How to Save Money on Healthcare With Insurance

Everyone knows that having health insurance is the main way to save the most money. Even if you are in your deductible and have to pay for medical services, you are getting the benefit of the reduced fees that the insurance company has negotiated with doctors, hospitals and other healthcare providers.

What most people do not realize is how the cost of care varies from place to place even if two providers are both in network. Understanding these costs is critical to be able to get the best care for the best fee. 

For instance, if you go to a hospital-based outpatient department for an Xray, CT scan, MRI or other testing, it is likely to be much more expensive than using an outpatient-based imaging center. It pays to call around and ask how much your study will cost, and you may be surprised at how much variation in cost there is between facilities.

There is another reason to watch your costs – premium increases. Insurance companies evaluate policies for utilization; i.e. how much did it cost to take care of a group of patients. 

If the costs go up due to utilization of services then premiums will go up. If premiums go up enough, your employer-based insurance will either increase in cost to the employee or benefits may be trimmed, deductibles and out of pocket expenses increased. By shopping around to get a better price for the same service, you will benefit yourself and your employer and thereby increase the likelihood in being able to remain insured.

In addition to imaging centers, having surgery or endoscopies at an outpatient center can save a substantial amount of money compared to the exact same service in a hospital or hospital outpatient department. This holds true for Medicare; outpatient centers are now paid at 65 percent of hospital outpatient department rates, or private insurers. Not only are the facility fees less expensive, but it is more likely that the anesthesia service is a participating provider and the pathology service is a participating provider.

By paying attention to where you obtain services and how much those services cost, it is easy to save 35 percent or more on these services. If we all paid attention to the cost of these services there likely wouldn't be a healthcare crisis and Medicare wouldn't be facing a financial shortfall.

This issue came to light when a patient of mine needed a CT scan of the abdomen and pelvis. She had a high deductible insurance and called around to see what it would cost. The local hospital quoted her $1,400, one outpatient center said $450, she had the test at a second outpatient center for $375.  It is a good center with reputable radiologists who do a good job. 

Our outpatient endoscopy center is able to also provide significant savings as compared to the same procedure being done at the hospital outpatient department. I know for sure that we get just 65 percent of the hospital outpatient department rate for Medicare. Consider the millions of dollars that can be saved if patients just look for a gastroenterologist who can do their colon cancer screening in a privately owned outpatient center. 

For private insurers, we provide the patients the opportunity to use a fully accredited and licensed facility and then we send the pathology specimens to the insurers pathology service of choice. This can mean the difference between a bill of several hundred dollars vs. no out-of-pocket expense.

As we get toward the end of the year, and people have used up their deductibles, we see more patients coming in looking for colon cancer screening. Be smart, shop around for a board-certified gastroenterologist with a private outpatient AAAHC certified state and federally licensed endoscopy facility to receive high quality cost and effective care.