How to Negotiate Healthcare Bills

How Do I Negotiate Healthcare Bills?

How Do I Negotiate Healthcare Bills?
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The cost of healthcare can be onerous. In a survey conducted by the health policy research organization KFF, about half of U.S. adults polled said it's difficult to afford healthcare, and 1 in 4 said they or a family member in their household had problems paying for healthcare in the past year.

Negotiation may not be the first thing that comes to mind when you're trying to pay 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. But before you try to get costs for things like MRIs, CT scans, and hospital visits reduced, it’s important to set your budget, including the maximum amount you’re able to pay overall and how much you could pay in a single lump sum.

“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.”

Drugs and Medication

While medication is often essential for treating a condition, it can be expensive. In the KFF survey, 21 percent of respondents said they hadn’t filled a prescription due to the cost, and 10 percent said they had cut pills in half or skipped doses in the last 12 months for the same reason.

To help reduce the hit to your wallet, talk to your different healthcare partners. Some pharmacies have price-matching programs that offer discounts on certain generic drugs, as well as membership or loyalty programs that entitle you to discounts.

 They don’t always advertise these programs, so be sure to ask about them.

You can also ask your doctor to prescribe generic drugs, which are typically much cheaper and work just as well as the brand versions.

Coupons are also available for drugs. Copay coupons and discount cards are available on some pharmaceutical companies’ websites, such as Gilead and GSKGoodRx and SingleCare are two sites where you can compare drug prices and find manufacturer and pharmacy coupons. Amazon Pharmacy is another resource for coupons.

“Ask your pharmacist about cash prices, which can sometimes be lower than insurance copays,” says Neal Shah, the chairman of CounterForce Health, a free platform offering AI tools and resources to help patients appeal denied health insurance claims.

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

Copays and Coinsurance

Copays and coinsurance — the set percentage of the bill you will pay in addition to what the insurer pays — are determined by the insurance company based on your specific plan.

“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 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.”

Read the fine print in your health insurance plan, and be clear on the percentage of bills you must pay, as well as any limits. Remember, too, that it’s important to stay within your network whenever possible. Using the providers that your insurer has arrangements with will mean you pay less, because the insurer has negotiated lower rates with them.

Lab Tests, X-Rays, MRIs, CT Scans, and More

Tests tell the tale of what’s going on with your body and are often essential for making a diagnosis. But imaging tests like MRIs and CT scans can be pricey. Total costs for an MRI can range from roughly $700 to more than $5,400 depending on your location, health insurance plan, and other factors.

A CT scan can cost between $300 and $3,280 depending on what body part is scanned, whether or not you have insurance, where you live, and whether dye is used, among other factors.

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. Take advantage of online comparison tools like Healthcare Bluebook and Hospital Cost Compare that 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 after insurance pays their part.

Some insurers, like Aetna and UnitedHealthcare, also have offerings like this. Find out if the cheaper options are available under your insurance, and ask your doctor to send you to these providers. You can also ask your insurer if they can negotiate a lower price for a test with their providers.

If you’re uninsured, request a good faith estimate from your provider so you’ll know what to expect and where to start your negotiation price.

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 make a difference as well. “Visiting a freestanding imaging center can be cheaper than similar services at a hospital,” says Ariela Simerman, the senior director of product at Turquoise Health.

Finally, always remember to get pre-authorization from your insurance for all procedures.

The Takeaway

  • Negotiation can be effective in reducing the price of medical care.
  • Before getting a test or procedure, research costs and see if your doctor, healthcare provider, and insurance company can work with you to come up with quality care at the best price.
  • Coupons and programs at pharmacies can reduce the cost of medication.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. America’s Challenges with Health Care Costs. KFF. March 1, 2024.
  2. DIY for Negotiating Medical Debt. Community Service Society of New York.
  3. Price Matching on Name-Brand Drugs. Revere Health.
  4. CVS Pharmacy Announces New Simplified Loyalty Experience. CVS Health.
  5. Health Care Prices: MRI. Health Care Cost Institute.
  6. Edwards S. What Does a CT Scan Cost With & Without Insurance? (2025). Consumer Shield. January 10, 2025.
  7. What Is a Good Faith Estimate? U.S. Centers for Medicare & Medicaid Services. November 11, 2024.
Sarah Goodell, MA

Sarah Goodell, MA

Reviewer

Sarah Goodell is a health policy consultant with over 25 years of experience. She is currently working as an independent consultant focusing on the Affordable Care Act, Medicare, health financing, and health delivery systems.

She previously served as director of the Synthesis Project, funded by the Robert Wood Johnson Foundation. At the Synthesis Project she managed projects on a variety of topics, including risk adjustment, Medicaid managed care, hospital consolidation, the primary care workforce, care management, and medical malpractice.

Prior to her work as a consultant, Ms. Goodell spent five years as a policy analyst in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services. Her work at ASPE focused on private insurance and patient protections, including external appeals processes and privacy.

sheryl-nance-nash-bio

Sheryl Nance-Nash

Author

Sheryl Nance-Nash is a freelance writer specializing in personal finance, business, health, travel, and lifestyle topics. Her work has appeared in Money magazine, Newsday, The New York Times, Newsweek.com, CNTraveler.com, The Daily Beast, Business Insider, BBC.com, and Health Central, among other outlets.

She enjoys writing about the intersection of travel, history, wellness, culture, and cuisine, and loves sharing strategies to help people grow their money and their businesses.