The United States has some of the highest healthcare costs in the world. The average person spent an estimated $11,000 on healthcare in 2017, which is projected to increase to $17,000 by 2027. Not only are doctor visits, services, and procedures expensive on their own, but health insurance, which aims to lower healthcare costs, comes with a high price, too — premiums and deductibles can make insurance inaccessible to many Americans and their families.
Despite the rising costs, there are plenty of ways to save on medical and health expenses whether you have insurance or not. This guide examines six ways you can drive down your healthcare costs and make your health more affordable and enjoyable in 2020. Learn the pros and cons of each money saving method, and get answers to pressing questions about what you can do when paying for healthcare may be just out of your reach.
Get a Healthcare Savings Account (HSA) or Flexible Spending Account (FSA)
Healthcare Savings Accounts (HSA) and Flexible Spending Accounts (FSA) are like personal savings accounts that are used exclusively for healthcare related expenses.
The basic concept behind HSAs and FSAs are similar, but the two savings plans differ in some important ways. HSAs and FSAs allow people to set aside money that can be used to pay for qualified medical expenses. These expenses can include copays, deductibles and monthly prescriptions but do not include expenses that are simply beneficial–rather than essential–to a person’s health, like vitamin supplements.
Key differences between HSAs and FSAs
You must have a qualifying High Deductible Health Plan (HDHP).
- Not all plans with high deductibles qualify. The minimum acceptable deductible changes each year.
You must not qualify for Medicare.
You can’t be listed as a dependent on somebody else’s taxes.
HSAs allow you to save money in the long-term:
- The money in your HSA is 100 percent yours, so you can take it with you even if you change employers.
- Because the money is yours, any funds not used on qualified medical expenses rolls over each year.
- You can withdraw your savings when you reach 65 years old without receiving a penalty.
FSAs are offered through employer benefits packages.
Unused funds do not necessarily roll over each year.
- Some employers have a rollover option, but the IRS caps the rollover amount at $500.
When enrolling, you choose how much money you will contribute over the course of a year.
- The amount can’t be changed, but once you’ve agreed on a contribution amount, you have full access to those funds, even if you haven’t yet contributed that money to your FSA.
- FSA funds come out of your paycheck at regular intervals.
- If you use your FSA funds and leave your employer before making your full FSA contribution, you will likely have to pay back your employer for those used funds.
…for the insured:
- People with HDHPs can use an HSA to help make up for the extra costs associated with that high deductible.
- Money put into an HSA can grow over time.
- FSA money can be used to chip away at deductibles and can help cover a range of other medical costs.
- Because money put into these accounts are untaxed, you save in taxes.
…for the uninsured:
You must have a health insurance policy to qualify for an HSA or an FSA.
- HSA money is untaxed as long as it is not withdrawn before retirement.
- Money is added to FSA and HSA accounts pre-tax.
- HSA funds can grow over time with interest.
- You can use funds on qualified medical expenses penalty-free.
- You can’t have both an FSA and an HSA.
- Using funds on non-qualified expenses will result in a penalty.
- Withdrawing HSA funds before retirement will result in a penalty, and the funds will be taxed as income.
- Because HSAs require high deductibles, they may not be suitable for people who anticipate many medical bills throughout the year, as the deductible may be hard to hit.
HSA Apps & Tools
Chard-Snyder – Tools & Apps. Employee benefits company, Chard-Snyder, has a range of tools and apps that can help you track your HSA savings goals, estimate your FSA savings, track your taxes and more. You do not need a plan provided by Chard-Snyder to access these tools.
IRS Guidelines, Contribution Limits, & Eligible Expenses. This table clearly delineates important HSA limits and rules, like how much you’re allowed to contribute each year.
FSA Savings Calculators. Provided by the Federal Flexible Spending Account Program (FSAFEDS), these three calculators can help users determine how much money they can save based on estimated medical expenses and FSA contributions.
See a Doctor via Telemedicine
Telemedicine, sometimes called virtual health, allows patients to receive remote clinical care, so they can see a doctor without going into a clinic or office. Telemedicine appointments are often considerably less expensive than in-person visits and are open to both insured and uninsured patients.
Depending on the telemedicine service, patients may connect with doctors through video conferencing, phone calls, chat messages or a combination. Patients have access to care 24/7 and don’t have to deal with getting to a doctor’s office or sitting in a waiting room. Each telemedicine provider is a little different, but in general, you fill out a profile and request a service or physician type, like counseling or general practitioners. Then you are either matched with doctors by the telemedicine provider, or you can browse through doctors who meet your criteria. You set an appointment and then talk with your doctor through video, voice or chat. Individual hospitals and clinics may offer their own telemedicine services, too.
…for the insured
On top of the already low rates telemedicine offers, many health plans partner with telemedicine providers, making virtual visits even cheaper.
…for the uninsured
The prices advertised on telemedicine websites is usually the rate without insurance, which makes it easy for self-pay patients to compare costs between doctors and telemedicine services. Telemedicine rates hover around $45 per visit without insurance.
- More insurances are supporting telemedicine and offering it at a cheaper price than a copay.
- It is being supported as a viable option to a doctor visit.
- Affordable and convenient access can prevent costly emergency room visits in the future and can lead to fewer people foregoing medical care altogether.
- Telemedicine may not be suitable for all people or medical circumstances.
- Patients must have access to certain technologies, like a reliable internet connection and web conferencing tools.
- Some people prefer an in-person experience.
Telemedicine Apps & Tools
Current State Laws & Reimbursement Policies. Telemedicine laws and policies vary between states. Before setting an appointment via telemedicine, check your state’s policies.
MDLive. MDLive is a large telemedicine provider in the U.S. There are many other similar providers out there, but this can give you an example of what to look for and expect when researching telemedicine companies.
OHSU Telemedicine. Oregon Health and Science University offers its own regional telemedicine service. If you are interested in telemedicine but want a more local provider, this is a good example of what to look for.
Shop Around & Negotiate
Shopping around and negotiating for lower healthcare costs are two hands-on ways to save a lot of money on medical bills. There’s a surprising amount of wiggle room when it comes to medical care pricing, so bargain hunting can be an extremely viable way to lower costs. Here are some tips and methods for shopping around and negotiating health care costs:
When shopping around
- If you have insurance, start by using your insurance provider’s price comparison tools.
- Don’t assume your healthcare network’s preferred providers get you the lowest price. Extending your search beyond your insurance provider can bring unexpected savings.
- You can use price comparison tools that aren’t associated with insurance providers, too. Many of these tools give average out-of-pocket costs for services in your area.
- Negotiate your bills before or after receiving medical treatment. Both methods have their advantages.
- Remember that negotiating bills is not unusual. Insurance companies do it all the time, and it’s totally reasonable for individuals to negotiate on their own behalves.
- If you are uninsured, ask if you can pay insurance rates. Healthcare Bluebook helps patients find the fair market price of medical services in their area, which can help in the negotiating process. Ask the billing department if they will accept the market rate in lieu of the higher rate charged to uninsured patients.
- See if discounts are available. Discounts are commonly available but seldom advertised, so it’s worth asking. For instance, some providers offer a discount just for paying over the phone.
- Create your own discount, like asking if you can lower your bill by paying in cash or paying a lump sum.
- Be upfront with your provider about circumstances that make it difficult for you to pay your medical bills so they can help you find a payment arrangement that works for everybody.
- After you negotiate and come to an agreement, make sure to get everything in writing. If your bill doesn’t align with the agreement you made in advance, you’ll want a written record of the agreement to fall back on.
- After you receive a bill, check it for errors. Mistakes happen, so it’s worth getting familiar with the medical bill coding system so you can make sure everything is square. If something is off, you have room to negotiate a lower bill.
- Along with medical costs, patients can negotiate their payment terms. Many providers are willing to work out payment plans.
…for the insured:
- Bills and payment terms can be negotiated even with insurance, and shopping around can be easier with access to insurance company price comparison tools. Savings gained from shopping around and negotiating work in addition to insurance savings.
…for the uninsured:
- Those without insurance may benefit the most from negotiating and shopping around, especially if they can pay insurance rates and work out discounts and payment plans.
- Shopping around helps ensure you’re getting the best possible rate, regardless of your insurance policy.
- Shopping around and negotiating help patients better understand the services they receive and can be empowering.
- Employing different negotiating tactics before and after receiving treatment can result in significant savings.
- Both shopping around and negotiating can be time consuming and frustrating.
- Shopping around may not be a viable option in emergency situations, but negotiating is still possible before and after emergency care.
Healthcare Services Shopping Apps & Tools
CarePay. Not only can users compare healthcare prices on CarePay, but they can also upload their medical bills so other users can get a real time view of medical costs. CarePay also provides help in getting quotes and negotiating service costs.
Healthcare Bluebook. Search for fair market prices on a range of medical services through Healthcare Bluebook’s search and compare tool.
How to Read Your Medical Bill. This article from NerdWallet helps demystify medical bills so you can understand your charges and check for billing errors.
Medicare.gov – Hospital Compare. Users can find and compare hospitals in their area that accept Medicare.
New Choice Health. With New Choice Health, you can compare recent costs for common medical procedures and ask health providers for quotes.
Take Advantage of Preventative Healthcare
As the proverb goes, “An ounce of prevention is worth a pound of cure.” Using preventive healthcare services can help people detect and address issues before they become more difficult and costly to treat.
By taking advantage of preventive services like check-ups, mental health screenings, immunizations, mammograms and other services, patients can take care of issues before they become expensive and unmanageable. A cholesterol screening is far less expensive than a visit to the emergency room for a heart attack down the road.
…for the insured:
- Under the Affordable Care Act, most health plans must cover certain preventive services at no cost to patients. This means that using preventive health services is a super viable way for insured people to save money on healthcare expenses.
…for the uninsured:
- While those without insurance generally have to pay out of pocket for preventive health services, early detection and prevention can save them money in the long run. Using telehealth and reduced-cost clinics for preventive health services can help keep your overall medical expenses down.
- Regular doctor visits, screenings and immunizations help people stay on top of their health and can prevent more severe and expensive health problems.
- Many preventive services are covered by insurance.
- Many free and low-cost clinics provide preventive care services and low rates for uninsured and underinsured people.
- Despite potential long-term medical savings, people without insurance may be less likely to seek preventive health services because of the upfront costs.
- The low cost of preventive care services can keep people from using non-preventive health care services when they need them.
- You may not be able to rely exclusively on preventive care.
Preventive Healthcare Apps & Websites
Electronic Preventive Services Selector. This web tool and series of apps helps users determine which preventative health services they should get and when.
Healthcare.gov – Preventive health services. Find a comprehensive list of preventive health services typically covered by health plans.
U.S. Preventive Services Task Force. Learn more about preventive health and related current events and initiatives.
Use Free and Reduced-Price Clinics
Free and reduced-price clinics provide low-cost care to patients, often on a sliding scale based on income. Types of free and reduced-price clinics include:
- College health centers
- Planned Parenthood
- Community clinics
- Dental, medical schools
- Federally Qualified Health Centers (FQHCs)
Clinics can differ in structure and services offered, but these clinics usually offer more affordable healthcare services than are found at traditional hospitals and clinics. Some clinics can offer reduced rates because they are federally funded. Others may be staffed by volunteers, or care services may be provided by students gaining their supervised practicum hours. Free and reduced-priced clinics typically provide primary care but can give referrals for specialized care.
…for the insured
While many of these clinics are limited to uninsured patients, it’s becoming more common for free and reduced-price clinics to treat low-income and underinsured patients, too. Buying a low-tier marketplace health plan, which likely comes with a high deductible, and using free and reduced-price clinics for primary and preventive care can be a great way to save money while ensuring you have coverage in case of emergency.
…for the uninsured
The idea behind free and reduced-price clinics is to provide people without insurance affordable access to care, so if you are uninsured, the sliding scale payment structure can help ensure your care is affordable.
- These clinics are often widely accessible.
- Most patients receive treatment at reduced rates. Some treatment may be free.
- These clinics can help uninsured people get preventive care.
- There are typically few requirements to receive care.
- Some clinics are limited to those without insurance.
- Clinics that accept underinsured patients have different definitions of “underinsured,” so you’ll have to check if you qualify.
- Although they may be called “free,” free clinics often run on a sliding scale. Some patients may pay nothing while others pay a fee based on their income.
- These clinics may not offer the specialized care some need.
Free and Reduced-Price Healthcare Apps & Websites
Financing Family Planning Services for Low-income Women: The Role of Public Programs. This article addresses public health programs specifically as they pertain to women’s issues, but it also goes into detail on low-cost clinics in general.
Health Resources & Services Administration (HRSA) Health Center Program. Learn about the national health center program and get a comprehensive list of HRSA-funded health clinics here.
Hill-Burton Free and Reduced-Cost Health Care. Learn about Hill-Burton free care facilities and guidelines here.
Look into Medical Assistance Programs
Medical assistance programs provide financial aid to qualifying patients. Many programs exist to meet the needs of different populations. These programs are often run by federal, state and local governments, but individual hospitals and clinics may offer their own medical assistance programs as well. Medicaid, CHIP and WIC are some examples of medical assistance programs.
Each program has a different set of parameters and qualifications. Reading through the qualifications or speaking with a human services officer and filling out an application for aid are the first steps to take. If you qualify, you may receive discounted or no-cost care, reimbursements and other benefits. Check the details of different programs to learn about their specific benefits and limits.
…for the insured
While many programs are not available to those with insurance, those that allow underinsured and low-income applicants may offer additional benefits, discounts and reimbursements that can add up to useful savings.
…for the uninsured
Many of these assistance programs provide insurance and other benefits to those who qualify at reduced or no cost. Patients save money on insurance and medical costs alike.
- They can provide lowered costs or full coverage on medical services and prescriptions.
- These forms of aid are widely accepted at different medical facilities.
- Each state has different policies, procedures and qualifications.
- You must renew your application for assistance every year.
Medical Assistance Programs Apps & Websites
Medicaid & You: Frequently Asked Questions. Learn about Medicaid and get answers to the most common and important questions about this aid.
Benefits.gov – Healthcare and Medical Assistance. Explore a range of different medical assistance programs throughout the country.
OHSU – Financial Assistance Programs: Oregon Health and Science University provides an example of hospital-specific medical assistance programs.
5 Tips for Saving Money on Prescriptions
While the advice above specifically addresses medical care costs, many of the tips apply to lowering the cost of prescriptions, too. However, knowing extra ways to pay less for prescriptions is important. Access to prescriptions can keep medical issues from getting worse and costing more over time. Plus, medicine is expensive, and even people who have insurance may not have prescription drug coverage, or certain drugs may not be included in their health plan. Here’s a checklist of five things you can do to lower prescription costs.
- Ask your healthcare provider for samples
Finding prescription medications that work for you can involve a lot of trial and error, which gets expensive. Asking for samples of medications before committing to a full prescription can give you a chance to test the medicine’s efficacy and side effects before spending a ton of money.
- Ask for generic drugs
Generic drugs can cost around 85 percent less than their brand name counterparts because they don’t have to spend money on research, development and marketing. While there can be slight differences in the amount of the active ingredient present in brand name and generic drugs, generic drugs tend to be as effective.
- Order by mail
Insurance companies often have lower copays for prescriptions ordered online. Check to see if your insurance provider has a home delivery prescription program. Online pharmacies, like HealthWarehouse.com, can also offer lower prices on mail ordered prescriptions.
- Compare prices
According to WeRx, a prescription price comparison website, prescriptions can be up to 16 times more expensive between pharmacies in the same neighborhood, so it’s definitely worth shopping around. Blink Health and GoodRX also provide price comparison tools to streamline the shopping process.
- See if coupons are available
Collecting coupons for prescriptions may sound weird, but it can result in significant savings. Check with the drug manufacturer, your doctor and your pharmacy to see what discounts are available. The price comparison websites above can help you find coupons, too. Between shopping around for the best price and using coupons, some prescriptions can cost less at retail price than when billed through insurance.
FAQ: Getting Help When You Still Can’t Afford Healthcare
Some people aren’t just concerned about lowering their medical bills—they are either swimming in medical debt or simply can’t afford to see a doctor no matter the cost. While some of the techniques above can help you lower your medical bills, you still may wonder if affordable health care is possible. Here are some answers to the most critical questions for those deeply impacted by high medical bills.
Negotiating is probably your best option. You can negotiate on your own, or you may consider hiring a medical bill advocate if their rates don’t outweigh the money they could save you. Carefully check your bill for errors, offer to pay insurance rates if you are uninsured and see if you can lower your bill by paying in cash.
Unpaid medical bills usually get sent to collections. Before this happens, you can try to negotiate for a lower bill and ask about payment plans. When setting up a payment plan, make sure the amount you agree to pay at regular intervals is something you can afford. If you can’t afford any payment, ask the billing department for referrals to charity programs and similar forms of assistance.
Depending on your situation, you may qualify for Medicaid, the national low-income health insurance program. If you don’t qualify for Medicaid, other medical assistance programs may better fit your circumstances. Even without insurance, you can still seek medical care and employ the cost-reducing tactics above, like using telemedicine and free clinics, requesting payment plans and negotiating for insured rates. You may also consider catastrophic insurance.
Those who don’t receive employer insurance and can’t afford a marketplace health plan might want to look into catastrophic insurance. This type of insurance usually has a low monthly premium and a high deductible. If you are in an emergency, you have to pay the deductible, but the rest is covered by your insurance company. Preventive care is typically covered, but most other medical services must be paid out-of-pocket.
No. Hospitals can’t deny people care if they can’t pay. However, that doesn’t mean they won’t expect payment eventually. If you need to go to the hospital but can’t pay for care, be upfront and ask about payment plan options, discounts and other forms of assistance.
Not only can this be stressful, but continued unpaid medical bills can lead to garnished wages and property liens. Hospitals often sell their debts to collectors for pennies on the dollar, so know that there is room to negotiate with hospitals before bills get sent to collections. You can also negotiate with the debt collectors themselves, who just need to collect enough money to make a profit.