As the wise man said, you have nothing if you don’t have your health. Even being rich sucks if you’re sick.
The problem, of course, is that healthcare is not free in America – not by a long shot. No fewer than two-thirds of all bankruptcies declared in the U.S. are caused by medical debt. Having insurance helps, but it may let you down just when you need it most. Disturbingly, one California woman who nearly lost her face in a bear attack described dealing with her insurance as the most challenging part of the entire ordeal. While her personal story is remarkable in many ways, you needn’t look far for more examples of an unfair and arbitrary system.
How can you reduce your medical bills in case they refuse to pay, though? Perhaps you can’t even afford insurance to begin with, making saving money on essential care even more important.
Table of Contents
- 1 Prevention Is Better than Cure
- 2 Getting the Best Deal on Treatment
- 2.1 Stay Within Your Network
- 2.2 Know What Is and Isn’t Covered
- 2.3 Avoid Using Credit Cards
- 2.4 Don’t Be Afraid to Haggle
- 2.5 Be Honest with Your Doctor
- 2.6 Consider Ordering Your Drugs Online
- 2.7 Choose Carefully Between Outpatient, Inpatient and Emergency Care
- 2.8 Get a Second Opinion
- 2.9 Check Your Bill
- 2.10 Explore Alternative Treatments
- 3 Planning for the Future
- 4 Paying Less for Medical Care: The Long and the Short
Prevention Is Better than Cure
Even though they’re less profitable, most doctors much prefer dealing with healthy patients. The biggest killers in America – cardiac problems, hypertension, diabetes, cancer – all have a major lifestyle component. While avoiding a nasty genetic jackpot isn’t in your hands, there is plenty you can do to reduce your risk of several unpleasant, expensive diseases.
The Lost Art of Walking
Chances are that you’re spending more than you’d like on gas and other vehicle-related expenses. Making a habit of not even starting the car for any trip shorter than a mile will not only save you money directly, but also reduce your medical bills for years to come – perhaps not in any way you’d notice, but just as certainly as water flows downhill.
At first, you may be plagued by sore knees and ankles, but don’t give up. Pretty soon, your lunchtime strolls will become a treasured part of your day. Walking more often will help to keep your weight under control, which is one of the single biggest predictive factors for diseases like diabetes and heart disease. Perhaps more importantly, it gives you time to think and perhaps enjoy some nice scenery. Walking is also, in case you’ve let yourself go a little over the past couple of years, a great way to condition your body for more strenuous forms of exercise.
Though we tend to forget this fact, our bodies really are designed for a hunting and foraging lifestyle. When you spend eight hours a day stuck in front of a computer, several more on the sofa and the remainder in bed, everything from your heart to your joints suffers and decays.
While consistent activity like walking goes quite a long way towards letting your body do some much-needed self-maintenance, there’s also a lot to be said for getting your heart rate elevated for twenty minutes or so, two or three times a week. How exactly you go about this is up to you: team sports, something like tennis if you’re the competitive type, or a solo activity like jogging.
Just like with walking more, the key is to not give up. It gets easier more quickly than you can imagine. Before long, you’ll notice that you’re less stressed, sleep better, concentrate for longer, and feel like a million bucks. “Runner’s high”, the fantastic feeling you get when aerobic exercise causes your brain to release endorphins, is a real thing and much more affordable than Prozac.
The thing about cardio is that it simply makes every part of your body work better. If your goal is losing weight, however, most experts agree that you can get rid of excess fat by jogging, but you’re much better off building muscle at the same time. Each pound of muscle takes 2,800 calories to build and burns an additional 10 each day even while just resting.
Ladies needn’t worry: the chances of a female body bulking up without steroids or hormone supplements are virtually nil. Rather, your muscles will get denser and more toned, leading to a more attractive figure, as well as medical gains like a lower resting heart rate, better cholesterol, and clearer arteries.
Improving Your Diet
Lots of people claim that they simply “don’t have time” to eat better. The same individuals often own Xboxes, DVD players, and Netflix subscriptions – time by itself is rarely the problem. Nor, in fact, is the cost of healthy food a major hurdle: eating better is often cheaper than you think.
Everybody can improve their diet, and the payoff is significant if not instant. In general, you should try to:
- Eat less red meat,
- Consume more vegetables, including raw ones,
- Cut down or even eliminate sugar,
- Avoid processed foods like the plague – anything with a commercial is probably bad for you.
- The Importance of Regular Checkups
The reason dentists want you to come in every 12 months isn’t that they’re sadists – at least, that isn’t the only reason. Any medical problem usually gets either better or worse by itself, but when it gets worse it often gets a whole lot worse.
Fixing a condition that’s been allowed to spiral out of control is often very expensive and sometimes impossible. Getting yourself checked out by a doctor once a year is the best way to keep this from happening.
Getting a primary care physician to answer any questions you may have, check your heart function, and evaluate your overall state of health can cost as little as $150. It is worth every penny for the peace of mind you’ll receive in return. In case something odd turns up, some simple tests can detect a number of major problems while they can still be nipped in the bud. Many medical insurance policies cover annual wellness visits since they know that this saves both you and them money in the long run.
Get Your Shots
One excellent reason to get inoculated is an upcoming trip abroad: nothing can ruin the perfect holiday like a bout of yellow fever. Still, even though some vocal, presumably well-meaning but entirely delusional individuals will tell you otherwise, there is no good reason or even excuse for not getting vaccinated. In a very small fraction of cases, these injections may lead to minor complications like a skin rash. Contracting measles or polio, by contrast, is a lot less fun than getting jabbed with a needle, as well as much more expensive.
Getting the Best Deal on Treatment
Almost invariably, refusing to go to a doctor or even the ER because you “can’t afford it” is a bad idea. It’s difficult to put a price on avoiding discomfort and the probability of an untreated illness spiraling out of control.
At the same time, you probably don’t want to spend more than you need to even on essential treatment, regardless of whether you have insurance. Just remembering a couple of simple things can save you a great deal of cash.
Stay Within Your Network
Assuming that you have insurance, you’ll always want to ask any service provider you visit whether or not they’re affiliated with your company. This can sometimes be tricky, for instance when a specialist rents an office in a hospital which is part of your network – without actually being a hospital employee.
Know What Is and Isn’t Covered
On a related note, it’s also a good idea to phone up your insurer before making an appointment. Few people know the conditions of their policy in detail, with the result that about one in three end up getting a surprise bill for something they assumed was included. Knowing in advance may cause you to seek out cheaper options or at least plan for the expense.
If you fail to get approval or one of your claims is rejected, you can always appeal to your insurer. This can be a multi-stage process and isn’t exactly straightforward, but the good news is valid arguments presented logically are successful more often than not.
Avoid Using Credit Cards
In an emergency, anything you need to do to get treatment is fair game. When you have a little time to plan for the financial implications, though, you really want to think about the longer term.
Somewhat frighteningly, the average American owes more than $6,000 on one or more credit cards. At typical rates, that means paying almost a thousand dollars each year on interest alone, making it that much more difficult to get ahead. If you can’t cover the cost of treatment out of savings, you’re much better off taking out a personal loan, some of which are designed specifically for this kind of situation. Your treatment provider may also be willing to offer you a payment plan at a competitive interest rate.
Don’t Be Afraid to Haggle
Dealing with doctors can be intimidating: you’re probably nervous about your prognosis already, they know a lot more what’s going on than you do, and they generally expect you to follow their instructions exactly. It may, therefore, come as a surprise that there is actually a lot of wiggle room when it comes to billing.
As mentioned above, many clinics and hospitals are willing to consider letting you pay off your bill in weekly or monthly installments – insurance claims are often tedious to settle, so they’re used to waiting a while for payment. Also, if you have limited financial resources, you can ask your doctor to skip tests that aren’t definitely necessary and prescribe generic medication instead of the brand-name variety.
If need be, you can even approach a patient advocate – someone with some medical and/or legal training who will help you find your way around the healthcare labyrinth. This is often a good idea if you need to appeal a decision of your insurance provider or interpret a hospital bill. Finally, you may simply want to ask different providers how much they charge for the procedure you need – one hospital often has prices double that of another.
Be Honest with Your Doctor
Patient confidentiality is generally taken very seriously in the medical profession; even your digital records are protected by some pretty stringent laws and traditions. In other words, there is no good reason to lie to a doctor, even about embarrassing and illegal activities. Doing so is only likely to lead them up blind alleys while they’re trying to make an accurate diagnosis.
In addition, you should be upfront with them if you’re on a plan with a high deductible or paying for the consultation yourself. They have other patients in the same position and may well be able to point out some ways to save on medical bills without compromising on the quality of care you receive.
Consider Ordering Your Drugs Online
If you take medication for a chronic condition, it’s very likely that you can save money by having a mail-order pharmacy fill your prescription. Generally, you’ll purchase a supply to last you between one and three months and get a bulk discount on several common forms of medication.
However, this may not be the best way of reducing your medical expenses when you’re trying out a new medication. Pharmacists aren’t doctors, but they’re very well educated in their own field and are worth asking for advice about possible side effects and adverse drug interactions. They may also catch an error in a prescription, which can be due to anything from a certain drug being contraindicated for pregnant women to simple bad handwriting – according to Food and Drug Administration estimates, as many as 1.3 million people annually are harmed by medication errors.
Choose Carefully Between Outpatient, Inpatient and Emergency Care
As the words suggest, an inpatient is someone who gets admitted and usually spends one or more nights in hospital, an outpatient leaves soon after treatment, and any patient in the ER is going to be charged four times the going rate for anything from aspirin to an arterial stent. What many people don’t realize is that even some kinds of surgery can be done on an outpatient basis – if your physician truly thinks that you should be kept under observation, they will let you know. Unsurprisingly, outpatient treatment is much cheaper, though a cautious doctor might not even mention this possibility to a patient.
The emergency room is someplace you should only visit for symptoms that are both unexpected and serious. Plenty of people have gotten stuck with a bill for a thousand dollars or more for something that turned out to be dehydration or even gas. Though you certainly don’t want to wait for the next available appointment if you’re suffering from something like shortness of breath or vomiting blood, staying objective can save you from spending a lot of money unnecessarily.
Similarly, while insurance will generally cover an ambulance ride as long as they consider it medically necessary, they may refuse if you use an out-of-network ambulance service or don’t take it to the closest suitable hospital. You may be just fine taking an Uber or taxi.
Get a Second Opinion
Despite how they sometimes act, doctors are not infallible, omniscient or psychic. They aren’t all equally experienced in the same diseases, and their diagnoses are often just the best guess that accounts for all of the patient’s symptoms and medical history.
If you’re told that you suffer from something serious and difficult to cure, the best course of action is often to wait a few days and see another doctor. This obviously means paying for more than one consultation and probably for extra or even duplicate lab work, but this is a drop in the bucket compared to the cost of treatment – not to mention the consequences of unnecessary or even harmful therapies. Consider this: one study found that seeking a second opinion changed the course of treatment in 37% of cases, and the bottom-line diagnosis in 15%. Combine this with the theory that mistaken diagnoses and medical errors actually kill more people than accidents, and it’s clear that it’s better to be sure and safe than sorry.
Check Your Bill
Medical bills are, by and large, pretty confusing and filled with acronyms and Latin words. This is understandable; what isn’t is that as many as four out of five of them contain errors.
The only way to catch these is by reviewing your itemized statement yourself, possibly with some help from Google and some specialized services. Certain items will most likely still be confusing, like “skin-to-skin contact” – a fancy way of saying a mother was allowed to hold her newborn (more specifically, having an extra nurse in the room so that both patients could be monitored closely after a C-section). Other errors are less easy to justify: a charge for a doctor who was never in the same room as the patient, medicines that were never dispensed or tests that served no tangible purpose. This means that your insurer is within their rights not to pay for them, yet the typical doctor will want to cover all the bases and may not even realize that some aspects of your care are just too pricey.
If something on the bill seems out of place or just ridiculously expensive, you have the right to request your medical chart and pharmacy file. Hospital billing departments aren’t always too interested in avoiding errors, but will generally remove such discrepancies or offer you a discount if pushed.
Explore Alternative Treatments
Most American doctors tend to think in terms of treating any condition with a pill or surgery long before considering any other kind of intervention; their patients expect nothing else. This tendency may go some way toward explaining why the U.S. has the highest per-capita healthcare costs in the world, arguably without a noticeably superior level of care or better health outcomes.
Meanwhile, it’s well known that a healthy lifestyle is often highly effective at curing conditions like anxiety and depression. Chiropractic sometimes seems like a hit-or-miss affair, but some patients certainly report major improvements after this kind of therapy. Nobody knows how acupuncture works in a scientific sense, but the World Health Organization considers it an effective treatment for a variety of conditions and several insurance plans cover a limited number of acupuncture and massage sessions. Eating “superfoods” like blackberries and turmeric may or may not improve your prognosis, but at least shouldn’t do any harm.
Of course, if your pulse rate is 150, you’ve fallen off a ladder or you’re bleeding from your eye sockets, you should probably consult someone who’s seen the inside of medical school. On the other hand, inexpensive, alternative remedies may be worth trying out for minor ailments or – with your doctor’s permission – in addition to more evidence-based treatment.
Planning for the Future
Without a doubt, the best time to manage an emergency is long before it rears its head. Particularly as you get older, an unexpected health crisis can even be good for you: a reminder that your body is not indestructible and free healthcare seems as remote a possibility as ever. Of course, you should still try whatever you can to pay less for medical care you need right now, but perhaps what you really need is a more long-term solution.
Review Your Medical Coverage
It’s a shame that something so important, not to mention expensive, is often selected without doing any significant amount of work or research. Even if you’re restricted to a single insurer, you probably have a wide range of options in terms of monthly premiums, maximum annual claims, co-pays, and which care providers you can see without paying extra.
Each of these plans works best for a particular type of consumer. Perhaps you have small children who need regular visits to a primary care physician. Maybe you need access to specialists without needing a referral from your regular doctor each time, or have to take expensive medication regularly, or your favorite hobby is chainsaw juggling. Though comparing each plan’s network of doctors, premiums and terms takes a little while, there are some comparison tools to speed up the process.
Once you’ve settled on two or three possibilities, you will most likely have to phone the providers’ call centers if you have any particular requirements such as maternity care or a pre-existing chronic condition – they probably won’t inform you of some limitations unless you specifically ask.
Start Thinking About a Health Savings Account
Everybody should really have an emergency fund which can, in a pinch, be used for medical bills. However, especially if you’re still fairly young and follow a healthy lifestyle, you may want to look specifically at plans with relatively low monthly premiums and high out-of-pocket deductibles. These are typically paired with a health savings account.
Now, instead of you pooling your insurance money with that of thousands of other people, you save only for you and your family’s expected future medical bills. The cool part is this: any money you put into a qualifying HSA is tax-deductible, draws interest payments and remains tax-free as long as you use it towards medical expenses.
Talk to Your Employer
The majority of people rely on their jobs for medical insurance. This has some disadvantages, including having a limited window of time during which to get a new policy after being laid off (while still having to pay premiums). There is one major point in its favor, though: typically, around 80% of the premiums are covered by the company.
Health and dental benefits used to be associated mainly with larger companies, but this has been changing for a while. As part of the Affordable Care Act, businesses with fewer than 50 employees can now take advantage of a number of incentives, including tax credits, that make offering a group health plan more affordable. Of course, however much they’d like to provide coverage for their employees, managers are bound to think of the bottom line first – they will probably be much more receptive to the idea if the company has difficulty attracting and retaining skilled workers.
See What Medicaid can Do for You
Although this program is available only in 37 states, this kind of assistance can be a lifesaver as long as your income is lower than approximately $1,500 per month for an individual or $2,000 for a couple. Depending on where you live, unfortunately, you may only be eligible if you’re disabled or older than 65.
Especially if you’ve been laid off recently, you can also see whether you can join the Affordable Care Act Marketplace. This is essentially a form of private medical insurance that’s supported by some government subsidies.
Paying Less for Medical Care: The Long and the Short
Death, taxes and illness are all certainties in life. How you approach them is under your control, though.
Ideally, you’ll already be prepared with insurance and perhaps other financial resources when medical problems strike. This is often only half the battle, though: very often, you can avoid the problem completely by taking care of yourself. In addition, it pays to educate yourself a little about how the healthcare industry works and occasionally fails to do so.
In the end, the most important thing when it comes to paying less for medical care may be to stay objective. Insurance companies love to use feel-good phrases in their advertising; you should remain cynical. Doctors and nurses are some of the people you can trust most, but they too have mental blind spots and separate agendas, so don’t be afraid to question what they say. And, if you suspect that you have some condition, make a point of reading up on it, but remember that free medical advice on the internet is often worth exactly what you pay for it.