How Do I Negotiate Healthcare Bills?

Negotiation may not come to mind when paying a medical bill, but the tactic can be effective. If you speak up and ask for what you want, you may be able to cut your costs by 25 to 50 percent — or even more, says Andrew Lokenauth, a financial adviser and the founder of TheFinanceNewsletter.com, based in Tampa, Florida.

“Everything’s negotiable: lab fees, facility charges, medication costs. I always tell my clients to question every single charge,” says Lokenauth, who recommends getting in touch with your provider and insurance company to question fees. “Remember to stay professional and keep detailed records of every conversation, including names and dates,” he says.

If you’re not already taking generic drugs, ask your doctor to prescribe them, since they are typically much cheaper and work just as well as the brand-name versions.

Coupons are also available for some prescription drugs. Copay coupons and discount cards are available on some pharmaceutical companies’ websites, such as Gilead and GSK. GoodRx and SingleCare are two sites where you can compare drug prices and find manufacturer and pharmacy coupons. Amazon Pharmacy is another resource for coupons. Note that manufacturer coupons generally can’t be used if Medicare Part D or another federal program pays for the drug.

Paying the cash price instead of using insurance can also save money. “Ask your pharmacist about cash prices, which can sometimes be lower than insurance copays,” says Neal Shah, cofounder of Counterforce Health, a free platform offering AI tools and resources to help patients appeal denied health insurance claims. If you pay with cash, however, it usually will not count toward your insurance deductible or out-of-pocket maximum, so you should check with your plan.

He adds that many pharmaceutical companies offer assistance programs for patients who cannot afford their medications. “These programs often have income requirements but can provide medications at reduced or no cost,” he says. Information about such programs is often available on company websites, and your doctor may be able to tell you about them as well.

“You can’t negotiate copays or coinsurance, so it’s best to ask your doctor about less expensive options available to you,” says Caitlin Donovan, the senior director of outreach and communications at the Patient Advocate Foundation in Hampton, Virginia. “It’s important for your doctor to know what you can afford, as they may be able to adjust your treatment.”

While insurance typically covers a significant portion of these tests, it’s still possible to negotiate lower prices. Research the average costs of the tests your doctor wants you to have, shop around, and get several price quotes. You can also take advantage of online comparison tools such as Valenz Bluebook and Hospital Cost Compare, which provide information about the cost of tests and procedures at different locations.

Another helpful site is Turquoise Health, which allows you to look up the total cost of care for common services at providers in your area. After inputting your insurance information, you’ll get an estimate of your out-of-pocket expenses.

Insurers, like Aetna and UnitedHealthcare, are also required to provide pricing information. Find out if the cheaper options are available through your insurance, and ask your doctor to send you to those providers. You can also ask your insurer if they can negotiate a lower price for a test with their providers.

And don’t be shy about asking your doctor if there are tests that could provide essential information at a price that better fits your budget.

The facility where you get your test done can influence the cost as well. “Visiting a freestanding imaging center can be cheaper than similar services at a hospital,” says Ariela Simerman, the vice president of product at Turquoise Health.

Finally, always check with your insurance company to find out if any of the tests or procedures you may need require prior authorization. Getting authorization beforehand can help prevent an unexpected bill if your insurer requires it for coverage.