When I got the co-payment bill for my MRI, I was ready to “take forever” to pay it back. A teacher’s salary isn’t exactly conducive to a lot of available cash and the debt was over $700. I found a way to reduce the amount by 30%. My wife broke a leg a couple of years ago and again, the hospital’s and doctors’ co-payments were rather stiff. It never ceases to amaze me how a five minute visit by a physician can lead to a $350 fee and how a simple glass of water in the hospital can cost a lot more than a good bottle of wine. But these experiences allowed me to become a lot more savvy on how to reduce medical bills.
Allow me to start with my prescription drugs, all four of them. For several years I was content to pick them up at my local pharmacy every month at a cost of approximately $30 of co-pay for generic drugs. A poster in my school caught my attention suddenly: Receive your medications by mail every 3 months. That seemed a lot more efficient as I no longer had to stand in tedious lines at the pharmacy almost every week. But there was an added benefit: $0 co-payment for generics. Hey, I said to myself! I just saved about $90. Of course, it helps to have a good medical plan provided by your employer. If you do have one, check with the insurance company about getting a 3-month supply; at the very least, you’ll save time and gas.
There are two important steps to take when faced with medical bills, especially from hospitals:
1. Check every item with a microscope to make sure you actually received the service or the product. Hospitals tend to “pad” their accounts by “mistake” of course (who would believe it?) so fight hard if you detect an error.
2. Offer immediate cash if you can afford it, which I did for my MRI, and you almost certainly will get a good discount. This will also work with doctors who’d rather avoid the paperwork involved in receiving small amounts every month or using a collection agency.
When you have to program elective surgery, do your negotiating before the procedure is done. Try to “charm” the doctor into reducing his fee if you are in the category of middle or low income; most doctors will agree to give you a discount if you come out frankly and explain your financial concerns. Even if you have insurance, not having any in case of a major surgery would simply bankrupt you, your co-pays might just be too high. In addition, do the following:
1. Find out what the Medicare cost of the operation is; even if you don’t have Medicare yet, it will help you determine what a fair amount is. Accept the fact that it may be a little higher than Medicare, but not outrageously so.
2. If your surgeon charges too much, shop around. There are plenty of good doctors who might be more reasonable.
3. Consider the real possibility of having the operation outside the U.S. Many insurances will cover surgeries in Mexico knowing that it will cost them less. Do your homework before you select a Mexican doctor and a Mexican hospital. The city of Monterrey is famous for its excellent healthcare. This applies especially to dental care which is extremely costly in the U.S.
4. Do not go to the emergency room for minor injuries or illnesses. Use local clinics which are much cheaper.
5. When you have your regular visit with your primary care doctor, ask the nurse whether they have samples. It pays to establish a cordial relation with them (the nurses). My wife was able to get a 3-month supply of cholesterol drugs for free.
A final thought; why didn’t I think of it before? Stay in shape and eat right. An ounce of prevention is… you know the rest.