I got a surprise $500 medical bill—how I could have avoided the shock
A few weeks ago I straightened my back by racking up weights at the gym. When things weren’t getting better after a week of rest, ice, and ibuprofen, I decided to see an orthopedist.
After sharing my medical history and the details of my injury with the nurse, I waited for the doctor in the examination room, lingering on my phone. But the next knock on the door was not a doctor, but a technician.
“Come into the corridor for the x-ray,” he said.
I should have thought, “Oh good.” “They can figure out what’s wrong.”
Instead, I felt a pang of fear.
Earlier this year, I was trying to resolve a skin condition and went to an allergist. They told me they were going to do the standard test where they would dip you in about 50 different allergens and see which ones you react to. It went well enough; Turns out I’m not allergic to very many things.
A few months later, the invoice for the test arrived in the mail. It was close to $500. I was on the hook for everything because I hadn’t reached my annual deductible amount yet. I was quite shaken. None of the doctors I saw even once mentioned that this procedure might be costly for me. They just ran the tests and scheduled me for follow-up.
When I returned to the orthopedist’s exam room after my x-ray, still not having earned my exemption, all I could think was: “How much did this cost me?”
Looking back, I shouldn’t have followed him silently. But it felt rude to refuse to go with the x-ray technician until he offered me a price. Plus, how would he know how much it costs? The amount you’ll pay for any procedure depends on your insurance coverage as well as the rates your insurer negotiates with your healthcare provider’s billing office.
I’m not the only one recovering from healthcare label shock. A. 2024 research by private healthcare organization Commonwealth Fund Insured found that 45% of working-age adults received an unexpected bill last year.
Your first step to avoid unexpected bills is to talk to your healthcare provider. This might mean talking openly during a medical consultation or having more in-depth discussions with your insurance company and your doctor’s billing department, says Carolyn McClanahan, MD, certified financial planner, and founder of financial planning firm Life Planning Partners.
McClanahan says this can feel scary, especially if you’re at the scene. You want to speak up for yourself and avoid surprise bills, but if you’re like me, you don’t want to ruffle your feathers when you need care.
How to avoid surprise medical bills?
I still haven’t received the invoice for my x-ray. But the discomfort I feel when I bring up the cost issue with the technician is common, says McClanahan. Still, it’s worth talking and advocating for yourself before and after your treatment, she says.
Talking to your provider ahead of time can help you understand the costs of procedures and get you on track for treatment you can afford. Even if you need high-priced treatment, doing a little research and making the necessary preparations regarding costs can help you avoid sticker shock down the road.
Here are three steps McClanahan recommends to avoid surprise bills:
Step 1: Contact your doctor
If you, like me, are faced with a procedure whose cost is uncertain, the first thing you should do is ask your provider if it’s really necessary, says McClanahan. You may find that there is leeway in timing or cheaper alternatives to the procedures or medications the doctor recommends.
McClanahan suggests a possible scenario: “I have this really high deductible and I’m trying to manage my bills. Can you please let me know how much this will cost or confirm that I really need this now?”
He says discussing your concerns with your doctor ahead of time can help you get a treatment plan that better fits your budget.
Step 2: Do your best to shop
Even if you are concerned about price, you may definitely need a certain procedure. And if you haven’t yet reached your deductible in a given year, you’ll probably have to pay it.
If you need to schedule a treatment for a later date, you could potentially save yourself some money. McClanahan says it’s important to compare costs across different providers.
This means calling different medical providers in your area and asking their billing departments how much they charge for the treatment you want. But getting answers won’t always be easy, McClanahan says.
“The challenge is that each insurance company negotiates different rates,” he says. “The person sitting at the billing table won’t even consider what that rate will be.”
What’s more, McClanahan says, what starts out as a single treatment, like a colonoscopy, can turn into a more expensive procedure if your surgeon discovers something worrisome and has to perform a biopsy.
In other words, it may not be easy to determine your medical provider’s billing department with an exact price. But do your best to explain to them that budget is an important factor in whether you’ll receive treatment at their facility, says McClanahan.
Step 3: Review your invoice
I still haven’t received the bill for my orthopedist visit. But when I do that, it would be wise to ask for a detailed list of the charges, says McClanahan.
“You need to see what they’re really accusing you of,” he says. “Then go online and compare that to what is actually a reasonable wage.”
McClanahan likes the search tool at: FAIR HealthShows estimated in-network and out-of-network costs for treatment based on what providers charge in your area.
If a bill you receive is much higher than the average cost, or if your doctor’s office charges fees that don’t seem appropriate for the care you’re receiving, call the billing department and plead your case, says McClanahan.
In the event of my allergy testing, a medical provider would be unlikely to negotiate with me, McClanahan says. The price tag was in line with what providers in my area were charging, and I was billed correctly.
In more extreme cases — say, when a high-deductible patient faces bills in the thousands of dollars — medical providers may be willing to cut costs, McClanahan previously told CNBC Make It.
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