How to avoid surprise medical bills

Posted: 6:12 AM, Aug 20, 2014
Updated: 2014-08-20 07:42:33-04

(PIX11) -- A quarter of Americans say they’re struggling to pay their health care bills or they can’t afford to pay them at all.

TheStreet offers these five ways to avoid paying more than you must:

Know what qualifies as preventive care and what is excluded: Because of health care reform, many preventive services -- like an annual checkup, immunizations and women’s health visits -- are now free to those with insurance. But be aware that not all medical care is free. For example, a doctor’s lab tests may not qualify as preventive care.

Stick with in-network physicians and hospitals: Visiting a doctor outside of your network may leave you with limited coverage or no coverage at all. Call your insurance company to make sure your doctors and any specialists they refer you to are in your network.

Find out who else will be involved: Procedures and surgeries are a team effort. Specialists like anesthesiologists and physical therapists could affect the total cost of treatment, especially if they’re out-of-network.

Negotiate your costs up front: If you have health insurance, you probably won't need to negotiate medical costs. But if you’re uninsured or if your plan doesn't cover a specific kind of medical service, it may make sense to negotiate your costs up front. Tell the doctor or hospital that you will be paying for coverage on your own and ask for a discount, something they’re used to doing (they do it all the time for insurance companies).They may be willing to offer you a 10 percent to 40 percent discount off the total bill.

Ask for an itemized bill: If an itemized bill is not provided, ask for one to cross-reference against your explanation of benefits. This is crucial if you need a test such as a MRI, PET or CT scan, which might need to be pre-authorized. Many plans will not pay for these services if they are not approved beforehand.