary,consider asking:

  • Are (inexpensive) do-it-yourself tests available for simple procedures?
  • If not, is there a less expensive alternative?
  • Does it matter where you have the test done? Some doctors feel strongly that a particular test be done by a facility or specialist they know and trust. If no particular facility or specialist is required, you can shop around for the best price.

When You Need Diagnostic Tests Such As X-Rays, MRIs or Mammograms

If you will have to pay all or part of a diagnostic test, you can save money by comparison shopping. There is generally no restriction on where tests can be performed even though doctors usually have a facility they prefer.

To comparison shop for a diganostic test, consider the following steps:

Step 1. Get information about the test. Ask for the specifics of what the doctor needs so you can accurately describe what is required in a phone call. For example,

  • if a chest x-ray is being ordered, is it one or two views? 
  • If it is an MRI, does the doctor want contrasting hues?

Step 2. Check on line. For example, www.CostHelper.com offsite link. Type the name of the test in the Search box.

Step 3. Call the facilities that perform the test you are interested in using. In addition to  the doctor's recommendations, you can find places that provide the scan you need at  www.ScanDirectory.com offsite link

  • Let them know you have a written order from your doctor.
  • Describe the test needed.
  • Ask the price. 
  • If the price is higher than those listed on the internet, use the other price to see if the facility will match it, or even go lower.

When You Need A Medical Device Or Home Equipment

Medical devices: In addition to checking local prices, there are websites that compare prices of medical devices for you. For instance,  AliExpress.com offsite link and ResourceNation.com offsite link.

Home Medical Equipment: If you need medical equipment for your home, click here.

 

 

When You Receive A Medical Treatment

Before Treatment

Before agreeing to receive any nonemergency medical treatment, find out how much it will cost you.

Step 1. If you have health insurance or Medicare, be sure that the treatment is covered.

  • Ask your doctor for assurance that the treatment is "medically necessary." If it isn't, insurers are likely to refuse to pay. If there is any question about whether a treatment is medically necessary, check with your insurance company before undergoing the treatment. If you have Medicare, this may be difficult to do, but it is worth making the call in any event. (NOTE: Even if an insurer agrees before a treatment that it is covered, that doesn't mean the company won't reevaluate the situation once all the facts are in. So if you get prior approval, be sure to note the name of the person, the date of the conversation, and his or her contact information. If you can get the approval in writing, that's even better).
  • Look in your summary of your policy, or the policy itself for "Exclusions" or "Not Covered." If there is any question whether the treatment is covered, contact your insurer.
  • If prior approval is needed, get it. Insurers can be very sticky about this requirement. Courts have been known to confirm that an insurer doesn't have to pay if the policy requires prior approval and you don't get it.

Step 2. If your coverage doesn't pay for treatment outside of the insurer's network or pays a lower amount than for treatments provided in network, check to see whether the treatment provider is in network. If not, look for an acceptable provider in network. If there are none, ask  your insurer for an exception. (If the company refuses, see Appeals: Arguments To Use

Step 3. Do the math to figure out how much you will personally owe. For example, include:

  • The amount of any deductible that hasn't been used yet. (A deductible is an amount you pay each year before the policy takes over).
  • Co-pays or co-insurance. (The part of a medical bill you pay)
  • Related costs such as transportation to and from the treatment facility, lost wages, home care, cosmetics or even new clothes.

During Treatment

Keep track of every drug, test and procedure you receive. If you're not up to it, ask a family member or friend to do it for you. This information will b needed to verify the bill.

After Treatment

Don't pay what you don't owe.

Step 1. Check to be sure the bill ony includes services you received.

  • Compare the "Explanation of Benefits" you receive from an insurer or "Medicare Summary Notices" you receive from Medicare with the list of what you actually received.
  • If the two don't match, call the health care provider. There could be a coding mistake

Step 2. Check to see whether you actually owe whatever you're billed. If the reason for a bill isn't clear, ask your health care provider for an itemized bill. 

Step 3. If you owe money, you can negotiate a lower amount.  Health care costs are not set in stone. In fact, there are generally various amounts depending on who is paying the bill.

Step 3. If you don't believe you owe the money, follow the procedure described by the insurer. If you don't get a positive response, appeal - and keep appealing. Statistics show that it's worth it. To learn more, see: Health Insurance: Appeals.

When Choosing A Health Insurance Policy

If money is an overriding concern, in addition to the premiums, look at how much you will have to pay during the year even with the coverage. For example, for a deductible, co-pays, or medications. A low premium, but excessively high deductible or high co-pays when you already have a health history may not make financial sense.

If other people are covered on your health insurance, think about the economics for all the people covered -- not just for yourself.

Instead of looking solely at the amount of the premium consider the factors that are important to you. See How To Choose A Health Insurance Policy.

You may trade freedom, such as choice of doctors or hospital, for a lower premium, but it's a fair trade if money is a concern. Just be sure that providers in the plan have a lot of experience with your health condition -- and great quality doctors and facilities such as hospitals. For example, with a PPO you'll be able to see specialists without having to get prior approval as well as out-of-network doctors. However, if you go out of network you'll have to pay a deductible and higher co-payments. This flexibility comes with higher premiums than an HMO.

When Using A Health Insurance Policy

Before incurring any medical expense, find out if your insurance plan covers it. Once you've received the service, you're financially responsible for the charges regardless.

If your insurance is from a private carrier or self insured by a large employer: make sure you're getting the most out of it and minimizing the amount you pay out of pocket. Read our article on the type of insurance you have.

To learn more, see: Indemnity Insurance, HMO, PPO, POS.

Seek advice from your doctor whenever possible by telephone or e-mail. Many doctors are happy to answer questions and provide advice over the phone or by e-mail. This can save on the cost of unnecessary visits.

When You Need Medical Supplies

In addition to checking prices at local medical supply companies, it is worthwile to check mail order medical suppliers. When you contact the supply company, ask if they take your insurance. Also ask for a copy of their catalog or see their catalog online.

These companies will mail supplies every month. You do not usually need a prescription to order products.

If a company does not accept your insurance, call your insurance company for a list of suppliers that do.

 

Tax Advantage Plans Such As A Health Savings Account Or A Flexible Spending Account

Using pre-tax dollars gives you more to spend on your medical expenses. Tax advantage health plans allow you to deduct pretax money from your paycheck to cover out-of-pocket medical expenses. If your tax rate is 25%, your pre-tax dollar is worth a full dollar. A dollar which is taxed is only worth seventy five cents to you. To put it another way, you save $250 for every $1,000 you spend. Actually, these pre-tax dollars are worth even more because they are not subject to Social Security and Medicare taxes.

To save the most money, it is advisable to put as much money as you can into a tax advantage health plan. Savings vary by tax bracket. You can contribute money to these accounts during an open-enrollment benefits period or when you have an event such as marriage or the birth of a child.

  • If the plan is one like a Flexible Savings Account in which you lose the money not spent by year end, limit your donation to the amount you think you will spend on your health care and the other people who qualify.
  • If you have a question about  what costs are likely to be during the coming year, speak with your specialist or a knowledgeable person in his or her office.

Note all the expenses you can pay for from tax advantage plan. As a general matter, acceptable expenses are those that would generally qualify for the mental and dental expenses deduction for IRS purposes. To learn about  those expenses, click here. Also check your plan to note the different people whose medical expenses are also included.

It's getting easier to maximize use of these plans.

  • Drugstore chains generally provide receipts or customized lists of purchases that show which items qualify for tax advantaged plans.
  • Many employers automatically debit co-pays and deductibles to providers who participate in their health-care plans. You don't have to go through the paperwork or delay of submitting claims.

If You Get Paid On An Hourly Basis

If you work on an hourly basis, when setting medical appointments, try to be the first appointment in the morning or just after lunch. Doctors usually start such appointments on time so you will be away from work for the minimal amount of time. If you have an appointment at a different time, call ahead to see if the doctor is running on schedule.

To learn more about saving money on medical costs, see Drugs, Doctors and Hospitals.