Most of us know when we spot a good deal on groceries, a car or a new pair of jeans. But when it comes to doctors and medications, it’s virtually impossible to fi gure out what constitutes a smart buy. Not only is there huge variety in pricing, but the real costs of care aren't clear—making it difficult to know what a fair payment for procedures or pills might be. And these days, even if you have health insurance, you’re likely to have a high deductible, forcing you to foot an ever-larger share of the bill. In fact, a recent study by the benefits consultancy Aon Hewitt found the average worker’s share of health costs was almost $5,000 (including premiums, deductibles and co-pays). The good news: Because of new technology, there are an increasing number of ways you can shop around to get a better deal. Read on for strategies, websites and apps that can help you save significantly without making a painful sacrifice.
You’d have no issue getting estimates from three handymen before fixing a sink right? You can do the same with a physician if you’re paying by cash or credit card (a possibility for those without health insurance or those with a high deductible). On medibid.com you can enter basic health information and the type of doctor or procedure you need (a colonoscopy, say), then within about a week you receive bids from doctors who are willing to do the work. Many include testing and even follow-up visits in their fee because they still make more than they would from an insurer’s reimbursement. Physicians’ qualifications are listed on the site, but it’s also a good idea to check for patient reviews on Yelp and zocdoc.com. After deciding to accept the offer, you can call the doctor directly to arrange your appointment. Note: MediBid charges $25 to submit your procedure for a bid, but that cost is usually more than offset by what you save overall.
If you have a recurring back or joint injury, ask the doctor whether an X-ray (cost: about $200) would yield the same information as a pricier MRI (about $900). It’s also OK to inquire whether you need a procedure at all; see a list of treatments and practices that major medical specialty organizations say might have little or no value (based on scientific research) at choosingwisely.org.
Major insurers such as Aetna and United Healthcare now have Web tools that allow members to look up pricing for procedures and doctors in their area so they can choose one with a lower cost—or set aside the appropriate amount in their flexible spending account (FSA) or health savings account (HSA) every year.
Although it’s easy to pick a physician under your insurer’s umbrella, you can unintentionally find yourself going out of network at the hospital. Even if the facility and surgeon are in network your stay might include visits from an anesthesiologist and specialty doctors who aren’t covered. Call the hospital ahead of time and ask who is covered and request that you see only those doctors. Also, when there you should ideally have a family member or patient advocate help you double-check especially if you are medicated and not thinking clearly.
The cost of a given procedure at different hospitals and medical centers near you might vary by thousands of dollars and those differences usually aren’t tied to medical outcomes. In Austin Texas for example, cataract surgery could cost anywhere from $3,500 to $13,000. Visit newchoicehealth.com, which lets you see prices in your area (which are derived from Medicare data) and receive quotes from specific facilities for the work you need.
Have a condition that’s straightforward such as pinkeye, strep throat or an ear infection? You often can get care for 30 percent to 50 percent less than you’d pay at your general practitioner’s office by going to an in-store clinic, like those at CVS, Target and Walmart. (Bonus: You’re apt to see someone that day rather than having to make an appointment for later.) If you live in New York City for example, going to your regular doctor for an earache would cost about $160, compared with $75 at CVS MinuteClinic. Retail clinics which might accept insurance are usually staffed by nurse practitioners, not MDs, so they aren’t good for general checkups, chronic health conditions or very worrisome symptoms (like chest pain, which should send you to the ER). If going the retail clinic route, ask for a record of your visit so you can bring it to your next visit with your GP.
Ask the person at your doctor’s billing office if she would be willing to knock an additional 10 percent or more off the fee if you pay up front by check instead of credit card or payment plan. Because doctors lose about 3 percent to credit card fees—and more for patients who ultimately don’t pay—some will agree.
Doctors and hospitals already accept a deeply discounted rate from insurers. You can use that information to negotiate when you’re paying out of pocket. To learn what doctors in your area typically get from insurers, search for an ailment or treatment plus your zip code at healthcare blue book.com, a privately owned source—like Kelley Blue Book for cars—that gets its information from employers insurance companies and health care providers. Then ask the doctor to match that rate.
Older treatments that work just as well as newer ones often are cheaper or covered at a better rate by insurers. Drugcompare.destinationrx.com can suggest alternative meds; talk to your doctor to see if you can safely make a swap.
The GoodRx app and the website, needymeds.org collect information on hundreds of coupons from manufacturers and pharmacies, increasing the chances you’ll find one for the drug you take. Recently via needymeds.org for example, you could find a $10 coupon for the asthma drug Advair, which can cost about $300 per month if you don’t have insurance.
Big drug makers sometimes offer free trials of medications. Recently you could get a free 30-day sample of the cholesterol-lowering drug Crestor (retail cost: about $225) by going to the manufacturer’s website and filling out a simple form
The free apps GoodRx, LowestMed, and WeRx (all Android and Apple) compare prescription-drug costs at chains. Even if you have insurance the price might be lower than your co-pay. Sam’s Club and Walmart offer some generic Rx drugs for $4 for example. Check all three apps; sometimes they find different deals.
If you don’t have prescription drug coverage or you need an Rx your insurance plan won’t pay for, you might be able to score a deal with a discount card like the ones offered through AAA and AARP. You also can find free savings cards at websites such as familywize.org and needymeds.org. Just know that not all cards cover all medications and discounts can vary greatly. Check pparx.org to find a listing of card programs.
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