Slash Your Medical Bills: 7 Ways to Haggle

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Slash Your Medical Bills: 7 Ways to Haggle

By Jeanne Lee

Haggling with your hospital or dickering with your doctor to lower your medical bills might feel, well, unseemly. But with health care costs pinching the typical household by about $15,000 a year and employers trimming coverage and shifting expenses to employees, it might be time to try your own personal health care reform.

Rising out-of-pocket costs have motivated many patients to ferret out what was, until recently, a dirty little secret of the medical world: You don’t always have to pay retail. If your health insurance isn’t covering your needs or you lack insurance, you can probably pay less for elective and planned procedures just by speaking up. “People often don’t realize medical bills tend to be eminently negotiable,” says Andrew Cohen, medical debt resolution program manager at The Access Project, a nonprofit health care advocacy group. Greg Voelm, owner of a health care testing company in Sacramento, Calif., and a 35-year veteran of the health care industry, thinks it’s possible to reduce medical bills by as much as 80 percent. But, he says, few people try. “It’s just not something that Americans are trained to do,” Voelm says.

Annette Pappas of Brockton, Mass., a medical billing administrator who has worked in hospitals and doctor’s offices, haggled over her own steep fees after developing breast cancer in 2005 while self-employed and without insurance. Knowing she’d need to tap a home equity credit line to pay for her $19,000-a-week chemotherapy and Herceptin shots, Pappas negotiated with the hospital before beginning treatment. “I said, ‘I’m paying for my own health care and can’t afford to pay you these charges. Can you work with me?’” The sympathetic billing manager gave her a 45 percent discount. “I knew that was well in line with what the insurance companies would have paid,” Pappas says.

You also may be able to lower the cost of a routine test just by calling doctors in your plan’s network and asking for their fee. “If you need an MRI of your knee and have Blue Cross, you could pay $500 to $3,000 for the same test within the plan’s network,” says Jeffrey Rice, CEO of the Healthcare Blue Book, a site that collects health care pricing information.

Use these seven tips for medical haggling to boost your odds of success.

1. Know the Real Cost

Arming yourself with price range information will give you a reasonable number to use when starting a discussion. Check your insurance carrier’s Web site. Most major carriers let members see their negotiated rates.

Sites such as the Healthcare Blue BookVimo, and New Choice Health also make it much easier to sleuth out these figures than in the past. With a few mouse clicks, you can get an idea of how much local hospitals and doctors charge, plus how large a discount the average insurer would receive.

The Healthcare Blue Book lists “fair” prices for self-pay patients, defining “fair” as a small premium above the average fee local providers accept as payment from insurers. For example, for knee arthroscopy in Brentwood, Tenn., the site says a fair price is $1,051 for the physician’s fee and $6,026 for having the procedure done in a hospital. New Choice Health will let you compare Healthcare Blue Book’s recommended fair prices with the list prices for medical facilities in your area. The list price for that knee operation? A whopping $9,200 in a surgery center and $20,200 in a hospital. Vimo provides average retail and discounted prices for hospital procedures. Type in, say, “balloon angioplasty of coronary artery” and you’ll see that the “average full list price” (the price a self-pay patient is likely to be billed) is $39,900. But the “negotiated national average price” (the discounted price the insurer pays) is just 30 percent of retail, or $11,800.

2. Use the Right Words

Once you have pricing reference points, but before you’ve committed to the procedure, visit the billing person in the doctor’s office or the manager of patient accounts at the hospital. This way, you can attempt to negotiate a discount before receiving treatment.

Then, be clear and confident. Say something like, “These bills are extremely expensive. Would you consider adjusting the price to be more affordable?” Or “My insurance isn’t covering this treatment, so I’m paying for my own care and would like to see if you can lower the price.”

Making things personal may help. If you’ve chosen a particular doctor because you’ve heard glowing recommendations from friends, mention that. If you’ve recently been laid off, say so. The billing staff may be willing to cut you a break.

Larry Gelb, CEO of health care advocacy firm CareCounsel, recommends offering to pay immediately in exchange for a discount. At the doctor’s office, “you could start by saying, ‘I’m going to pay out-of-pocket this year. Would you consider seeing me for the same amount you received in past years from my health plan? I’ll pay you up front in cash,” says Gelb. If the office agrees to accept your former insurer’s rate, that could translate into a 40 percent discount.

This tactic worked for Marty Rosen, co-founder of Health Advocate, in Plymouth Meeting, Pa., which serves businesses and individuals. While trying to avoid a second round of periodontal surgery with regular teeth cleanings, he lost his dental coverage from his wife’s employer. “I told the office manager, ‘I no longer have coverage. Can I be charged what the insurance carrier was paying the doctor?’ She said, ‘Yes, you’ve been a good patient to us.’”

In a hospital, ask whether you could qualify for any financial assistance programs. “These are not just for poor people,” Cohen says. “Someone who earns $100,000 a year but has $50,000 in medical expenses might qualify.”

3. Ask About Going Outpatient

Some types of surgery scheduled for a hospital with an overnight stay can be performed equally well at a less expensive outpatient center. Rice says one person who read the Healthcare Blue Book advice on knee surgery saved more than $5,000 just by knowing to ask his surgeon if he could have it done at an outpatient center. Of course, your doctor may have important medical reasons for choosing a hospital setting, but it can’t hurt to ask.

4. Negotiate Afterward

If you’ve already had the procedure and staggering bills are arriving, you can still ask for a discount. Hospital billing departments are often eager to collect something and get the charges off their books, rather than deal with a lengthy collection process. Cohen says you have nothing to lose by starting with an aggressive offer. For example, “If I pay you 30 percent of this bill right now, will you write off the rest?” Even if your initial offer is rejected, the hospital may counter with a discount you can live with.

In a hospital, if you are offered a 10 or 20 percent discount, press on. That is not a big reduction compared with the markup they are probably charging. “Go up the chain of command, calling the billing manager or the vice president of finance and so on, building a relationship with each person by telling your story,” says Cohen. Make sure you write down every person’s name, title, and contact information; the date and time you called; what you asked; and what each person said. If you reach an agreement, get it in writing.

5. Don’t Pay by Credit Card

Forgo the credit card if you think you might be asking for a discount later. Using plastic puts you in a weaker bargaining position with the hospital. “We recommend against credit cards, because the hospital loses any interest in negotiating with you” once they have your money, says Carol Pryor, policy director at The Access Project. And your bills could be even higher if you end up paying interest on the charges.

6. Inquire About a Payment Plan

If you are still facing a huge bill after negotiating a discount, ask for an interest-free payment plan. This strategy leaves you with the option to renegotiate the amount down the road, after demonstrating good faith by making timely payments. You can then write to the billing office: “I’ve been faithfully paying this bill for a year and half.” Remind the office of the total you’ve paid to date, and say something like, “My family is having a tough time during this economic crisis. Will you forgive the rest of the bill?”

7. Call In a Pro

If the hospital or doctor won’t give you a break and your medical bills are out of control, enlist the help of a nonprofit or professional advocate that can help bargain for you. Medical Billing Advocates of America has specialists who typically keep a percentage of the reduction they negotiate for you — perhaps a third. The Access Project provides free one-on-one coaching, including negotiating with doctors and hospitals. You can fill out an online form and a staffer will call you back.

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32 responses to “Slash Your Medical Bills: 7 Ways to Haggle”

  1. Ellis Weidner says:

    Highly descriptive blog, I liked that a lot. Will there be a part 2?

  2. Irmgard Zuehlsdorff says:

    This info is priceless. When can I find out more?

  3. von says:

    Great Article !!

  4. Steven J says:

    I have an issue and not totally sure there will be a solution for it. I needed to have surgery for retinopathy 5 years ago, and didn’t have insurance. The bill ($50,000+) has since gone to a collection company. I was unemployed then, and still am to this day, receiving no benefits other than health care (thanks to Obama care!) Is there anyway to clear this up maybe a forgiveness program?

  5. Radhika says:

    very informative and helpful blog, nice work for people like me who got big medical bills.

  6. Mitzi A says:

    I have insurance and had surgery on my hand. I had to have OT to regain use. My insurance said my plan did not cover OT. The EOB that I received shows the contracted rate of 26% of the total charged. I called the hospital that billed me yesterday to see if I could just send them a check for the contracted amount and was told that all they can do for me is offer me the cash discount which is only about half of the cost. This doesn’t seem fair to me. If insurance had paid then the hospital would have only received the contracted rate. What should I do? I was very nice on the phone but tried to let the staff know this wasn’t right in my opinion. Any help you can give me would be appreciated.

  7. Steven J says:


    In this case I would say to go in person and meet with the business office manager. In many cases it is harder for a provider to say no if they are looking at you…..
    I have been in the insurance industry for over 25 years, and it isn’t fair in many cases. Remember this is a business just like buying a car, there is wiggle room.
    I have been a director in many hospitals and I was always understanding when someone isn’t looking to get out of the bill but only trying to help manage it. If the balance goes to collections they will be paying that agency 20-30% so really I think if you go in and state your case they will work with you.
    I hope this helps.

  8. […] people assume that the numbers they see on their hospital bills are non-negotiable. This is not the case. Due to fluctuations in costs for everything from medical […]

  9. Meghan says:

    Hello. I looked at my credit report yesterday 11/30/2015. I have bills added on recently from 2010. I had Medicaid from 9/10. I have bills from 5/2010, 6/2010. One for $951 and another for $50.50. The bills were not submitted for retroactive coverage. I was not told of charity care as well. I was 18 and pregnant and no one had guided me. I am stuck and with no one to help. I paid 2 off. I can’t afford the one for $951.. . Would they at all be willing to write it off being almost six years

  10. Elaine says:

    Outstanding information for us consumers (patients) as self advocates! Look forward to updates as the deductibles and out-of pocket costs keep increasing to the point insurance is nearly non existant. In addition, excluded and non covered procedures appear to be increasing. Thank you!

  11. Jenny says:

    Hey there!!!

    Thank you for writing this! I have a question. I recently had a d&c for placenta removal after birth. Same procedure you would receive after a miscarriage. I waited for over an hour in a room while they had me fill out paperwork…I lost 3 liters of blood during this time and checked into the OR not ER to cut down on costs. I ended up okay in the end BUT. On a side note they tried to blame on my midwife the next morning for the 3 liters of blood loss even though it happened there at the hospital and my midwife was complaining to the staff about the time they were taking….they claimed she brought me in with the blood loss (I had a homebirth which the doctor made clear she was not happy about…which is why I think she spun the story about my midwife and the blood loss…). Anyway….the bill came to over $15000 (which is extremely excessive, it’s more than a birth itself). and we already had a non profit group try to negotiate it down, but the hospital has refused to negate any of the bill….what can I do? I have never heard of a hospital not willing to negotiate anything for a cash patient? I need help.

    Thank you

  12. Anna Palmer says:

    I just had blood tests done for pregnancy. It is $1300 and I have no insurance. According to my research, they are overcharging me by about $600 compared to the neighboring institutions in the same area. What can I do about this? My doctor visit was $181, I didn’t think my blood work woud be $1300 and I would have 0opted not to have it since I knew I didn’t have any STD’s

  13. Rochell Buck says:

    Medical service provider is billing me the medical exclusion amount. My insurance company says I do not owe them anything at all. I sent them a certified letter. They did not respond at all and they turned me over to collection agency for the $87.00 they were supposed to write off. Who do I need to contact I have all paperwork needed from my insurance co?

  14. Meenal says:

    An inspiring article to help self-advocate medical bills. I had unsuccessfully tried negotiating my bill with the provider. They had said that they do not participate with Healthcare Blue Book. I had received an estimate from the hospital prior to surgery, which went with the amounts stated in Healthcare Blue Book. But, After receiving a higher bill, they bring in the deductible not met scenario. I had tried asking them to pay an amount of the bill instead of the entire bill. Is there any way that I can lower down my bill.
    Your suggestions would be appreciated.

    Thanking you!

  15. David says:

    Thank you for this very helpful information.  Recently I went by ambulance to the ER after eating something that caused an allergic histamine reaction.  I have received the attending physician’s bill for $476, but I feel It would be helpful to know all the charges prior to beginning negotiation.  When can I expect to receive all the bills associated with my ER visit?

  16. Marjorie says:

    My husband was recently hospitalized in icu and unfortunately died there. He was in a big cancer hospital in NYC for four and a half days.
    He had medical insurance. My question is do I just have to pay the maximum deductible or will I be responsible for more?

  17. Ryan K says:

    I went to Er on February.15 due burning and excruciating pressure sternum I am unemployed and my mother brought me while I was their they told me I must give social security number. I waited in waiting area for half an hour before going back when back there they came in once every 15 mins. They gave me one chest X-ray then someone in billing came back and ask me what my assets were bank balance and that I needed to pay 300 upfront before they would treat me further. My mom is on a fixed income but she paid 300 they requested because she was scared from pain I was in and they statement they made. I find this to not be right But when you are in so much pain how was I to argue. Another note they totally misdiagnose as they said I had ulcer but the next night I laid by toilet because my whole insides were now burning and stayed up a full 24hrs but I would not go back because of the way I was treated night before and found out from family friend I had influenza and upper respitory not an ulcer they claimed. I am just sickened by this whole mess

  18. Steve says:

    I had a heart attack about a month ago. My deductible on my insurance is $800 and my insurance is a 70/30 split. My max out of pocket expense $1600. I am on a silver plan through the healthcare market place and do receive a subsidy is why I think my deductible and oop are as low as they are. But I went from being in what I thought of being in ok health to overnight of having heart disease, diabetes, and sleep apnea and being admitted directly from the ER into the ICU then two trips to the Cath Lab two days in a row for heart stent placements my deductible and OOP max was met rather quickly. I have never really understood about all this until now and I am still educating myself on things insurance related. When I was first released from the hospital my initial prescriptions I did have to pay my copays which most were $10 for generics a few were a little cheaper. Now I am on nearly a dozen medicines trying to get my health wrangled. Since all the Doctors and Hospitals have started billing insurance my OOP has been reached and I am no longer being charged anything out of pocket for my RX meds which is good for now anyway. Sorry for being long winded. But my question is my OOP max for the year has been reached. I have have office visits with my PCP and several specialist scheduled over the next few months. Should I have to pay any more Co-Pays directly to them? My PCP office was okay with waiting on insurance to respond, but the Cardiologist office was not so receptive to waiting they wanted money even though I know they could easily could verify it with insurance online that I have no co-pays left to pay. IF I pay them I am afraid that I will end up in a fight trying to get them to refund the over payments. How should I handle this situation?

  19. […] Whatever you’re going in for, get yourself armed with the right information. It is actually possible to “haggle” with hospitals and insurers to help reduce your bills. It’s not a perfect solution, but it can go a long way towards helping you out. Check out the guide at […]

  20. […] course, but these initial stages are essential if you want a more positive outcome. The trouble is, medical bills start to stack up – and you may not have the money. Not everyone has the right insurance […]

  21. Kelly says:

    I was admitted to a hospital that wasn’t in my network through BCBS in Georgia under emergency conditions. My insurance company agreed to pay their normal contracted rates as if I was in network, but the hospital is still charging me “non-network” prices. They gave me a 70% prompt payment discount when I had an x-ray done a few months ago and didn’t go through my insurance, but refuse to give me any type of discount on the remaining hospital bill of $12,000 since they already filed with my insurance company and received $4,000. Also, I wasn’t told the hospital wasn’t in network until after I was already admitted and hooked up to IV, oxygen, etc. An administrator came to the room and asked me to sign a form accepting responsibility for payment and told me I may have to pay 10%. Now they’re trying to charge me 75%. It doesn’t seem fair that they are charging “non contract” prices, but won’t give me the discount that usually goes along with that if paying up front. I would have been better off not even using my insurance. They told me there is nothing they can do at this point since my insurance company is already involved. Any suggestions?!?! I am in a panic.

  22. Maria says:

    Hi my name is maria on Nov 2016, I went to see my medical Dr due to numbness of my left arm and left leg.My Dr immediately sent me to emergency room for possible stroke,which I had no idea which hospital to go to so I went to Saint Jude. I was taken in to emergency room. Right away since I had a not from my Dr. They did a EKG and everything was normal they had me sitting and waiting out side in a hall for a Dr. To come and examine me which he did in the hallway. An hour later after they had a room open they laid me down in the room until I was taken for an MRI and was also taken blood out for testing after MRI was taken 30min later I was dismissed from the hospital and was sent home with a prescription. I have insurance health net HMO and the bill was 15,258.00 after insurance my out of pocket bill is $6,375.86. Unfortunately I can and don’t have that kind of money to pay. I called the hospital and they want me to fill out a financial assistance form. Ive never have applied for assistance before..

  23. John says:

    I like that you suggested being careful with your words when negotiating price. If I was going to get a procedure then I would want to know if I could get some sort of a discount. I think that if you can then you might want to ask for help from someone else if you can’t afford the bill.

  24. Diane says:

    My husband had cataract surgery and we opted for him to get the newest multi-focal lens, the Doctor told us there would be a slight upcharge. Well first the surgery center called and told us we had to pay $950 for the lens because insurance does not cover that particular lens. We have several conflicting bills from the Doctor and the latest had the normal charge of $1795 for the catatarct lens replacement plus $1395 for the upgraded lens replacement. We were never told the cost of the upgraded lens and how can it cost $1395 more due to us choosing a different lens? Our total cost that we were told would not be billed to insurance was the $950 plus the $1395, could this amount be negotiated?

  25. Need Help says:

    My MIL was visiting US last year from India when she had a cancer scare. Due to that she had a lot of bills from her biopsy, lumpectomy, blood work, imaging. I have spent the last one year on the phone with her Insurance company trying to get them to finish the claim process (I have literally spent hundreds hours on the phone with them) and they kept giving me the turn around. They kept saying we need medical records…ok we got it now its processing and when I would call back they would say we need more medical records. Finally few months back, they started processing some of the claims and have sent checks to my doctors. There are 5-6 left that they have not done…and one they are denying due to pre existing condition. It clearly says in the contract that if you have an acute onset of your pre-existing condition then it will be covered. How can I go about disputing this?

  26. […] providers for discounts on the amounts you owe out of pocket. Try to arrange an affordable payback plan without […]

  27. Jill says:

    I had some std testing done by my doctor’s office and received a $700.00 bill from LabCorp. I tried to look up the fair price using the Healthcare Blue Book but I could not find any pricing. Evidently the tests that were used are specific to LabCorp. I find $700.00 a bit much for standard STD tests. Any suggestions to negotiate this?

  28. […] correct errors, but it will often be well worth the effort. You might get waved away at first, but keep trying. When emails and phone calls don’t get you the results you’re going for, try writing a formal […]

  29. salil says:

    This is a crowd sourced funding program. It may help where concerned people make charitable donations directly to the person that needs assistance.

  30. Bren says:

    I went in to have an annual physical done which is required by my insurance. Everything was fine and the doctor asked if I wanted blood work done to test for everything. I’ve never done it and thought why not. To my surprise I just received a $1200 bill for the blood work. Seems strange considering the doctor made it seem like it was part of the annual. I can’t afford it and it’s due this month. Any advice??

    • says:

      Hi, Bren. We would like to get more information from you to be able to assist. Could you call our Consumer Division at 855-203-7058? Thanks!