Martine Ehrenclou, MA, is a patient advocate and award-winning author of The Take-Charge Patient. Learn more about Martine and her work at thetakechargepatient.com.
In these tough economic times, paying for medical care and medications may not be at the top of your list. Even if you have a problem with your health, it’s tempting to put off seeing a medical provider or having a procedure because money is tight. Maybe your health insurance plan has a high deductible, or your medical provider doesn’t take your insurance, or perhaps you don’t have insurance at all.
If you need to see your doctor or have a procedure, there are ways to receive discounted medical care. Treating a medical condition or disease is much easier if it’s in its infancy stages rather than when it has progressed. Try not to let finances stand in the way of your good health.
4 tips to keep in mind
1. Many people don’t know that they can negotiate medical provider fees. Whether you're dealing with a doctor, nurse, surgery center, or hospital, you can negotiate reduced fees just like you would for the purchase of a car or house. You will be in a position to do this if you do not use your health insurance.
2. You can ask for a cash pay discount from any medical provider. There’s no guarantee you’ll get it, but chances are you will. The time to ask is before you receive the service, not after.
3. Most doctors and hospitals prefer to receive payment upfront, within 30 days, or on a scheduled payment plan, rather than risk not getting paid at all. According to the Centers for Disease Control (CDC), one in five people in the U.S. reported problems paying their medical bills. You are not alone. Many physicians will accept a 20 percent discount on their office visit fees if you pay at the time of service. All you have to do is ask.
4. Many medical providers have stopped taking Medicare because of the low reimbursement rates. If your doctor does not take Medicare or if Medicare does not cover the medical service you need, follow the tips to ask for a cash pay discount.
Tips to negotiate your medical fees
1. Ask to speak to the financial decision-maker in your doctor’s practice or medical facility. This might be the finance manager, manager of a doctor’s practice, or the medical biller. Do not waste your time speaking to a nurse, doctor or whoever answers the phone.
2. Be calm and polite, but confident. Explain your financial situation or hardship. For example, “I am a single parent with two children. My hours at my job were cut back last month and my son’s medical bills have put me in a bad financial situation. I cannot afford the $500 charge for my procedure.” You want the person you are speaking to on your side, so it’s important to be honest and explain the necessity for the procedure.
3. Start by offering 30 percent of the estimated fee quoted for the medical service. For example, you can say, “I can afford $350.” The professional might deny your offer and counter with a higher figure. Depending on your circumstances, you can stick to the $350 amount or counter with a slightly higher fee. You and the professional will probably settle on a figure around 25 percent of the original fee.
4. If you need a payment plan, establish the agreed upon fee first and then ask for a payment plan. Propose a payment schedule. For example you can say, “Is it okay if I pay $X a month for X months?” You may have to decide if a reduced fee is more important than a payment plan, as you might not be able to get both.
5. If you are not comfortable negotiating your own medical bills, there are companies that will do that for you. Medical Cost Advocate is one such company, and their cost is a percentage of what they save you.
Tips to find discounted or free medications
If you cannot afford the medication your doctor or nurse prescribes for you, talk to him or her. Be honest about your financial situation so he or she can help you. For example, you can ask, “Is there a less expensive alternative?” Medical providers have resources to assist you.
1. Ask your medical provider if you can receive a higher dose of the medication so you can split it in half.
2. Ask for free samples of a medication. If you have a time-limited illness or condition, free samples can be very helpful, but if you need medication for a long period of time, this may not be a good option. Keep in mind that all samples are brand medication, not generic.
3. If you require medication for a longer term, ask your medical provider if he or she has resources for free medications from pharmaceutical companies.
4. Ask for the generic of the medication.
5. Get medications filled at a major drug store chain. These tend to have less expensive medications than smaller pharmacies.