There’s no sugarcoating it—our current health system has major problems, particularly when it comes to paying for care.
Healthcare today is expensive. It’s complicated and confusing—even for experts. And it can leave us feeling powerless.
VisitPay believes people deserve better, so we’re giving you the information and tools you need to better understand and take control of your own financial experience. When you’re informed and you know what questions to ask, it’s easier to seek better patient payment services together with your healthcare provider.
Take our healthcare cost quiz to test your knowledge about the finances of healthcare—and learn some new ways to improve your own personal financial journey.
VisitPay believes families deserve to be more informed when making healthcare finance decisions.
Let’s get a baseline. A few questions to figure out how much you already know about paying for healthcare.
When you’re healthy, why not stay that way?
Before illness strikes, take the time to dive into your health insurance policy and understand its benefits.
Thanks to the Affordable Care Act, most preventive care must be covered by your health insurance without requiring coinsurance, copayments, or even a deductible. Preventive services involve health and medical services whose purpose is to prevent certain health conditions or diseases and help people live healthier lives through planning, early detection, management and medical guidance.
If you don’t have insurance, a dose of self-care could be an ounce of prevention that saves you time, money and worry.
Questions you might ask during this phase:
Insurance company
What do all those insurance terms mean, like deductible, co-pay, co-insurance and out-of-pocket balance?
What is my deductible?
Do I have a co-pay? How can I budget for them?
What is an out-of-pocket maximum?
What wellness benefits do I receive without incurring out-of-pocket fees?
What is the difference between in-network and out-of-network providers?
What is a health savings account and how might it benefit me? What is a flexible spending account?
How can I get health insurance if I don’t have it now?
If I pay cash for healthcare, does it cost less?
State government
Do I or my children qualify for Medicaid?
How does Medicaid work?
(If 65 or older), do I understand the ins and outs of Medicare?
A dose of self-care could be an ounce of prevention that saves you time, money and worry.
A diagnosis occurs when you or someone in your family has an injury or illness. The severity of your diagnosis will deeply impact how much you will owe your healthcare provider.
These illnesses might range from acute issues such as strep throat or a broken bone to chronic conditions like diabetes or cancer. Thus, you should get familiar with a variety of financial issues during this phase of care.
While the healthcare experience may not be as intuitive as buying a car or home, it can be almost as expensive. The more you know about medical costs, insurance benefits and options to pay, the better prepared you’ll be to ease the pain of medical debt. If you have a high deductible health plan, you may be required to pay a large out-of-pocket sum for healthcare services.
While it may feel embarrassing to ask someone about financial issues, you might save hundreds—or even thousands—of dollars by doing some digging. All health systems have financial counsellors, and their job is to help, so don’t hesitate to pick up the phone and ask.
Important Issues to Understand:
Insurance company:
When should I obtain pre-authorization from my insurance company for a medical service or medication?
Will my insurance cover the cost of a treatment, procedure or test I might need?
Will selecting a provider that is in-network save me money?
Can/should I consider contributing to a health savings account or a flexible spending account? What’s the difference between the two?
Can I get a tax break on medical expenses?
Healthcare provider:
Are there any ways I can save money on the services I need, like imaging or blood work?
Should I get a second opinion?
How can I seek cost estimates for services I will receive?
Does my health system o er financial assistance?
Self/Online:
How can I estimate my out-of-pocket costs?
How can I estimate my medication costs?
(If 65+), how can I estimate my Medicare costs?
Calculate your co-insurance costs, if applicable.
What are my options if I don’t have insurance?
It's a good idea to get familiar with a variety of financial issues during the diagnosis phase of care.
Helpful Resources:
Insurance company (online and phone)
Employer benefits manager
All health systems have individuals in their billing departments who assist patients with financial issues. It is beneficial to contact these patient financial advocates in person or over the phone with questions about medical costs and payment options. You might ask them:
What are your policies on financial assistance?
Do I qualify for free or discounted care through the health system?
If so, is there paperwork I need to fill out?
If not, are there options for paying my medical bill(s) over time versus immediately after treatment?
If there are options, can I set up a payment plan on my own, online? (You may get better terms this way than by talking to an agent in the hospital call center.)
Depending upon your diagnosis, treatment may last for a day or years. Regardless of severity or duration, now is a great time to determine the actual costs of your medical care.
Finding out those costs will provide better context to determine a financial plan that works for you and your family. Your medical care might require surgery, in-patient hospital stays, medication, blood work and/or imaging. The sooner you can verify costs and their accuracy, the fewer surprises you will experience down the road.
Questions you should ask:
Billing specialist/financial advocate at health system:
When will I receive my final bills?
What are my actual costs?
How many di erent bills can I expect to receive?
Do I qualify for financial assistance? How do I apply?
How much can I afford to pay each month?
Can I sign up for a payment plan?
If I had to pay on an estimate, and the estimate is wrong, what happens?
Insurance company:
What will I have to pay out of pocket?
What medications will I need and how much will they cost?
Are there generic medications which might cost less than the one(s) I was prescribed?
Healthcare provider:
What unexpected services/fees might come my way?
Verifying treatment costs ahead of time can help you avoid surprises down the road.
Helpful Resources:
Insurance company (online and phone)
Employer benefits manager
Check with a patient financial advocate at your health system to understand:
What are my payment options?
Can I establish payment terms that meet my budget or do I have to pay all my medical bills in full?
Can I get a low or no interest payment plan?
Does my health system have an online payment portal? If so, how do I sign up?
Q:
Ask a patient financial advocate at your health system:
What are my payment options?
Key Terms to Search:
Out-of-pocket balance
Calculator to determine Your out-of-pocket Balance
It’s vital to have a game plan to pay for the care you have already received or may receive in the future.
Recovering from an illness or injury varies in duration and complexity. You may require physical therapy, follow up appointments and/or additional imaging and blood work. You may overcome your illness or have a relapse. Knowing how you plan to handle the financial aspects of recovery is vitally important.
Questions you should ask:
Billing specialist/financial advocate at health system:
Have I received all of my bills?
How can I read my medical bills?
How do I know if my bills are accurate?
How can I make sure the health system used the correct medical code?
If there was an error, how do I correct it?
Can I set up a payment plan to pay o my medical bills?
What are my payment options?
Does my health system have a payment portal? Can I sign up for reminders to pay?
How long does it take before bills go to collections?
Is it possible to get a consolidated view of expenses and insurance coverage?
Insurance company:
How much will my insurance cover?
What is an Explanation of Benefits (EOB) and how is this different from medical bills?
If there was an error, how do I correct it?
Healthcare provider/clinician:
What services/costs can I expect to incur in the future?
Knowing that you have a plan to handle the financial aspects of recovery can give you confidence in the process.
Helpful Resources:
Insurance company (online and phone)
Employer benefits manager
Check with a patient financial advocate at your health system if:
You haven’t received all your medicals bills
If you have found an error in (one of) your medical bills
If you need help signing up for online payment, if the option is available
If you are having trouble paying your bills on a timely basis
Q:
Ask your insurance company:
How much will my insurance cover?
Key Terms to Search:
Out-of-pocket balance
Health system payment plan
Explanation of Benefits
Health system payment portal
Medical codes
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At VisitPay we want to learn more about what Americans think about managing medical bills so we can make the system work better. If you would be willing to participate in future surveys about managing medical expenses, please sign up here.
