How to haggle for a lower medical bill

Marcus Pickett

Negotiating the price of cars, houses and other big purchases is commonplace. Yet many people fail to negotiate the price of health care, even if their hospital bills cost as much as a car. Haggling over health care, however, can save patients thousands of dollars.

Although some patients might not feel comfortable bidding with their doctors, a Wall Street Journal Online/Harris Interactive poll of more than 2,000 adults shows that when patients do negotiate, they are largely successful. For example, 70 percent of those who said they negotiated were successful in lowering their hospital bills, according to the poll. The rate of success was 64 percent for dentists, 61 percent for doctors and 56 percent for pharmacists.

Given that health care costs are on the rise, more patients might be willing to bargain with their doctors. Here are some pointers for successfully negotiating your medical bills.

Pay upfront

Hospitals and doctors often provide uncompensated care because many patients don't have insurance and can't pay their bills. So those who can pay end up getting charged more. If you don't have insurance (or if you have a high deductible you still need to pay down), offering to pay the doctor upfront removes this uncertainty -- and your doctor might be willing to reduce your bill as a reward.

Change Healthcare Corp., a company that specializes in health care savings and transparency, recommends asking whether you can pay the Medicare rate; Medicare is able to negotiate lower prices with health care providers. Or you could simply start by offering to pay what you can afford. If you can't afford to pay much up front, you could offer to pay a portion of the bill right away followed by monthly installments.

Discounts for paying up front can be substantial. For example, Marin General Hospital in the San Francisco area said it would offer a 25 percent discount to customers with health insurance who paid their deductibles promptly. It also offered half off the sticker price for uninsured customers who paid on time.

Ask in advance

It's often best to take a proactive approach and ask about health care rates and cash discounts before receiving care. The Consumer Health Action Network suggests asking whether a provider's office would be willing to offer you a lower price before making an appointment. If it's not, try another doctor. Even if you aren't successful in getting a discount, calling around will at least help you determine the most affordable price in your area.

Ask your doctor

You may not be able to get an accurate estimate for a procedure over the phone because the doctor hasn't been able to assess your condition yet. So you might have to do much of your bargaining face-to-face with your physician.

The Consumer Health Action Network advises, above all else, to be polite -- doctors have bills of their own to pay. Express your concerns about not being able to afford the bill. Ask whether certain tests are necessary or whether you can be prescribed a generic form of a certain drug.

Other options

If you still can't afford your medical bills after all your negotiating, ask a hospital social worker for help, Change Healthcare recommends. Many hospitals have assistance programs, and a social worker might refer your case to a patient advocate who can guide you toward charitable care or government assistance.