Want to know what the #1 expense is in my personal budget?
Health care.
And thank G-d, it’s not because anyone in our family is sick or has a chronic condition. It’s because my husband and I are both self-employed and our healthcare costs are therefore insanely expensive.
After doing extensive research, we chose a high deductible plan, which keeps our monthly premiums under $1000 – but also means that we pay for all of our basic medial care up to that high deductible.
Again, fortunately we are quite healthy; but the bills add up quickly when you don’t have a co-pay — even for a routine procedure.
Last month, I had to have a biopsy. First and foremost, thank G-d, everything came back fine!
But the bills for that procedure have run over $12,000.
Our insurance negotiated rate dropped the bill down to “only” a few thousand – but since we have the high deductible plan, that’s coming out of our pocket.
We contribute the max to our Health Savings Account every year (which for a family is $6,450 – but confirm that with your insurance broker or plan administrator), so at least these bills are coming out of before-tax money.
Tip #1: Save Up for an Emergency Fund
When the bills started rolling in this month, I immediately imagined what would have happened if I didn’t have that money on hand in our HSA. What if we were living paycheck to paycheck? This procedure could wipe us out.
It’s easy to understand how people get in trouble with their credit cards when even routine medical care is so costly. Which is why it’s so important to plan for emergencies.
And let’s face it – what I went thru doesn’t even qualify as emergency. That was just the unexpected nature of life. The unexpected happens all the time. Especially when it comes to our health. And sadly, sometimes actual emergencies happen, as we know all too well.
The stress that my husband and I felt when I had to undergo that biopsy was nothing short of acute. But thank G-d “How will I pay for this procedure?” wasn’t adding to it.
If you don’t yet have an emergency fund – please, put it at the top of your Priority List. Even if you can only afford to save $20 or $50 a month toward it right now. Saving for that Emergency Fund is one of the hardest, most self-disciplined things I’ve ever done. But at times like these, I am so glad for the effort!
Tip #2: Ask for a Discount
Our bills for this procedure came in a number of different forms — there were doctor bills and pathology bills and radiology bills and hospital bills. The biggest chunk was for the hospital.
Even though we have money in our HSA, I still decided to go out on a limb and ask them for a discount.
Specifically, I called the number listed on the bill and said, “Is there any flexibility with this payoff amount?”
Immediately, the woman started to tell me about a payment option.
I waited while she told me about that 20-month plan and then asked again, “Actually, I’m wondering if I can get a reduced rate if I pay the balance in full today.”
Right away, without any haggling, she told me that if I pay the balance in full, they will reduce it by 30%.
I was so grateful, once again, that we have our HSA (backed up by our Emergency Fund) — since without it, I wouldn’t necessarily have been in the position to offer payment in full.
Is spending all that money for one (of many) medical bills my idea of a good time? Absolutely not. But it is less painful than the alternative.
When it comes to our health, there are all sorts of stresses and anxieties that come along for the ride – one of which is money. Unless you’re a millionaire, it’s almost impossible to inoculate yourself from that stress.
But you can put up barriers and defenses — not the least of which are having an emergency fund and asking for a discount.
How do you deal with the stress of paying for health care? I’d love to talk about this in the comments section below.
I’m glad you’re okay but don’t those bills hurt?! We had PLANNED medical procedures and it’s still killing us. We don’t have many options for health care but we took the lesser of all evils. I can definitely agree with having a savings to back up a medical (or any!) emergency. Also, it NEVER hurts to ask for a discount for paying all at once. With my hospital bill from my c-section, my husband didn’t even have to ask and we got 10% off which came to about $200 – a nice chunk of change!
I am glad everything turned out ok for you!! (Healthwise anyway 🙂 )
We are dealing with similar now – one of the kids had a test done and everything is fine B”H but I just this morning looked at our insurance’s website and the EOB says we owe over $1000!
In the past, I have applied for financial aid when faced with big bills from the hospital we go to, and have consistently received a 80% to 100% reduction in our bill. The financial aid takes into account income, household size, other issues.
This current bill is for a different hospital though. It seems high for the procedure, so I will ask for an itemized bill and see if I can figure out why.
Glad your kiddo is okay, Rivkah!
My husband went from a full time job to contracting since its the way to get into the tech area with a major employer in my area. We signed up with their contractor healthcare, which is expensive. Then it turned out the prescription plan wasn’t as promised, its actually pay 100% then file to go against deductible ($500) then once deductible is met we still pay 100% but then get 70% back.
I did some research and found I get discount on prescriptions because I have AAA, it saved me over 50% of the cost.
Wow – I never knew AAA gave prescription discounts! Good to know, Cheryl.
Well done, Mara. BH everything is OK.
Re your Item #2 – although personally I agree you should ask for a discount – if you have insurance, and the hospital billed your insurance, if you then ask for a discount on the deductible amount you have to pay and the hospital agrees, it’s a violation of federal laws and considered fraud – for the hospital (and if they get audited – which they regularly do – you’d get dragged through a mess.) My husband is a doctor – he’s shocked that the hospital would do that for you. It’s different if you don’t have insurance and are self paying – then the hospital can do what they want. But if they are contracted with the insurance company, they are not allowed to discount what the insurance says is due.
Be careful with “discounts” when there’s any coordination with insurance. Since in this case, it appears at least $500 is being coordinated with insurance (assuming that the first $3,000 of the cost of the procedure ate up your entire deductible because you had no health care costs earlier in the year). But here are some problems:
1. Most insurance companies, in their contracts with providers, have a caveat that if they provide discounts for a patient, they receive that much less from the health insurere, too. So, let’s say a bill is $1,000, and both the patient and the insurer are supposed to pay $500 each. The doctor gives the patient a discount, so the patient only has to pay $400. Well, the insurance company can now tell the doctor they will only pay $400, too. So, instead of getting $1,000 (or $900 after the “discount”), the doctor gets $800. Without something in writing saying that the discount is granted for the patient, the doctor will be likely to try to “undo” the discount.
2. In a high-deductible plan, where the amount a patient pays gets counted dollar-for-dollar against a high deductible, the plan will often require patients to inform them of any discounts. If a patient does not inform the plan of a discount, then the patient is in violation of the plan rules, can get sued, get their coverage terminated, be required to pay for past services, etc. But, informing the health insurer of the discount will often result in the health insurer acting as in #1, bringing the doctor/facility to act as in #1 as well.
So the moral is: READ YOUR HEALTH INSURER’S SUMMARY PLAN DESCRIPTION, which is required to be provided to every plan participant. If you don’t understand something in the SPD, call your plan, ask your question, document the question and the answer, repeat it back to the person with whom you are speaking to make sure you understand the answer, and get the person’s name and a confirmation number for your phone call. Or, ask questions via email and request a response back in writing.
Many medical institutions allow you to apply for financial aid! It’s just like applying for a scholarship at school. We did and got all our bills 100% covered, basically taking care of our entire $5000 deductible.
Another thing to consider- if the tests are planned (ie not emergency room or inpatient hospital related) ask the hospital or dr office what your coinsurance amount will be for the test/procedure. If they will not give that to you (they should) then ask them for the cpt codes for the test and call your insurance company yourself. You will need to tell them where the test is taking place- hospital, dr office, surgery center etc.
also you may have an option of where to have the test. You often have very different pricing at a private (not owned by a hospital system) dr office versus the hospital. Hospital tests normally cost more because hospital rates are set much higher than dr office rates. Any planned test cost should never be a surprise if you do your homework – and then you can plan, schedule and budget accordingly.
Keep ALL receipts for anything medically related! Parking, mileage, hotel, meals, copays, prescriptions, glasses/contacts, medical equipment, etc… If you hit the 10% of income threshold then it is all a tax deduction (see a tax professional for questions). We can deduct a percentage of our electric bill because my oxygen concentrator is medically necessary. I hope you don’t end up with bills that high but if you do, the deduction can help.
Healthcare costs can be ridiculous at times. I’ve been back and forth with actually having insurance coverage as an adult. Several years ago I was diagnosed with a chronic condition that was best controlled with an expensive medication. When first diagnosed, I had really good prescription coverage and a $25 copay for an $1000/month medication. Then I changed jobs and insurance and the copay went up to $150! I was able to discuss the issue with my dr who ended up writing me a prescription for 4x my needed dose so I only needed to pay $150 every 4 months, instead of every month. Talk to your dr and see how they can help you out with stuff like that. There are many brand-name medication discount programs available from drug manufacturers as well as patient assistance programs that can be applied for. At one point when I didn’t have insurance at all, I price compared the cost of my medications at every pharmacy in town – Sam’s Club ended up being the least expensive overall, and while I do have a membership, you do not need to have one to use their pharmacy. Also make sure to tell your dr if paying for an expensive medication may be difficult to see if a generic or alternative medication may be an option. The other thing I’ve found out from working with patients is that there are some amazing foundations out there that will provide free diabetic medications and supplies.
Great post, Mara — to which I ‘d like to add:
Be very very clear on whether the hospital AND ALL the medical personnel accept your health plan. We discovered AFTER a procedure (B”H, all turned out fine) that while the head surgeon’s office said they would accept whatever insurance paid as the paid in full — the hospital did NOT, and in addition billed us for the services of the additional surgeon who was not in network.!
We worked it out, but it was very frustrating. So my advice is try to be clear up front who will accept what insurance and whether you will have to pay more.
Great post! I want to just add that you should always review the itemized bill. I have found errors so many times! I received an exorbitant bill for an office visit to my OBGYN. I looked through it and it turns out they charged me for two sonograms @$350 each, when I really only had one. I’m glad I looked it over!
Great post! I want to just add that you should always review the itemized bill for errors. I have found errors so many times! I received an exorbitant bill for an office visit to my OBGYN. I looked through it and it turns out they charged me for two sonograms @$350 each, when I really only had one. I’m glad I looked it over!