How to shop around for medical services
What does it mean to “shop around” for medical services?
Nowadays, you’ve got more control over your healthcare spending than you might think. As hospitals become more transparent about their pricing, you have the freedom to compare and shop around for the best option.
To be shoppable, healthcare services typically need to be non-urgent and able to be scheduled in advance. This includes anything from imaging and laboratory services to therapy services, outpatient clinic visits, and even prescription drugs. That means expenses you don’t plan for, like emergency visits, aren’t typically shoppable.
Shopping around isn’t just about saving money (although that’s a big perk). It’s also about feeling empowered and in control of your healthcare decisions. If you’ve never shopped for medical services, then the process might sound daunting. But fear not. It’s similar to shopping for most other things.
Here are a few tips to keep in mind as you start your search.
Tips for shopping around
Shopping around for health services is a lot like buying a new couch or a plane ticket. You may take the extra time to look into all of your options, read through reviews, and compare cost and quality before you make a final decision.
The same is true for health care, except you’re not only investing in a good or service — you’re investing in a healthier future. Take your time, shop around, and use these tips to find the best option for your unique needs.
Remember: Estimates may not represent the total cost of services, and some additional fees may not be included.
1. Use a price estimator tool
Thanks to price estimator tools, you can better compare and contrast the cost of certain services at different locations. These tools are usually offered through your insurance provider, your employer, or hospital websites. There are also some nonprofit organizations working to collect pricing data.
If you need help finding a price estimator tool, consider calling potential hospitals and providers for more information. Since they may need to learn the details of your insurance coverage, you might have to follow up with your insurer, as well.
2. Have your insurance info handy
Even if you’re searching directly through your insurance provider, you’ll want to have your group number and policy ID on hand. Price estimators often need this info to give you more accurate pricing models.
If you don’t have insurance, you can usually still use these tools by selecting the “uninsured” option.
3. Have specific services in mind
Price estimators usually have most medical services listed, and you’re free to browse as you please — but it can also be overwhelming to stare down a long list of medical jargon and codes.
One way to simplify the process is to write down the exact names and numeric codes associated with your services. Often, this information is available with an online search or a call to your insurer or potential healthcare provider.
4. Compare and contrast providers
As you search, consider noting your options’ names, locations, and prices. You can print out each price estimation as you go, so you have records readily available. Remember that estimates are just that; some costs, like physicians’ fees, may not be represented.
Then, dig deeper and browse each provider’s website and reviews. Ask yourself questions like:
- How much am I willing to pay?
- Is this provider in my network?
- Am I willing to travel a farther distance for a better price or better reviews?
- Do any of the options have glowing or concerning reviews?
- Will there be any follow-up services I need to consider?
- Are there any notable differences in the equipment or technology that will be used?
Answering these questions ahead of time should help in narrowing down your options.
5. Call providers with any last questions
If you find yourself stuck between options or just need clarification, don’t hesitate to reach out directly to healthcare providers. A call to their customer service line can likely provide answers and steer you in the right direction.
How does shopping around make a difference?
In the end, you may wonder: “Is there really that much difference between one hospital and the other?” Since hospitals can usually set their own rates, there certainly can be — even if you’re insured.
A study from the Health Care Cost Institute found that prices for the same service in the same metro area could be up to 39 times more expensive, even after excluding the top and bottom 10% of prices.
As part of the study, HCCI compared the cost of a new patient office visit within the same metro areas. The lowest variance was in St. Louis, Missouri, where prices ranged from $83 to $134. The largest variance was in the Minneapolis-St. Paul-Bloomington areas of Minnesota and Wisconsin, where prices ranged from $87 to $266.
With healthcare costs consistently rising, saving here and there can make a significant impact on your financial well-being. As more data is released and healthcare transparency increases, you can use this information to make informed, cost-effective decisions about your health.