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We all like to shop around to get the best price.  Why not for health care?

The whole idea of High Deductible Health Plans was to give the patient more control over where they spend their health care dollars.  How can we be savvy shoppers when we can’t compare prices?

A recent study in a prestigious medical journal examined the inability to predict out-of-pocket costs of medical procedures and surgeries.  What they found was that even if you call the hospitals and doctor’s office and your health plan for a price before undergoing a procedure you cannot find out what your out-of-pocket costs will be.  They also found that if you are able to find out what the usual charge is for a procedure from the hospital, when you compare these charges with other hospitals the estimates can vary by thousands of dollars.

These variations in charges are not necessarily from different parts of the country or even in different states, these can be from hospitals in the same city, zip code, or just across the street!

WHO KNEW?

Did you know?

  • If you have a procedure done in a hospital that you may receive 3 bills
    • one from the hospital for the use of their facility and supplies
    • one from the anesthesiologist
    • one from the doctor (s) who did the procedure
  • You can be treated by a doctor who is in-network for your health plan, but is affiliated with a hospital that is not in your network.  This means that the doctor’s charges would be considered in network, but you may have to pay out of pocket for the hospital and other charges which are out of network.
  • If you have Medicare and do not check that the hospital and the doctors accept Medicare “assignment”, you may be responsible for all or part of the charges from your procedure or surgery

The moral to the story is:

  • If you are able to get a quote, make sure you get it in writing
  • Ask a lot of questions and keep asking until you get the information you need
  • Call at least 3 times with the same questions to ensure that you are getting the “correct” answers
  • Insist of speaking to a supervisor if you are not getting consistent responses to your questions
  • Always document each call, the name of the person you are speaking to, and the time and date of the call.  If you are calling a health plan, as for a reference number for each call

In Good Health

Health Champion