More people than ever have health insurance, but they’re also paying more out of pocket. Insurance companies and hospitals make it confusing to know how much they will owe. A Consumer Reports survey found that one-third of Americans got a bill they had to pay that was more than they expected for medical costs.
The key to not being caught off guard is to know how much you’ll pay before you go in for treatment. But that varies widely, even within the same state.
But that varies widely, even within the same state. For example, in California, the amount patients pay out of pocket for a total knee replacement ranges from being fully covered to almost $13,000 dollars. And out-of- pocket costs for a C-section range from being fully covered to more than $14,000.
Many insurance companies have a cost estimator on their website so you can look up how much you’ll have to pay before you go have the procedure. You can even compare the charges among providers.
One big reason for medical sticker shock is that although your doctor and hospital are in your network, someone else, often the anesthesiologist, is not. To protect yourself from going out of network, ask that everyone on your medical team be in your insurance network. And if you do have to go out of network, make sure you call the provider before you go to find out how much you’ll have to pay. You may be able to negotiate a better rate.
If you still get stuck with an unexpected bill, call your insurance provider to explain the problem. If that doesn’t work, Consumer Reports has a resource to help you find out where to complain and how to take action. You’ll find it at EndSurpriseMedicalBills.org.