How to Estimate Health Care Costs Before You Get Care

Blues Perspectives

| 3 min read

When you make a big-ticket purchase such as a television, appliance or computer, you likely shop around online to make sure you're getting the best deal. Did you know you can do the same thing with health care services? If you’re like most Americans, you’ve probably taken on more of the responsibility of paying for health care costs in recent years. What if we told you getting an MRI at a hospital is roughly two and a half times more costly than going to a stand-alone imaging center? You would want to know this so you could make the most appropriate choice for yourself, financially or otherwise. Here’s how you can know the true costs of a doctor’s visit, test or exam before you go:
  • When your doctor refers you to a specialist or tells you to get a test, ask for the specific name of the procedure or service you’re going to have, including the medical billing code.
  • Next, shop around. Call several health care providers and tell them the procedure you need and the insurance coverage you have. They can tell you if they’re an in-network provider, and they should be able to provide an estimate of what your out-of-pocket costs will be. Some hospitals and doctors list prices right on their websites.
  • Finally, make a decision about your care based on the price and provider that best fit your needs.
If you’re a Blue Cross Blue Shield of Michigan PPO plan member, you can also use our Find a Doctor feature at bcbsm.com to compare prices when you’re logged in.
The tool allows you to estimate what the cost will be for a doctor’s visit, test, surgery and other procedures before you step foot in the doctor’s office. You’ll find costs for more than 400 health care services, allowing you to compare costs by different facilities and doctors nationally.
Doing your homework up front has the potential to save you thousands of dollars for just a little extra time. It’s perfectly acceptable to ask your health care provider questions and request that all providers participating in your care be in your network, so you can avoid any surprise charges on your bill. (Just going to an in-network facility doesn’t guarantee that all the medical personnel you’ll come in contact with will be in your network.)
Make sure to also double check your coverage information online to determine the percentage of charges you’ll be responsible for, including any deductibles or co-payment amounts. You ultimately drive your own health care decisions. Talk to your doctor about the most cost-effective, high-quality ways to receive treatments, lab tests and other services. By comparing costs of services ahead of time and assessing what’s covered by your plan, you can make an informed decision and save money.
MI Blues Perspectives is sponsored by Blue Cross Blue Shield of Michigan, a nonprofit, independent licensee of the Blue Cross Blue Shield Association