According to statistics from the Society for Human Resource Management (SHRM), employer-budgeted healthcare costs increased to an average of $12,792 per employee in 2021. Employees can help keep employer healthcare costs – and their premiums – down by planning ahead and negotiating fees for service.
Call Before Your Treatment
When you’re busy, sending an email might expedite your request. However, it’s best to stop, take a little time to pick up the phone and talk to a real person. Ask for the hospital’s billing department and get an estimate of how much your procedure might cost. (Write down the name of the person you speak with, plus the day and time.) Send this to your insurance provider to find out what your plan will cover. Then contact the hospital and let them know how much you can afford. When you’re recovering, you’ll have less worry about how to pay.
Offer to Pay in Full Up-Front
If you have the resources to do this, go for it. Consumer Reports estimate that you could save 20 percent off your bill. Ask to speak to someone who has the authority to grant you this deal and again, jot down the details of your call. However, if the treatment is more than you can afford, you might consider medical debt consolidation.
Shop Around for Less Expensive Providers
Insurance companies usually offer cost estimates for treatments. Some companies like UnitedHealthcare and Blue Cross Blue Shield even have cost comparison tools. If your insurance provider doesn’t offer this, try third-party sites like Healthcare Bluebook and GoodRx to shop and compare. Remember that though important, cost should never be the top consideration when deciding on a facility for your healthcare.
Understand What Your Insurance Covers
And what it doesn’t. Ask for a Summary of Benefits and Coverage from your provider to find out exactly what’s what when it comes to coinsurance, deductibles and more. Being prepared is always a good idea.
Ask for an Itemized Bill
After your treatment, you’ll receive an Explanation of Benefits (EOB) from your insurance company. This isn’t a bill and might be updated while your claim is being processed. But the first thing to do when you receive these are to check them for errors – humans make them!
Make Sure Services are In-Network
Before your procedure, check to see that all your labs, anesthesiologists and other services are in-network. Some states prohibit out-of-network providers from charging out-of-network prices when performing care at an in-network setting. Learn about your state’s level of protection at The Commonwealth Fund.
Seek Assistance Programs
Ask your healthcare provider – the hospital or lab’s billing department – about financial assistance and/or charity programs. Thankfully, hospitals have a standard procedure for helping those who are unable to pay their bills. Some hospitals even have discounts for people who don’t have access to medical insurance. You might also ask your provider about medical debt forgiveness. If this is an option, you’ll be asked to share tax returns and other relevant documents. Other resources to help you navigate your healthcare expenses are the Patient Advocate Foundation or the PAN Foundation.
Get on a Payment Plan
Generally, healthcare providers offer no-interest payments and are available to anyone who needs it. Better still, you won’t have to meet eligibility requirements like you would with payment assistance programs. But when setting something like this up, make sure you agree to a plan that you can stick with. Otherwise, your bill might be turned over to a collection agency.
As you know, your health is your most precious asset. Make sure you’re fiscally prepared to care for it.
Medical Debt Consolidation: Using a Loan to Pay Medical Bills (lendingtree.com)
State Balance-Billing Protections | Commonwealth Fund