6 Ways to Avoid Surprise Medical Bills

by Camilla Cheung on 17 March 2016 (1 comment)

Understanding how your health insurance coverage works can be a great way to avoid unexpected medical bills. If you’re savvy about your health benefits, you can save cash and avoid unnecessary medical expenses.

1. Be Proactive With Preventative Care

Has it been years since your last physical? Book one, stat! Preventive care visits are 100% covered under most health plans (make sure to see an in-network doctor when making the appointment). Take advantage of screenings that may be available to you depending on your plan: diabetes tests, mammograms, colon screenings, skin checks, and blood pressure tests can often detect issues before they become serious.

Don’t be a hero when it comes to your health! Don’t let your pride, or the co-pay, keep you from seeing a doctor when you feel that something is wrong. In fact, for non-urgent questions, see if you can talk with a doctor or nurse over the phone. Some doctors are even available via video through telemedicine services like MDLive. (Depending on your plan, these visits are usually less expensive).

For more tips on taking advantage of preventive care, visit http://www.cigna.com/takecontrol/.

2. Stay In-Network

Going outside of your plan’s network is a common way for people to rack up surprisingly high medical bills. Always do your research beforehand to find a doctor in your plan’s network (unless you’re in an emergency situation). Doctors that are in your plan’s network have been vetted by your health insurer to ensure they provide quality, affordable care. To avoid surprises, also double check that any new specialist you see is in network.

If you’re treated at an in-network hospital, there is still the chance that one of the doctors or other health professionals treating you may not be part of the network. Leave room in your budget for those costs. This is of course a tall order when you’re just focused on getting well, but it can cut down on financial headaches afterwards. If you do receive medical bills for out-of-network treatment after you leave the hospital, be sure to call your insurer for more information before paying the bill.

3. Comparison Shop

A friend of mine recently needed some lab work done. She was quoted what seemed to her an outrageously high price at one lab, and she decided to see what her options were. Turns out, a lab just a few miles down the street was willing to do the same work for a third of the price. Doing a little comparison shopping can save you hundreds of dollars, if you’re willing to make a few calls.

Going to an independent lab (many of them are nationwide, such as Quest Diagnostics and Labcorp) can save you up to 80% compared to using the lab at the hospital, depending on your location and health plan. You should also compare costs at radiology clinics, where the cost for an MRI, CAT scan, or X-ray can vary widely. Doing your research is your best bet.

4. Ask for an Estimate

Before treatment, ask your doctor or health insurer to give you an estimate of what costs to expect. Knowledge is power, and you may find that you can save some money by changing to a different medical facility (procedures done in hospitals generally cost more than those done in outpatient centers), switching to a generic drug or ensuring that preventative care procedures are billed correctly. Many health plans offer online tools to help you estimate costs for a specific treatment, doctor or facility ahead of time.

5. Switch to Generics

The FDA requires generic drugs to have the same quality and performance as brand name drugs. According to research cited by the FDA, generics work just as well as brand name drugs.

Ask your doctor if there is a generic version of the drug you need. Some plans don’t cover brand name drugs when a generic alternative is available, and many charge you more for brand name than generic.

6. Double Check Your Medical Bill

Before grabbing your checkbook, look at all the charges to make sure they are accurate. Billing mistakes happen all the time. I’ve been charged several hundred dollars for office visits that should have cost me a $50 co-pay. The first time, the billing office had forgotten to bill my insurance. The second time, my insurance had already paid the bill, but somehow the full medical bill still got sent to me through a mailing error.

Be aware of what your plan should cover (if in doubt, call your insurer), and double check all your medical bills. Sometimes, you may be mistakenly charged for a procedure you didn’t receive, or you may be double charged. And if your insurer declined to cover a procedure, call to ask why. The doctor’s office may have used the wrong code to charge you for the treatment, or another clerical error may have been made. If you feel overwhelmed by the billing process, check out this wonderful infographic explaining how to read your hospital bill.

I sure wish all billing snafus would resolve themselves immediately. The reality is that your medical bills are something that should be managed proactively if you want to save money. Taking control of your healthcare is one of the best things you can do, both for your health and for your wallet.


This article is sponsored by Cigna. Visit Cigna.com/knowyourbenefits for more great information on how to save money on your health plan. This article is for educational purposes only and is intended to promote consumer health. It is not intended as financial or medical advice and you should always consult a professional for financial or medical advice. 

Like this article? Pin it!

6 Ways to Avoid Surprise Medical Bills

Average: 4 (1 vote)
Your rating: None
Guest's picture

How do you join?

Guest's picture
Medical Recovery Services

When asking for an estimate, make sure to get it in writing and make sure that the quoted cost covers all related services. Also, to make sure you are adequately checking your bill, request a detailed itemized statement. Otherwise, you are checking a summary bill that does not break down the charges.