Healthcare Price Lists: A Short (but Useful) Guide
Consumers are taking on more and more responsibility for controlling their own healthcare costs. Many people have high-deductible health plans or consumer-directed health plans that come with high deductibles and high out-of-pocket expense caps, ranging from $1,250 (self-only) to $12,500 (family) in 2013. (See also: The Types of Insurance Plans)
According to a survey by the Kaiser Family Foundation and the Health Education Research Trust, 19% of people with employer-sponsored plans have an HDHP with a savings option (HDHP/SO). That percentage is expected to grow as more employers shift to these plans or expand offerings to include them in benefit packages. You may be one of those people, or you may want to control expenses even if you are not directly responsible for paying medical bills.
But when consumers try to control costs, there's a problem — getting prices from providers can be difficult and time-consuming. And, unlike your mechanic, healthcare providers typically don't give cost estimates before proceeding with a diagnostic or treatment. Sure, you can see pricing after you use services and get a bill. But to control expenses, you need to know the price of office visits, screenings, tests, surgeries, medications, and more before receiving services.
Asking about pricing from providers, such as doctor’s offices, hospitals, and screening facilities, is a simple and straightforward tactic. Occasionally, that approach works. But in my experience, staff members are often elusive about prices. They act alternatively fearful, confused, and guarded, seeming scared of the possibility of dispensing inaccurate information, unsure about what price they should give (list price, negotiated price, or billed price, which may vary by insurance company and plan type), and defensive regarding the value of services being rendered.
Fortunately, price lists are becoming more commonplace. Here are resources with useful information.
Fair Health has a consumer cost lookup feature at its website, fairhealthconsumer.org. Enter your location and select a procedure to get an estimate of the initial charge, reimbursement, and out-of-pocket cost. Based on my experience, the results seem accurate. Note that you are limited to a certain number of searches.
Healthcare Blue Book
Among useful web resources for saving money on healthcare is Healthcare Blue Book. You can get price information plus guidelines on possible price variations throughout the country. Search results break out facility and professional fees when applicable.
Clear Health Costs
You can find general information on healthcare costs by state and city as well as the lowest and highest prices of certain services by providers in New York at Clear Health Costs. The site collects and shares prices provided by consumers.
Davis Liu, M.D., a practicing board-certified family physician pointed me to Leslie's List as a source of price information. Pricing is available for diagnostic testing services and prescriptions in Chicago and Dallas.
You can check out prices and order medications at healthwarehouse.com, a U.S.-based pharmacy mentioned by Dr. Liu in his book, "The Thrifty Patient: Vital Insider Tips to Staying Healthy and Saving Money."
Some healthcare providers post price lists or ranges on their websites. You can see how much an office visit and strep test cost at Minute Clinic or the price of a colonoscopy at Dartmouth-Hitchcock Medical Center.
My healthcare insurance company has a tool that allows me to look up prices for office visits, procedures, and other services. Results indicate a range of prices for negotiated rates and out-of-pocket costs (though this number does not include co-pay amounts).
These sites and others like them can help you to:
- Plan your consumption of healthcare.
- Set aside money in a Health Savings Account (HSA) if you have an HDHP or determine how much to save in a Flexible Spending Account (FSA) or a regular savings account even if you do not have an HDHP.
- Determine the cost-benefit of a proposed procedure or treatment.
- Compare costs at different providers.
- Save money by choosing lower-cost providers if appropriate or negotiating a lower rate.
Have you consulted a price list for healthcare services?