BY DR. JONATHON SAVAGE, DO, FAAEM
In the swing of summer, with kids out of school, transmittable infections like the cold and flu are down but the likelihood of allergies, food-related illnesses, and injuries (hopefully minor) increases. As an emergency physician, I will often be asked by my Wash Park friends and neighbors, “Should I get medical treatment?” and “Where should I go?” But the question of “How much will it cost?” often drops down in the priority list when they are under the stress of their own or a family member’s illness or injury. But once those bills start rolling in for care they did seek, there may be yet another question that leaves their lips: “What the …?”
Yes. Healthcare can be crazy expensive. Costs can vary by over 400% for the exact same treatment at various locations. With premiums, co-pays, co-insurance, deductibles, and cash or credit payments weighing us down, how can we minimize our out-of-pocket health costs?
CONSIDER YOUR SOURCE OF CARE
We are lucky to be in a city with so many quality healthcare options. But not all similar options are created equal. Keep these costs in mind when you are considering where you might want to seek care.
An emergency room is designed to be there for you for emergencies. It is open 24 hours/day and can run a large set of tests. We have several excellent ERs but the potential “convenience” of going there for non-emergency care will likely cost you hours of time and thousands of dollars. But be wary of freestanding emergency rooms that often look a lot like an urgent care. If you go there for a minor issue, your may save some time but will likely pay nearly as much as a standard hospital ER.
Urgent care centers are a less expensive alternative to the ER yet often has many of the same lab and X-ray capabilities. There are several urgent care locations nearby on S. Broadway, Colorado Blvd, and Hampden Ave. Hours and prices vary but they will generally charge about $120 – $200 for the visit not including tests. Similar to the urgent care is the retail clinic which is located in some pharmacies, grocery stores, and department stores. Best for minor walk-in issues like coughs, colds, and bladder infections as they generally do not possess a full lab or x-ray capabilities. A visit charge here will run in the $60 – $100 range.
Telemedicine combines the stay at home features of a House Call with the after-hours availability of Urgent Care centers and the cost-savings of retail clinics. Many medical issues can be addressed through a video interaction and, if medically indicated, a prescription can be written. These visit charges will usually be in the $40 – $60 range.
Primary Care Offices and Clinics are the traditional method of obtaining standard medical care with some offices offering extended hours and occasionally a walk-in urgent care option. While a great source of care, you may be out of luck after-hours and appointment wait times can occasionally be measured in weeks to months. An approximately 10 minute office visit will usually cost in the $70 – $150 range. An alternative related practice model is the Direct Primary Care practice which charges patients usually a flat fee per visit or a recurring monthly fee for improved access and expedited appointments with the care providers. These can be as low $60 per month to $200+ per month for each patient.
House Calls while still relatively rare are making a resurgence across the country. The convenience factor mixed with more face-to-face time with the clinician makes this an attractive option for many. The often higher visit price-point in the $200+ region may be worth it for the bonus of not having to leave the house.
STAY IN THE NETWORK
If using your insurance plan to go to a private medical office for care, it is often best to stay within the network of healthcare providers that have contracted with the insurance company. While plans vary, the plan may not pay anything for an out-of-network provider leaving you with a potentially large bill to pay. Occasionally, you may find an out of network provider that charges less than what you could find in-network.
Trying to figure out what some medical visit or test should or does cost is difficult at best. There are some methods to consider to have more knowledge about what you are getting into. Sources like healthcarebluebook.com can show you the range of prices for a given visit, procedure, or test plus provide you a “fair price” that can be used as a bargaining tool. Yes, you are allowed to bargain down the cost of your care and will likely be more successful at it if armed with the right information.
Also consider visiting the Colorado Hospital Associations website cha.com/colorado-hospitals.com/price-report to see average charges and insurance reimbursements for certain procedures and hospitalization diagnoses. Knowing the difference between what is charged and what an insurer reimburses the hospital could save you thousands when renegotiating your charges.
SAVE ON PRESCRIPTIONS
Research shows that generic drugs work just as well as brand name drugs, so no need to pay more for a certain brand. Mail ordering regularly taken medications can save hundreds or more over the course of the year. Just like medical visits, drug costs vary widely. Using a website like goodrx.com allows you to see price differences and print coupons to lower the cost.
READ YOUR BILLS
Many medical bills contain errors. Over-charges, double-charges, and charges for services never provided are some examples. Ask for an itemized bill, read it well, and get those mistakes corrected.
Applying the above techniques, could potentially save you hundreds to thousands a year in unnecessary medical costs.