Shopping for the best price on an X-ray or even where to deliver a baby may seem strange if you’ve never done it before. But taking charge of where you go, how much you pay and the potential outcome of your transaction is even more important when it’s your health (and not electronics or a new pair of shoes) on the line.
Americans, both insured and uninsured, feel the pinch of higher health care costs, though they may be reluctant to look outside their family doctor or the closest hospital for competitive rates. But comparison shopping for medical care could save you money and your health.
Your Share of Costs Is Up
It’s not all in your head. Despite more Americans having health care coverage under the Affordable Care Act, many have seen their cost responsibilities rise. Overall, premiums and out-of-pocket costs like deductibles are up, and sometimes alarmingly so.
Deductibles, which used to not only be lower but less common altogether, are now standard. Among employer-based insurance plans in 2003, about half had a deductible; the average was $518 for a single person. In 2013, it rose to 81 percent and an average that more than doubled to $1,273, according to an analysis from The Commonwealth Fund, a foundation that supports health care research.
This means that Americans are responsible for a greater amount of their medical costs before they get maximum input from their insurer. It also means when you go for something like an X-ray, you could be paying for the entire visit, even when you’re insured.
Prices Vary From Doctor to Doctor
In addition to potentially paying more out-of-pocket than ever before, prices can be wildly different from clinic to clinic and depend on a variety of factors, including where you live.
In the case of a CT scan of the brain, for instance, where the national average is $695, you could pay as little as $75 in Lanham, Maryland, or as much as $4,600 In Issaquah, Washington, according to data from OkCopay.
But you don’t have to cross the country to see dramatic price differences. According to analysis from Castlight Health, a drive across town could cost or save you hundreds. The health care information company found that cholesterol panels across Dallas, for example, could cost anywhere from $15 to $343 for the same test.
Getting the Best Deal for Your Health Care Dollars
Comparison shopping for something like LASIK or even an MRI is pretty easy, as these procedures are relatively simple with the bill and insurance claim coming from a single provider. A few phone calls may be all you need. But in the case of surgeries or having a baby, price shopping will be a project — a project that could ultimately save you thousands. Here’s what you need to do:
1. Know your network.
You’ll always pay more for medical services outside your insurance network. So, it’s probably best to steer clear of physicians, clinics and hospitals that aren’t included on your plan. This could narrow your options considerably if you’re part of a growing number of narrowed networks.
2. Start with online tools.
There are several online tools from reputable organizations — your health insurer or local hospital may even have them. These will help you estimate costs for various procedures. But they aren’t the final word on how much you’ll pay. FAIR Health Consumer Cost Lookup and the Healthcare Bluebook are reliable places to start.
3. Call the provider.
You may have found a good estimate online, but you’ll want to verify it. Contact the medical provider for an estimate. In some states, providers are required by law to provide such estimates. But even if they aren’t required, they’ll usually oblige. Planning ahead is key here, as receiving an estimate for an intensive procedure may take several days.
4. Contact your insurer.
If you have health insurance it will likely cover some but not all of your costs. So after you receive a detailed estimate from the medical provider, contact your insurance company to figure out how much of the tab will be your responsibility. They will be able to provide information on what goes toward your deductible, what is covered by a simple copay and what may be denied altogether.
5. Remember, price isn’t your only concern.
Price may be a major factor in where you go, but it shouldn’t be the only one. After all, this isn’t a television we’re talking about, and the lowest price doesn’t always come with the highest quality. While price shopping, make sure you check out online reviews and feedback about your medical provider or hospital. You’ll want to balance cost with quality of care.
Shopping for high-quality and reasonably priced health care isn’t always a quick and simple process. But when providers in the same town charge hundreds more than the next clinic over, it could be time (and money) well spent.
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Price Shopping: Getting the Best Deals on Medical Care originally appeared on usnews.com
