This story is part ofan online community dedicated to financial empowerment and advice, led by CNET Editor at Large and So Money podcast host Farnoosh Torabi.
Believe it or not, I once had a pleasant visit to the dentist.
Years ago, after a routine teeth cleaning, I received an expensive estimate for necessary dental work. Since the cost exceeds my insurer’s maximum annual coverage, I would have to pay $1,000 out of pocket. Desperation and fear let me speak.
“Can we reduce the price somehow?” I asked while the toothed bib was still stuck to my shirt.
Things took a turn for the better then. My dentist discussed the request with his staff and suggested doing the second half of the procedure in the New Year, which was only a month away. That way, if I renewed my insurance, a larger portion of the cost would be covered. When I asked my dentist for financial advice—something I didn’t know I could do—I saved $300.
It’s a small example of how self-advocacy can lead to better financial outcomes, including medical savings. And as healthcare costs continue to rise, we need to practice this now more than ever. In the past five years, more than half of American adults reported debt related to medical or dental bills.
The advice was repeated on my podcast when I spoke with Emily Maloney, author of Cost of Living, a book that chronicles her painful observations and experiences both as a healthcare professional and as a patient with mental illness.
In our conversation, Maloney mentioned the many dysfunctions in our healthcare maze that can result in huge medical bills and other problems for patients. For example, at one hospital where she worked, the facility had $54 million in debt (common for small, busy health centers), resulting in medical shortages, reduced staffing and outdated equipment, and billing errors and misdiagnosis. “That debt creates rationing, and that rationing naturally trickles back down to the patients,” Maloney said.
5 ways to reduce healthcare costs and stress
Because the burdensome cost of medical care is largely borne by us as individuals, Maloney has shared these critical pieces of advice that can help us save money and stress.
- Have the “money talk” with your doctor
As my experience at the dentist has proven, doctors a “fiduciary responsibility” as part of their code of medical ethics to promote the best interests and welfare of their patients – that includes financially.
But we have to proactively mention that we want to save money. If your doctor doesn’t address it on their own, ask about cheaper generics. Ask them to review your health insurance to get a better sense of what’s financially feasible. Make sure your doctor provides the correct medical billing codes for your visit to ensure proper health insurance as well. Before you book a procedure, you can compare prices on sites like Health Care Blue Book and Fair Health Consumer and see if your doctor can match or beat the lowest list price.
2. Question your medical bills
Many medical bills contain errors, so you should wait to pay immediately. “Usually it’s not accurate or they haven’t gone through all the insurance, so you end up with an invoice that might not be accurate,” Maloney said.
You can work with a billing specialist or attorney, who may be provided by your employer, to review costs and diagnostic codes. Or call the healthcare provider and request a full breakdown of all billable components of the visit to spot any errors. If your bill is correct and you need more time to pay, ask the doctor’s office to create a payment schedule.
3. Review debt law
If a medical bill goes unnoticed and is handed over to a credit agency, there are safeguards that give Americans up to a year to pay their outstanding medical bills before they are published on credit reports. Also, the big three credit bureaus — Equifax, Experian, and Transunion — will stop reporting all medical collections under $500 in 2023.
If your medical debts are in collection and you’re having a hard time paying even the bare minimum on large medical bills, check your state’s statute of limitations for collecting that debt. With medical debt, the legal window for creditors to sue you for unpaid balances ranges from three to 10 years. In Maloney’s case, she learned about this from a collections officer, who told her that her debt had essentially “expired” and been forgiven. It would spell the end of her five-figure medical debt saga.
4. Find medical allies
It might sound obvious to say that you want a doctor you’re comfortable with, but that’s not a given, especially if your insurance doesn’t allow for a wide variety of providers, Maloney said. “It’s really important to find vendors you can trust, and I think that can be a challenge.”
Many women aren’t taken seriously, so finding compassionate healthcare is often difficult, according to Maloney. Also, she said, people of color and LGBTQ patients could face significant discrimination. Find testimonials from friends, family, co-workers, and even social media groups. You can also read patient reviews on sites like Zocdoc before making an appointment.
5. Get a friendly advocate
No matter where you receive care, for more serious or complicated appointments, have a friend or loved one accompany you for both professional and emotional support.
“The experience of being in the doctor’s office can be really stressful,” said Maloney, who sought support as she tried to find appropriate care. “Don’t be afraid to bring someone with you. He can take notes. He can be your advocate. He can hang out with you in the waiting room.”
See the overall social picture
To improve the health care system, Maloney insists that we need to improve health literacy across the country so patients know, for example, when to go to the ER or ER or a doctor’s office. Our country also needs more physicians and naturopaths, as well as a standardized electronic medical record system to ensure patients everywhere receive consistent and accurate care, she noted.
As for a more fundamental change, Maloney proposes single-payer, or universal, healthcare, where the government foots the entire bill. “There should be a system where everyone can be taken care of.” From their point of view, it is a myth that such a system will be more expensive. “It’s just a question of who ends up paying for that care,” she said.