10 ways to cut your medical bills

6. Explore state-sponsored hospital Web sites

The Health Care Price Transparency Act of 2006 requires hospitals to report to the public information on specific inpatient and outpatient charges.

According to the American Hospital Association, 33 states already require hospitals to report pricing information, and 10 more are voluntarily doing so. As an example, the South Dakota hospital pricing information Web site lists average annual costs for the 25 most common procedures performed at the state's hospitals. That site shows that the average charge for delivering a baby at one hospital is nearly $500 more than the same service at another hospital in the same city.

• Raising your $299,000 baby

Although these rates represent averages, checking a Web site before checking into a hospital could save you hundreds of dollars on your medical bills. Check your state's hospital association to find out whether local pricing is available online.

7. Check your insurer's Web site, too

One major drawback of looking up prices online or contacting finance departments is that the pricing information you receive is likely to be a hospital's high list prices. If you are insured, your insurance company probably negotiates a lower rate for you, even if you have a high deductible.

Fortunately, several providers are helping solve this problem by proactively placing their customer's out-of-pocket price information online.

• Compare health plans

Cutler says Aetna is implementing an online rollout of comparative cost information in several states, since primary-care doctors usually aren't able to provide this information to their patients.

"Most physicians wouldn't know the cost of lab fees or what the cost of another specialist is," he says. "That's one of the reasons why we've been trying to provide more information. (We want) to help people get some of that cost information."

Check with your insurer to see if it lists comparative costs online. Also, be sure to verify that any additional specialist you plan to use (such as an anesthesiologist) is covered by your plan.

Even though your insurer's negotiated rates are likely to be lower than the hospital's list prices, 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%, you might assume that your 20% (out-of-pocket expense) is $400," says Jason Beyrouty, a director with Benefit Advisors, a 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 $100.

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 pre-negotiated fees that hospitals accept for certain medical procedures. It's likely that these negotiated rates are less than the hospital's listed rates, Stewart says.

"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)," Cooper says. "The best cost savings result when people use generic (medicines) versus brand."

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," Cooper says. 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 whether you qualify for an assistance program. The partnership 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-reducing 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.

This article was reported and written by Margarette Burnette for Bankrate.com.

Published Dec. 4, 2008

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