Health Care: How To Compare Prices

Health Care: How To Compare Prices for a person with cancer, HIV/AIDS, heart disease, ALS, MS, Parkinson's and other life changing conditions DONE

Summary

Learning the prices charged for different procedures, tests or use of medical premises requires work. There is no single source that has the information. To make matters more confusing, there is no single price in the health care industry. A doctor may charge one price to uninsured patients, another to patients covered by Medicare, and yet additional prices depending on what insurance company or plan covers the patient.

One alternative to learn about prices is to contact a service such as CoPatient. CoPatient will analyze your bill and send you a report including how much it believes you should have been charged. You can then either negotiate yourself or hire CoPatient to negotiate for you. If CoPatient negotiates for you, it charges a percentage of the amount of money it saves you.

Alternativle, consider the following steps:

NOTE: It is advisable to check the quality of a health care provider before agreeing to work with that provider. Information about how to do that is included in:

Step 1. Learn the name of the health care you need.

Before you compare prices for health care, ask your doctor or his or her office manager to describe the procedure or test you need in both medical terms (to use with medical personnel) and in lay terms (so you understand).



Step 2. Look online for costs in your geographical area.

Websites from different types of organizations provide health care cost information. All are generally available to all users except sites provided by insurance companies. The insurance company sites generally require that you be insured by that company and that you have a password. (Consider asking family members or friends who are insured to check their insurance company web sites for you). The types of sites currently available are:

When checking prices on web sites:

  • Check to see what approach the site takes to pricing. For example, some sites provide the list price -- the price the provider would like to get - but seldom does. Others list the price the Medicare pays. Sites from health insurance companies may list the price they pay.
  • Check to find out what is and is not included. It may not be the same. For instance, for surgery, the price may not include the cost of the anesthesiologist (the person who monitors your vital signs and administers anesthesia).








Step 3. Call the providers.

Call the providers in your area that provide the healthcare.

  • If you have an idea of price, confirm their charge.
  • If you don't have an idea about their price, ask what they charge for a person in your situation (uninsured, insured, Medicare etc).

Note the name of the person with whom you speak and his or her direct line or extension number. (Also note the date and time of your call). File your notes with your medical files.

Step 4. Negotiate

Once you know the prices in your area, pick the provider(s) that have the quality you want, and negotiate price. Ask for the price that insurance companies or Medicare pays, whichever is less. You may even get a lower price if you offer to pay cash.

If you have insurance, speak with your insurer to see if you can reduce your share of the cost. A particularly strong argument is if you lower the price the insurer will be charged. For example, if the insurer would normally be charged $5,000 and you are able to get the procedure for $4,500, you can ask that the company split the savings with you.