Coping With Out-of-Pocket Health Care Costs

As the economy sours, more employers are cutting back on health insurance benefits, if not outright eliminating them. Add these workers to the hundreds of thousands of uninsured and underinsured Americans, and there's little doubt that consumers should expect to shoulder more of the burden of paying their own medical costs.

The U.S. government predicts that consumer out-of-pocket health care expenses will reach an average of $3,301 a year for each household by 2014 from $2,500 in 2009. These costs are in addition to any health insurance premium from employer-sponsored health care plans, COBRA coverage or private health insurance, all of which continue to increase at a pace higher than inflation.

According to a 2008 study by the Commonwealth Fund in New York, two-thirds of U.S. adults younger than 65 in 2007, or 116 million people, had trouble paying medical bills, went without needed care because of cost, and were uninsured for a time or were underinsured, meaning they had high out-of-pocket medical expenses or deductibles.

As more consumers find themselves struggling to pay growing levels of medical-related debt, providers are searching for payment options to help stem defaults.

Among the options are specialized health care credit cards and provider-sponsored payment plans and loans targeting certain medical procedures. All of these options, while not available to all consumers, provide the opportunity to pay for potentially expensive care over a period of time.

"I think the health care system is getting set up to be a lot more accommodating to people who are having trouble paying their bills and can demonstrate that," says Steve Findley, a senior health policy analyst with Consumers Union, a not-for-profit advocacy group in Yonkers, N.Y.

Take a three-pronged approach
When seeking help with paying out-of-pocket health care expenses, it makes sense to understand the specifics of the treatment you need, find the least expensive place to get it, and negotiate costs and payment methods upfront. This three-pronged approach can lessen your overall direct costs and help you obtain the least expensive payment option.

When you need medical treatment, whether it's covered or not covered by your insurance plan, the first step is to understand exactly what the treatment is, why you need it and how badly, and how much it's likely to cost.

"Ask your doctor for more details," Findley says. "If it's a test, what is the test? Why do I need it? On a scale of one to 10, how important is it that I have it? Is there a place where I can get it cheaper because, guess what, I'm paying for this out of my own pocket?"

Ask about low-cost health care options
When it comes to finding the lowest cost care, not only are consumers reluctant to ask about these options, but information is also not widely available. While there is a lot of comparison shopping for prescription drugs, there isn't for medical procedures or tests.

Next: "There is no substitute for getting on the phone and calling around." >

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