The Importance of Comparison Shopping Health Insurance

A few months ago, my wife started to get frequent headaches. Some were mild, others were so severe she had to stay in bed all day. After talking with her doctor, a bunch of tests were ordered. For the most part, our health insurance kicked in and paid for the majority of the bills. In most cases, we were left paying up to $100 for what insurance didn’t cover. But then the surprise bill came. A scan from the local hospital cost us $2,000! And this was after our insurance paid their portion.

The Current Health Care System

For reference, we have a high deductible health insurance plan. Instead of our insurance covering most charges, leaving us with some small co-pays, with a high deductible plan, we have to meet an annual deductible – in our case about $6,000 ñ before insurance takes over.
With the passage of the Affordable Care Act (aka Obamacare), more and more employers are turning to high deductible health insurance plans.

While the part I mentioned above sounds scary, there are many benefits to this type of plan. They include more options for seeing specialists and the ability to save money in a savings account that is tax-free, so long as you use the money for healthcare expenses. So, even if you aren’t currently enrolled in a high deductible health plan, you should keep reading as chances are you might find yourself in one sooner rather than later.

Shopping Around

Since you pay more of your health bills with a high deductible plan, it makes it imperative that you shop around. This may sound strange to some, since with traditional health plans, you only pay the co-pay. But prices for services in health care vary, just like they do for food, depending on which grocery store you visit. Here are some steps for you to follow so that you get the best service for the lowest price.

Contact Your Employer: Most employers that offer a high deductible plan also offer a website for you to visit that helps with health related services. On this website, you can see the estimated cost of various procedures, from CAT scans to MRIs and X-rays. By going here first, you can get a rough estimate of how much the service should cost you. You most likely won’t find this exact price in the market, but it’s a good guideline to start with.

Call Around: For some services, hospital prices can be astronomical. Before you have the service, call ahead and ask what the price is for the service you need. After that, call imaging centers or urgent care centers and see what they charge for the same service. When you find a good price, schedule the service.

One side note here, you shouldn’t base your entire decision on price alone. Some places might have more experienced professionals running the equipment than other places. For example, if your estimate is $1,000 and an imaging center is going to charge you $50, you might want to keep looking.

Get Various Referrals: When your doctor refers you to a specialist, don’t just accept the referral. Ask why you are being referred to this specific specialist. Many times doctors will just refer you to the specialist in the same network.

You should go home and research local specialists and see who sounds like the best one for your situation. Then you can work with your doctor to schedule a visit. You should be scheduling two specialists as well, just so you have a second opinion.

Negotiate: Even after you do all of this work, you may find that you still get hit with a lofty bill. Don’t worry, you still have a few options left. The first option is to contact your employer. Many employers now offer a third party service to review your health care bill and see if the charges are in line with standard prices. Depending on what they find, you might end up owing significantly less.

In the chance that doesn’t work, you can call the hospital or service center directly and negotiate. Be honest with them and tell them you were expecting a lower bill and cannot afford the price. They will first offer a payment plan, but if you keep at it, you can get your overall bill reduced. Note that this tends to work more successfully in hospitals than in smaller imaging centers.

Final Thoughts

As for my wife, we went through her employer and unfortunately, the bill was correct. By the time I received the text from her telling me this, she had already written the check and mailed it to the hospital, so we didn’t get a chance to negotiate. Going forward though, she now knows she can negotiate with the hospital and will do so before mailing off the check.

3 Responses to The Importance of Comparison Shopping Health Insurance

  1. You are absolutely right that shopping around is really important. I use the internet a lot to get a sense of the costs and services provided. I also really value what personal friends and family members say about different programs.

  2. MomCents says:

    I feel your pain! We got about a $2800 after insurance and also have the high deductible plan and HRA. I’m seriously thinking about switching to an HMO….I have about a dozen options to choose from as a federal employee.

    Too bad you didn’t get a chance to negotiate…they will almost always knock off 20% just for asking in my experience.

    Hope your wife’s headaches are gone!

  3. Your suggestion to shop around fits the intent behind high deductible plans. The premiums are lower in part because policyholders will think twice before seeking care, and will seek out low cost providers. People behave differently when spending their own money as opposed to the insurance company’s.