Medical price resources

With high deductible medical insurance we’re paying a lot more for services out of our own pocket. It has been notoriously difficult to find the prices of medical procedures so I thought I would start a thread on resources for finding these prices. Obviously you’re not going to price shop in an emergency but many times you do have time to shop around and you can save a lot of money.

Harry Sitt over at the finance buff blog has an interesting example of how he saved $500 for about 15 minutes of work comparing prices for MRI scans using a tool he found on his Medical Insurance web site.

Recently I was price shopping for Medigap insurance policies. My home state California has something called the birthday rule that allows you to switch policies every year for the month following your birthday without going through medical underwriting. I found that the California Dept of Insurance has a web page where you enter your zip code and it gives you the prices for all types of Medigap policies for insurers that offer it in your zip code. With this tool I was able to save $20.00 a month or $240 a year. Since these policies are highly regulated by Medicare I think that they’re pretty much interchangeable.

So what tools web or websites have you been able to find that help you get prices for medical procedures? Unfortunately some of these resources may only be local but at least they will give us an idea of where to start.

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What kind of medical procedures? Good luck trying to get a cost estimate on something like back surgery. Also, never heard of the birthday rule but I’m also not 65.

The only sort of financial resource that I can find is directly thru my insurance company. Although they will do it by phone, you can login and use their cost estimator for the technical portion of a variety of procedures. Unfortunately, they will never tell you the cost of the professional portion.

The contracts between providers and insurers are so myriad and secret that I’ve been unable to find my cost until after the procedure is complete, and only then when I get the bill. It is damnably frustrating to fight an illness and “the system” at the same time.

One of the rules I’ve come to learn is that if you can get a procedure done away from a hospital, you’ve saved at least 50 percent.


That’s why I go to a dentist in Mexico and I get plastic surgery in Brazil. Hospitals overcharge because they know that insurance companies will cut them off. Insurance coverage varies so different people pay different amounts. Maybe you pay $20 and I pay $50 for the same $5 bandages that they billed insurance for $100. It’s the American way.


Is switching to a HMO an option?

I ask my doctor. I call around. Imaging can vary greatly. It is never easy it takes patients, but the payoff is worth it. Also sometimes if you pay for full services in advance and submit to your insurance afterwards yourself you can save big $. YMMV.

I see what you did there.


Also sometimes if you pay for full services in advance and submit to your insurance afterwards yourself you can save big $.

That has been my experience also. I used to have a high deductible policy. If I wanted a specific procedure like a diagnostic image done I called around and said I was paying cash and what was their price. Many times I would get 50% off their list price. I could then submit the bill to get my payment to count towards my deductible,

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Not for me. I’ve not had any experiences with HMO’s but remember all of the jokes and supposed horror stories from the late 80’s. That’s not the reason it’s not an option. The only option that makes economic sense at the moment is a high deductible plan.

From my recent experiences, the list price for medical procedures is about as relevant as rack rates at hotels. It’s the starting point for discounts. My insurance company typically gets over 50% off the list price. That is one of the reasons that you can’t get a firm price. The customer service personnel at your insurance company have no idea what discount you get with a particular provider. Most of the providers I’ve tried to nail down on a specific price also deny knowledge of my discount.

For prescription medicine, the Costco pharmacy provides prices online for most but not all medicines. They usually have a pretty decent price so it gives you a benchmark. Sometimes it has been less than the copay thru my Part D insurance plan.

At least here in California, you do not have to be a member to buy the medicine at their pharmacy.

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Definitely worth checking. Costco, at least for my Rx. For example, a 90 day supply of one generic drug was ~$18 from their mail order pharmacy, without insurance. With or without insurance at CVS was easily $30 for 30 days.

That medical and drug prices aren’t single-priced like a dvd from Amazon makes me a little crazy. You could be in a line of four people at a pharmacy, all filling the same prescription, and each pay a wildly different price.


My insurance company also had a website that was able to give pretty good estimates for an MRI. I saved a few hundred dollars that way, although I also had to function as tech support for them as the CD they provided was incompatible with my doctors computers.

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Costco also has decent prices on supplements, especially their store brand. They also have good sales. For example, this month (Sept 2018) they have CoQ10 on sale. I don’t have the price right now but look for their ad online.

I am too cheap to buy a membership so we do the gift card routine. We had a one year membership from the Groupon deal a few years ago and until recently could buy gift cards using the old online account. Last time I did that they caught it and said they would allow me to buy a card one last time but no more. :blush: Next time will probably buy a gift card using my sister’s account. Against my advice she bought in anyway so I might as well take advantage.

BTW, got an email that the Discover card 5% category in the coming quarter includes Wholesale Clubs. You can’t use the card in the Costco stores but IIRC their website accepts Discover.

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Buy GC online with Discover then pay in store? I’m asking.

Buy online return in store

So you’re too cheap for $60/yr membership, but you buy an enzyme supplement that hasn’t been proven to have any benefits?


Yes. In the past, I have bought a gift card online with a Discover card and then used it in the store. I am not sure whether they will still let you do that.

Do you know who accepts Discover? Sam’s Club.