How not to go broke at the doctor’s ofce
Time is money, right? Save both and learn how to prevent medical overcharges.
When you walk into a coffee shop you know exactly how much you’ll pay for a latte or Americano. That’s true for almost everywhere you spend money – except your doctor’s office. You trust your doctor to run a test, and then you find out it wasn’t covered by medical aid. You go in for what seems like a routine procedure, then get a bill (after medical aid pays its share) for more than your monthly rent. Health care is a killer combo for anyone’s budget: unpredictable and expensive. As a result, as many as 56% of young women skip seeing the doctor because of the cost. But you do have some control over your medical bills. Here’s how to rein in those expenses, without putting your well-being at risk.
SET yourself up for SAVINGS
A little prep can prevent surprises later. Most doctors’ offices will ask for your medical aid information and can tell you standard office fees when you make an appointment. Next, contact your medical aid company to confirm your co-payment. That’s the bare minimum you can expect to shell out. You can also ask whether a treatment you think you need is covered, like travel vaccinations and flu shots.
Your medical aid deductible is one of the biggest indicators of out-ofpocket costs, so know if you’ve met it and try to time visits accordingly. Of course, no one can ever plan a health scare, but you can ask if it’s possible to process your claim before your deductible resets for the following year. The folks in billing are likely familiar with the pinch patients feel when a new plan year kicks in.
Take action IN THE room
If your doctor is recommending anything beyond a basic blood draw or urine sample, know that those specialised tests or procedures may cost you – and you may have other options. We suggest asking, “I’m concerned about my out-of-pocket costs. Tell me what tests or procedures you want to order today, and why. Is it an option to wait and see?” It’s often perfectly safe to delay, but you and your doctor can decide how urgent your situation is.
Remember: a doctor’s primary focus is understanding your symptoms, determining what tests are needed and prescribing treatments to help, but you can still ask about prices. They should know general fees, and recognise what care tends to be above and beyond the basics. The receptionist may also be able to check with your medical aid.
As your doctor explains the next steps, listen up. Certain words should send up ‘This is pricey!’ flags. Medical aid generally covers most preventive care, such as vaccines and screenings for diabetes, blood pressure, cholesterol, and colon and breast cancer, including your office visit and lab work (assuming you stay in network). But there are some grey areas. For example, if your doctor recommends taking a ‘second look ’ or a repeat test, that may not be covered. When care switches from prevention to actual treatment, know that you may be in more expensive terrain. So when in doubt, ask.
Also your prerogative: waiting to get a test or procedure until you have a clearer picture of the cost. Consider asking your doc to take a beat, and then call your medical aid right then and there. A representative should be able to estimate what’s covered and how much you’ll have to pay.
If you and your doctor are sure there’s no other way around a pricey procedure and treatment, or if you don’t have any aid, you may want to ask about payment plans or financial assistance – negotiate until you reach an agreement that you can both meet.
SCRUTINISE THE bill
It sounds silly, but when you get a bill, first verify that it’s actually yours. Mistakes happen, and someone else’s throat culture is truly the last place you should be spending your money. Also check that there are no duplicate charges or services you didn’t receive. In hospital settings, sometimes tests or medications are ordered that don’t get administered – and only you will know to cry foul. If anything seems amiss, call your medical aid company immediately. It could be their error or a slipup in your doctor’s billing office, but just because you’ve been billed doesn’t mean the cost is set in stone. If the facts do check out, but you’re concerned about your ability to pay, it’s always worth asking what can be done. Always remember that as a patient, you alone are in control of your health.
“If there’s no way around a pricey procedure, or if you don’t have any aid, you may want to ask about payment plans or financial assistance.”