Medical debt is squashing American families across the country. In 2017, 19% of households who received care couldn’t afford to pay for it upfront, the U.S. Census Bureau found. They were in debt for an average of $2,000.
If you’ve gone in for a checkup recently, you may have noticed the astronomical costs of taking care of yourself. Many Americans flat-out couldn’t pay their hospital bills without insurance. Here’s why the prices are so high.
One of the biggest heavy hitters to our wallets is out-of-pocket costs. When you unknowingly get care from providers outside of your health plan’s network, your bank account may hemorrhage money. Luckily, a new rule will restrict these high surprise costs.
Here’s the backstory
Medicare and Medicaid both prohibit balance billing, according to the U.S. Department of Health & Human Services. That’s when a provider says a patient needs to pay what their insurance didn’t cover.
Americans insured through employer-sponsored or commercial healthcare plans often have to pay the remainder. And the cost can be staggering. In fact, National Health Expenditures 2017 Highlights found that that out-of-pocket medical spending in 2017 rose to $365.5 billion.
Thankfully, this new rule could change the tide of medical costs. Now, Americans who get their health insurance either commercially or through the workplace will see a cap on balance billing. Lawmakers hope this will provide much-needed relief to Americans who struggle under the heavy financial burden hospitals often place on their newly-discharged shoulders.
No one should ever be threatened with financial ruin simply for seeking needed medical care … Today’s Interim Final Rule is a major step in implementing the bipartisan No Surprises Act that will protect Americans from exorbitant health costs for unknowingly receiving care from out-of-network providers.U.S. Secretary of Labor Marty Walsh
This is big news from now on. But did you know that different hospitals can charge you different bills for the same treatment? Yep, there’s a huge amount of price variation depending on location.
You could pay $1,000 for a colonoscopy at one hospital … or $4,000 at another
It’s only now that we’re getting some much-needed transparency on price variation. That’s thanks to a January rule from the Trump administration. It required hospitals to step out of the dark and reveal price data like:
- Drug prices they accept from insurers
- Insurer prices they accept for procedures and treatments
- Not only that, but they have to present it in a way that’s easy to read
- They need to list 300 “shoppable” services, from fixing broken bones to childbirth
Get this. If you pay in cash, you may be dishing out a bigger amount than powerful insurance companies, NPR reports. Some hospitals don’t want you to know this — which is why a few refuse to play ball.
Some hospitals hide the data on their websites so consumers like you can’t easily find the information they need, ADVI says. They might not even include all the categories they’re supposed to.
Luckily, we found two tools that help you learn more about hospital pricing. When it comes to the complex world of medical bills, life can feel like an M.C. Escher illustration. Nothing makes sense, and you’re completely lost. These free resources should help you navigate the difficult maze of price comparisons.
1. Care Compare
This tool lets consumers see important data about the quality of care at over 4,000 Medicare-certified hospitals. This easy-to-use search engine lets you input your location, provider type and any keywords that help you narrow down the search. You can even scroll down and search by more specific criteria, like hospice care, doctors, nursing homes, dialysis facilities and more.
This is another great tool that lets you find the care you need. It’s a search and comparison resource that lets you match your personal needs with different providers and facilities. It also provides extra tips on basic hospital information, health and drug plans and more.
Whether you’re looking for x-rays, outpatient visits or more, this tool lets you be informed and shop around. It’s a great way to save yourself thousands in the long run.
Here’s another helpful transparency tool that lets you be your own advocate. You can find out how much a medical procedure will cost if you seek out-of-network care.
Its easy-to-use website is color-coded to help you find what you need as soon as possible. You can read articles on insurance basics, including costs, dental coverage and understanding your bill. There’s also a helpful page on your rights, which helps you defend yourself and stop others from taking advantage of you.
You know what they say: It’s always good to be informed! That way, you won’t be taken by surprise. (Surprise bills, that is!)