In case you can't make it overseas but still want to pay a reasonable price...

Posted August 30th, 2007 by David Williams

In What are the real savings in medical tourism?, Dr. Michael D. Horowitz suggests uninsured patients negotiate pricing upfront with their US-based provider rather than waiting for the bill, which invariably will be for much more than the inflated prices that insurance companies pay.

But how can a typical consumer handle such negotiations --and do so without offending the providers on whom they are relying for their health?

AOL Money Top 5 Ways to Save on Health Care suggests using Medicare reimbursement rates as a benchmark. The figures are published by the Centers for Medicare and Medicaid Services (although finding exactly what you are looking for is much harder than the article implies) and hospitals and physicians are used to receiving these rates. Physicians, in particular are also more likely to be flexible if you pay at the time of service, which reduces uncertainty and eliminates billing and collection expenses.

For patients who are considering traveling overseas for medical care to save costs, I would recommend letting your provider know that upfront and asking them for the best price they can offer. They might offer something less than the Medicare rate. If not, you can always fall back on asking to pay Medicare rates.

You can view information on Medicare physician fees here.

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Negotiating prices with providers

On August 30th, 2007 Michael D. Horowitz says:

This is good information and a useful resource for American patients who want to establish a target range when considering price negotiation.

Patients should recognize that most physicians believe Medicare payments are about as low as they can accept.  I suspect that some providers will agree to this fee schedule if substantial payment is made in advance.  Probably, a more realistic position is to offer payment of the Medicare rate plus a certain percentage.  For example, Medicare + 10% may be acceptable to some physicians but others will require Medicare + 20%.   

The important point here is to have the discussion with the physician or designee (office manager, billing coordinator) and to make it clear that even though there is no insurance coverage, payments will be made according to the established arrangements.  Although I cannot speak for others, I expect that patients who address these  issues and offer meaningful payment in advance will get more favorable considerations.