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How to get the most for your health care bucks

Here are some resources to stretch your health and wellness budget further

Vincent Plymell //July 5, 2016//

How to get the most for your health care bucks

Here are some resources to stretch your health and wellness budget further

Vincent Plymell //July 5, 2016//

Most consumers (81 percent according to a survey by GE Capital Retail Bank) spend hours poring over reviews and comparing prices before making a major purchase. But how many of us would do that same kind of research before scheduling a medical procedure?

To be fair, comparing prices and checking reviews for consumer electronics is easier than finding similar information for health care services or providers. But with higher deductible plans more common and more medical costs coming out of our pockets, becoming a savvier health care consumer could pay off.

Doctors and hospitals are often reluctant to quote prices because costs for the same procedure can vary from one insurance company to another. While we have a way to go to before health care prices are as transparent as prices for electronics, there are some resources that can help us make more educated decisions about how much we pay for care and who provides that care.

Many health insurance companies offer price estimators on their websites.  These tools can at least provide some gauge of what to expect when the bill arrives.  Additionally, the Healthcare Bluebook offers a free “fair price” search tool that allows consumers to search for services by zip code to obtain a common price for that service in their area.

Here are some other strategies to keep in mind when purchasing health care services, prescriptions and coverage.

Consider health above insurance premium costs: It’s common to choose a health plan based solely on the cost of premiums, but if you don’t factor in your specific health care needs, you may end up paying more in the long run. Insurance companies charge more for out-of-network doctors, so if you have a chronic condition that requires regular visits to a specialist, make sure that your doctor is in the health plan’s network.

If you’re planning to have a baby, make sure you check the plan’s maternity benefits.  Does the plan cover care for long-term injuries that may require physical therapy or chiropractic treatments? Taking the time to clarify coverage and costs in advance can help prevent surprises later.

Shop around: While finding accurate pricing information for many services can be challenging, there are a few items – such as travel immunizations or minor diagnostic procedures – where comparison shopping is possible.  Retail pharmacies like Walgreens and CVS offer strep tests, for example, and they may cost less than they would at your doctor’s office. 

Alternative medicine providers such as acupuncturists are often willing to share pricing information on their websites or over the phone. Prescription drug prices can vary wildly, so ask for generics when possible and check the price that large retailers charge for maintenance drugs. Mail order pharmacies offered by your health plan may also provide savings.

Do your homework: When it comes to price shopping for medical care, some consumers worry that the lowest-cost provider will also deliver the lowest-quality care. But care and price don’t always go hand in hand. To ensure high-quality care, do your homework. and offer physician reviews based on online satisfaction surveys.

The Colorado Business Group on Health has several quality tools available on its website, including the Bridges to Excellence program, which recognizes doctors who have provided exceptional care to patients with heart disease and diabetes. Individual providers may also offer information on their websites to help patients make more informed choices about their care.

Prepare for the unexpected: It’s especially difficult to determine how much it will cost or who will provide care when an emergency arises. That’s why it’s important to plan ahead. Know which hospital is in your network if an accident or urgent illness occurs. Make sure that the provider who treats you is in-network.

It’s easy to forget those details when an emergency happens, but try to specify that you’d like to see an in-network physician if possible. And remember that identifying an in-network facility or doctor means more than asking, “Do you accept XYZ insurance?”  You have to get specific – “Are you in the network for the 123 Health Plan from XYZ insurance?”

The Colorado Division of Insurance, can serve as a resource for consumers. For more information, call 303-894-7490 or 1-800-930-3745 (outside the Denver metro area), or visit