Home / Tips for discussing medical costs (and who can help)

Tips for discussing medical costs (and who can help)  

  • Let your doctor and office manager know that you are concerned about medical costs.
  • Many people share your concern and have similar discussions with their healthcare team.
  • Doctors often do not know the price of the treatments they prescribe, so you need to make it clear that cost is important to you.
  • Ask to speak to the billing expert at your doctor’s office or your pharmacy. These experts are especially helpful in developing strategies to reduce costs for you (at no extra charge).

Do your homework     

  • Prepare your questions ahead of time, and find out who can help with answers.
  • Do your homework–call your insurance company and shop around for pharmacies that offer the best prices on common drugs.

Questions to ask your doctor or pharmacist 

  • “Who’s the best person here to ask about lowering my costs?”
  • “How long will I have to take this medication?”
  • “How often will I have to have this procedure or test?”
  •  “Are there any ways to lower the costs of my treatment without changing its effectiveness?”
  • “How many times a week (or month) will I need to see a physical therapist (or other medical provider), and for how long?”
  •  “What else is involved in the treatment? Will blood work, X-Rays, follow-up appointments, or other procedures be required?”
  • “Can I get a generic drug (for both prescription and nonprescription medications) that is cheaper and just as effective?”

Questions to ask the billing expert in your doctor’s office 

  • “How much will it cost me?”
  • “How much will I have to pay out of pocket?”
  • “Are medications, tests, lab work, and consultations included in the cost of treatment?”
  • “Can you suggest ways to lower the cost of my treatment?”
  • “Can you give me a detailed list of my procedures and costs?”
    • The hospital billing expert may not always be able to provide this information to you in advance.
  • Some organizations will ‘bundle’ charges differently, and that can affect how much they charge. For example, many facilities bill for surgeons separately, so if surgery is part of the treatment, ask if their costs are included. If there will be a biopsy, ask if the cost includes the fees of the pathologist who reads the slides. The same applies for anesthesia and anesthesiologists and X-rays and radiologists.

Why doctors don’t think much about costs

  • Doctors see patients who have a range of insurance policies, and those policies set the cost of drugs. This means that patients may pay different prices for the same drug. It is nearly impossible for doctors to keep track of costs for each individual patient.
    • This situation is similar to that of passengers on a plane. The pilot probably won’t know how much each passenger paid for a ticket. One person’s ticket may be more or less expensive than that of the passenger in the next seat.
  • Your doctor does not set the price or have any say in the cost of equipment, procedures, or other treatments.
  • Your doctor does not profit from the drugs that he or she prescribes.
  • Many doctors do not want to consider costs when making decisions about treatment. This is not because they don’t care about you or your wallet, but because they believe they should recommend the best treatment, regardless of the cost.
  • Talk to you doctor if the recommended treatment is too expensive for you. Your doctor will honor your wishes if you ask him or her to consider the costs when prescribing treatme