The ColoHealth Health & Wealth Newsletter
December 2022
Vol. 12, Issue 21

7 Powerful Ways to Reduce Your Out-Of-Pocket

Medical Expenses

Even with health insurance, families are taking on more and more of the burden of skyrocketing health care costs. Deductibles and coinsurance amounts have been steadily rising for years.

Today it is not uncommon for someone to have a deductible of $9000 or more. So even if you have health insurance, if you end up needing medical care you’re probably going to have to pay a chunk of money, here are ways to reduce that amount. 

1.  Shop around before you get care. If you have to pay a lot of money out of pocket, but still don’t expect to meet your insurance deductible for the year, just shopping around can make a big difference.

For example, a given service in a big city is often much more expensive than the same service in a small town. You could save thousands of dollars just by being willing to drive an hour or two.

Obviously, you want to treat medical emergencies right away. But for non-emergency procedures, just shopping around for a cheaper provider may make great sense. 

2. File your claim. It’s important to submit your claim to your insurance carrier, even if you don’t meet your deductible. This is important for two reasons:

First, your insurance company probably already has an arrangement through the HMO or PPO network to substantially discount what you are charged. That can result in significantly lower out-of-pocket costs for anything that doesn’t eat up your entire deductible for the year.

Second, filing your claim ensures that you’re given due credit for having paid a large amount of your deductible already. If you need more care during the same plan year, then you won’t have to pay the same amount twice, and you won’t have to deal with a billing hassle later. 

3. Ask for the cash price. Many doctors, hospitals, and clinics charge full price to insurance companies, but provide a much-discounted price to uninsured patients and others paying with cash. A lot of times, they will be open to providing that cash discount to people with high-deductible health plans and others in need.

If you’re outside of your HMO or PPO network, you’ll need to negotiate directly with the hospital itself. Ask the office or billing manager for the cash price. It’s best to make this request before services are rendered. They know that if they say no, you can walk away and find another provider who may.

Tip: If the provider refuses to offer a cash discount, ask what the Medicare rate is for the same services. They like to charge the rest of us more, but knowing this amount will give you some valuable information.

For example, you can go to a different provider and offer an amount a little higher than the Medicare rate, but lower than the first provider was asking. If they agree, you’ve saved some money right away. 

4. Use a medical bill negotiation company. If you have very large charges that your insurance will not be covering, it could be worth contacting a medical bill negotiation company.

Medical services negotiations are famous for having asymmetrical information. The medical provider has much more information, knowledge, and experience than the patient. They therefore have a huge and unfair advantage when it comes to price negotiation. 

Medical bill negotiation services help level the playing field. These organizations know what charges should be, and have a good idea for how low they can get your charges.

Bill negotiation services are a great way to make sure that you aren’t treated unfairly, exploited, or taken for a ride by medical providers. 

Most will work with a nominal initial fee, and then a cut based on how much they save.

5. Bunch Expenses. Once you meet your deductible for the year – or getting close to it, it makes sense to try to take care of as many other medically necessary treatments and services taken care of during the same plan year. 

That way, you avoid having to pay another deductible for anything you have to put off until the next plan year.

For example: Suppose you have an ER admit for a bicycle injury early in the year. You spend a couple of days in the hospital. You didn’t plan to do it. But you wind up paying your entire deductible for the ER and hospitalization costs and subsequent physical therapy.

Now’s the time to schedule any other services you expect to need. Don’t put them off to the following year. 

Consider scheduling these common medical services before the year is out: 

• Hip/knee/shoulder replacements
• Cataract surgery/refractive lens exchange
• Bunion surgery
• Infertility treatments
• Vasectomies
• Hysteroscopies
• Hernia repairs
• Back/neck pain surgeries
• Migraine treatments
• Weight loss surgery
• Sleep studies
• MRIs 

If you’re likely to have to go through any of these procedures soon anyway, it makes sense to bunch as much of your medical treatment as possible into the same plan year. So you don’t have to pay another deductible.

You still may have copays. But in most cases, you can finance these copays if they are a financial hardship.

6. Open a Health Savings Account (HSA). If your health plan is a qualified high deductible health plan (HDHP), you can open a health savings account. These innovative savings vehicles allow you to set aside money tax free, and pay for your medical expenses with tax-free money. 

That’s equivalent to a significant discount on your out-of-pocket medical costs right there.

What’s more, since you control the money in your HSA. you aren’t limited to any narrow network. And you can ask for the cash price.

7. Consider healthsharing. Healthsharing is the revolutionary affordable alternative to traditional medical insurance. With monthly fees that are just a fraction of what a typical unsubsidized health insurance premium costs, healthsharing is a viable and increasingly popular non-insurance alternative to traditional insurance.

Healthsharing organizations are administered by non-profit healthsharing ministry organizations that facilitate the sharing of unexpected medical bills among large numbers of like-minded fellow members.

They also typically assist members with negotiating pricing for medical services.

These seven cost-reduction techniques have proven themselves time and again to deliver significant discounts on out-of-pocket medical costs – while still ensuring patients get the care they need.

To Your Health and Wealth,

Wiley P. Long III
President- ColoHealth

The ColoHealth Health & Wealth Newsletter is published monthly and emailed to subscribers at no charge. Subscribe now to stay on top of the critical information you need to know about health insurance, healthshare plans and managing your finances to achieve financial security.

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