After a hospital stay, bills will start pouring in, and trust me, they will be shocking. Even with good insurance your out-of-pocket costs may still be an “ouch.” Most hospital charges may appear out of control to you, but you do have some control. Just know how and when to speak up!
3 Keys to Controlling Your Costs
- Make sure your prescriptions and medical providers are covered by your insurance policy
- Double check your bills for accuracy. Question anything that doesn’t look right to you.
- If you don’t have insurance, make sure you are paying the deeply discounted rate that every hospital grants to insurance companies. Don’t pay the full rate just because you don’t have insurance coverage!
Question Your Prescriptions
Before you leave the hospital, doctors will often start “stabilizing on the meds,” which means they give you the drugs they’ll want you to take at home, but watch you carefully to make sure they work for you.
But what if your insurance doesn’t cover them ?
- For each drug, ask: Do you plan for me to take this at home?
- If yes, ask the hospital’s social worker, case manager, and/or a friend or family member to check if it’s covered by your policy.
- If not, ask if there is a similar drug, or generic, that is covered.
- If so, share this with your doctors and nurses.
- Ask if the drug manufacturer has any special programs or discounts for patients. This might take some extra work, but it’s worth asking.
It pays to be frank about cost concerns – no one wants your health to go down hill or for you to suffer a return trip to the hospital because you can’t afford your medications..
Does Your Doctor Accept Your Insurance? (You may be surprised.)
Little known fact: many doctors and other medical professionals (like physical therapists) work in hospitals as independent contractors. These “independents” may not take your insurance even though the hospital does.
So…. for every new medical provider you see, ask: “Do you take my insurance?” If not, it’s OK to ask for someone else.
These are tough conversations to have as a patient, dealing with illness. This is why you should have someone with you, a family member or friend. Let them manage these details so you can focus on getting better.
Is Your Bill Correct?
First of all, if you have questions about your bill, don’t hesitate to call the hospital.
I’ve often heard, “Oh it doesn’t matter if there’s a mistake — insurance is taking care of everything.” Overcharges add up, and we all pay higher insurance rates as a result. If you see a big error, like a misdiagnosis, be sure to get the correct bill.
Know Your Options:
- For charges not covered by insurance, appeal to your carrier to reconsider. However, before calling, ask the hospital advocate to call for you. They ‘speak the same language’.
- In cases where doctors (and others) who see you in the hospital don’t take your insurance, ask your carrier to pay anyway. Get the hospital billing office to go to bat for you — they see this all the time and may help you get results.
- Report errors in your hospital bill in writing ASAP! The hospital cannot press you for payment on any charges you have disputed in writing while they investigate. (Note: emails are OK but your dispute is far less likely to fall through the cracks when you send a letter – and better yet – send it certified with a signature required.)
- Send copies of your letter, along with your bills, describing the errors to the hospital advocate and insurance company case manager.
About 25% of bankruptcies in the US stem from medical bills.
It’s worth knowing what your hospital care costs, and your share of it. Believe it or not, costs vary for every kind of surgery. We are entering a new age of consumerism in health care, so dare to compare. Don’t’ be tempted to buy in to the idea that higher costs = better care. This doesn’t necessarily add up!