How to Keep your Medical Costs Down

• If you have a pre-existing condition and have lost your job and health insurance coverage or suffer a gap in your health care for some reason, make sure to check with COBRA. There are rules that will not allow you to be denied coverage.
• You CAN negotiate with both your doctor and the hospital for lower costs. For example, you should find out at what level the hospital and your doctor are reimbursed for the same procedures by Medicare. It will be less, and you might need to find a happy medium for yourself between the highest cost and the Medicare payment.
• Make sure you talk with your insurance company before having any major procedure. Have them put it in writing exactly what they will cover and what you are responsible to pay so they can not hit you with unexpected charges after the fact.
• Take your own prescribed medications and over-the counter meds with you when you go into the hospital. If you get your pills from the hospital, which the nurse must administer, you pay for the extra labor of that walk down the hall plus the medication!

And be an advocate for yourself. You can save yourself money!

• 70% of all claim appeals by patients require action and net patients money. Be persistent.
• Letters of complaint, especially if copied to your state’s insurance commissioner, receive quicker action than phone calls to insurance companies.
• Don’t always trust what insurance companies charge. For example, if you have surgery and part of the operating room team, assistant or anesthesiologist is not in your network, insurance companies will say you have to pay for their services, but if you had no say in who performed the auxiliary jobs in the OR, you are not responsible for payment.
• Don’t give insurance companies extra information or allow them to review your medical histories before you have surgery or an expensive procedure. They may be fishing for conditions you may have had when they insured you in order to deny you coverage. Most of these “investigations” will last for only 60-90 days and you are not likely to be pursued beyond that. Wait them out and avoid possible problems.
• Ask for itemized bills from both the hospital and your doctor(s). You may be overcharged. For example, hospitals may charge you for supplies that can be re-used by other patients who come after you. They can not do so, and you should not accept the charge.
• Keep dates and notes of all that is done to you under a physician’s care and under hospital care. Also keep copies of all your claims and bills. If you organize and retain documentation, you will be better able to pursue appeals.
• If you are having real difficulty, be in touch with the Patient Advocate Foundation. You will have to pay for services, but those fees may well be worth huge savings on your medical bills.
• Ask if the hospital is funded by federal monies. If it is, they are required to give you an application for charity care if you do not have insurance.

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