Success Stories: Here’s How Not To Stress About The Hospital Bill

If you have a planned hospital need, you aren’t at the mercy of the billing department: if it makes sense for you, you can pay cash and save—sometimes up to 75 percent! In this article, we’ll look at how.

Here at Uncovered, we get it. All those tests, procedures, and surgeries are stressful enough in premise alone. Then, you factor in the cost, the fear of medical debt (and the fact that it can feel impossible to know how much you’ll owe ahead of time), and your stress level goes through the roof, right?

It doesn’t have to be like that. With a few calls and by asking the right questions, you can learn your all-in price and determine if it’s smarter (and cheaper) to pay in cash.

When it doesn’t make sense to pay in cash

Look at what kind of plan you have. If you have a full plan that covers preventative care, you’re safe. Or, if it’s early in the year and you have a low deductible that you know you will hit—and need to hit to account for more upcoming expenses during that calendar year—you’re also safe. Nothing to do. (Just make sure you stay in network!)

When it does make sense to pay in cash

If you have short-term insurance, it almost never covers preventative care, so it makes sense to find out the cash price. If you have a deductible you know you will not meet during the calendar year and are having a non-preventative procedure, it also makes sense to find out the cash price. You’ll be paying it in cash anyway, so why not pay less?

Here’s how to find out the cash price:

Step One: Call the surgery center or physician and say you’d like to negotiate.

Step Two: Ask who is involved in the procedure, what services you will receive, and get a breakdown of those costs. For example, for Eric’s colonoscopy, they broke it down for him all the way to the cost per polyp removal.

Step Three: Tell them you’d like to negotiate an all-in price to pay on the day of service.

Step Four: Save big money!

These Tips in Action

Eric Neuville is the perfect example of what to do when it comes to negotiating hospital bills. When his doctor referred him for a colonoscopy, he knew it wouldn’t be covered under his short-term medical insurance because his plan didn’t pay for preventative care at all. He also knew his deductible was high–$8,000—and that he wasn’t going to meet it.

Eric’s doctor told him he wasn’t sure how much the colonoscopy would cost. What he refers to as his “sort-of” insurance carrier also told him they didn’t know (and wouldn’t until the surgery center billed them). The common refrain was that the procedure had to be done for them to know—which, according to Eric, was ridiculous. And he would know, as a twenty-five year veteran of the insurance industry who ran product development for Anthem Blue Cross and Blue Shield.

Eric’s wife called the surgery center and asked for the all-in cash price on a colonoscopy. They broke it down for her: if they paid in full on the day of service, it would be $1000 cash, a savings of almost 70 percent.

The day of the surgery, Eric walked in and told the receptionist he was quoted a cash price of $1,000. He gave them two cards: his insurance card and his payment.

When the couple later got a bill with a “discounted” price of over $3,000 for the surgery, Eric had to remind them that he’d already paid—and that he hasn’t paid nearly that much.

It wasn’t the couple’s first time using the cash method to save. When Eric’s wife had a hip and knee replacement due to arthritis, they got another 75 percent discount by paying a quoted all-in price up front.

What Eric Has To Say About Negotiating

Eric is an advocate for healthcare consumerism not just when it involves his bank account.

“We need to be as active in our healthcare choices as we are when we make a choice about what television to buy next,” he says. “We have to challenge ourselves. I have zero patience for the ‘I have insurance, so I don’t have to worry about it’ mindset. That drives up costs for us all.”

Proven Health Insurance Advice For Open Enrollment

I spoke with M.C. Laubscher on his podcast, Cash Flow Ninja, recently about the things everyone should be thinking about when they’re making decisions about their healthcare. His listeners come to him all the time with questions about healthcare…”What should I do? How much should I be paying? How do I find better information to make smarter decisions?”

M.C.’s audience is filled with entrepreneurs and investors and the advice I have for them is perfect for anyone who is looking for individual insurance during open enrollment this fall. We talk through:

  • The difference between healthcare and insurance
  • What everyone should be doing during open enrollment to find the best insurance plan
  • How to manage healthcare costs

Listen to the full episode below

How To Choose The Best Health Insurance For 2020

Picking your health insurance plan for 2020 is an important decision you’ll be stuck with for the entire year. Which means it’s worth taking the time to do a little homework and make the pick that’s right for you.

Follow these seven steps to make sure your insurance plan fits your health needs and your budget.

1. Start With Your Health History

Make a list of how much you used your health insurance last year. The list needs to include physician office visits, prescriptions, diagnostic and lab work, and medical procedures.

2. Find Out What Plans Are Available To You

Identify the plans available to you, the amount of cov- erage they offer, and the amount of upfront dollars you will need to pay.

Use a chart like this to help you organize:

Plan 1Plan 2Plan 3
Premium (cost per month)

Deductible (amount you pay before
insurance kicks in)


Out of pocket charges

3. See How Each Plan Stacks Up Compared To Your Expected Medical Costs

Compare the costs of every health plan available to you. Don’t automatically exclude any, even those with a high deductible. Which plan costs you the least in total?

4. Find Out What Can You Afford Monthly

Can you handle your healthcare costs in one payment or, if not, how much you can afford monthly. For example, can your pocketbook sustain $694 in monthly costs, or $8,365 annually? Be realistic.

Tip: check out the Kaiser Foundation’s calculator for help with this.

5. See If Your Current Doctors And Hospitals Are In Network

If you go to an out-of-network provider, your copay, deductible, coinsurance, and out-of-pocket maximums will generally double. You’ll have to decide if that doctor/provider is worth it or be forced to find another doctor. 

6. See What’s Covered

  • Pregnancy
  • Hospitalization
  • Emergency services
  • Outpatient care
  • Mental health
  • Prescription drugs
  • Rehabilitation services
  • Lab services
  • Pediatric services
  • Preventative services

7. List the tax deferred mechanisms of each plan

Ask for and study all tax deferring or saving mechanisms available like premium-only plans, flexible spending accounts, health reimbursement accounts, and health savings accounts. These plans all allow you to save and use your dollars before income tax is applied, kind of like a 401K. These options are no brainers when they’re available to you since they increase the amount of money you have to pay for your health expenses.

 Remember, don’t overinsure by selecting the plan with the lowest out-of-pocket fea- tures, because it will have the highest premiums, which are non refundable. This checklist will give you a clear idea of the most cost-effective plan that meets your specific needs. 

You only have one chance a year to make the best choice, so do your homework!

Check out Health Sherpa to find and compare the best insurance plans for you.

Uncovered’s Top Healthcare Transparency Services | 2019

Healthcare transparency sites give you access to information that could help you make smarter decisions and save you thousands of dollars. But not all healthcare transparency sites are created equal. Below is our list of the top healthcare transparency websites for 2019.

Be Careful Who You Trust

Healthcare transparency sites are usually built on access to real, anonymized healthcare records that allow them to analyze cost, effectiveness and provide reviews. The only problem is, sometimes this data isn’t accurate, or the site just isn’t pulling from a large enough population to provide accurate information.

The Sites That Made Our List

We’ve reviewed each an every one of these sites to make sure they’re helpful and user friendly—but most importantly, that you can trust them. They’ve earned our stamp of approval as insiders and we think you should use them.

Reviews, Affiliation & Scheduling | Qualitative Sites

Reviews & Comparison

Reviews & Scheduling

Procedure Cost Predictors | Quantitative Sites

Cost estimator tools

Carrier cost estimator tools

Coupons And Saving Sites

Patient assistance programs

Rx Coupon Codes

EHR vendors

Even More Sites Are Coming

Healthcare price transparency is a growing trend—more and more people want to know what they’re going to pay when they visit the doctor or hospital. Everyday new sites are started to help people better understand the cost of healthcare. 

Bookmark this page. We’ll continue to update this guide as new sites become available. But most importantly, use these sites! The information they give you could save you hundreds or thousands of dollars.

From No Coverage to Affordable Coverage, with HealthShare

“It’s not technically insurance—even though it is. And I can’t speak for everyone, but from my experience, there are no downsides.”

That is the way Nat Comisar describes the HealthShare program he and his wife switched to after finding the traditional route—searching on the Healthcare Marketplace (Obamacare)—to be far too pricey.

Nat was no stranger to the world of insurance, either. In the past, he was the employer who provided healthcare to his employees. When he became self-employed, he figured he’d have no problem securing insurance. After all, he was a healthy 55-year old man with no preexisting conditions and on no medications.

Easy, right? 


To the best of his memory, the best deal he could find was going to cost him $680 a month with a $7200 deductible. Because he rarely had any reason to go to the doctor in the first place, that could have amounted to almost $16,000 annually for something he didn’t even use.

So, what was next for Nat? He made the same decision a lot of people in that situation do: he went without insurance for five years, finding it far cheaper to simply pay the fine when tax time came around.

When Nat’s wife went to search in the Healthcare Marketplace, her premium was more reasonable—at first. It started at around $270 per month. Then, it started steadily increasing, all for the exact same coverage. When it approached $500 per month, Nat’s wife made the same decision as her husband: she went without insurance for about a 18 months.

Discovering HealthShare

While out to lunch with a friend—a friend who had just happened to be writing a book at the time about how to take control of your healthcare and save money along the way—Nat learned of an option he had no idea was out there: HealthShare.

“The way I understand it, the HealthShare Market is the way insurance is supposed to be,” Nat says. “It’s a pool of individuals who are funding a contingency for one another for health concerns.”

HealthShare programs are religion-based. Many don’t require you to be a member of that particular religion, just that you are a person of faith. Remember—each program is different, so do your research wisely.

Nat did just that, focusing on three major HealthShare companies. He ultimately chose the one that seemed easiest to join and most organized—Solidarity HealthShare, a Catholic Organization.

Practically, Nat now pays $300 a month to cover both him and his wife. Collectively, they have a $1000 deductible. 

“We still don’t use any of our insurance dollars,” Nat says. “In this last year that we’ve been a part of this, I bet we’ve only spent about $400 towards our deductible. Still, it’s so worth it. A plus is that with this company, if I do get to a place where I need assistance, I can see who it comes from. I can also see where my contribution is being sent and send a message to them, if I want.”

To be eligible for this program, Nat had to pledge a few things: that he was a nonsmoker, did not use illicit drugs, and was a moderate drinker, if he drank at all. If he had any preexisting conditions (he didn’t), he’d have to declare them up front—but that would not make him ineligible for coverage. Instead, it would mean he could not be reimbursed in the first year of being in the pool, and only up to $25,000 annually the second and third years. For everyone—preexisting condition or not—there is a $1 million lifetime cap.* 

Nat’s plan sends him and his wife to annual checkups, both of which are covered. There is no pharmaceutical component to his plan, but that’s okay—there are discount cards to help with that.

Sometimes, when Nat does need to use his HealthShare—which, by the way, satisfies the legal requirement for having health coverage, saving him that annual tax penalty—receptionists give him a funny look. He says he’s used to explaining from there.

“I tell them, ‘It’s HealthShare, not insurance. You should be able to file it. If you can’t, just consider us a self-pay, and we’ll file it.’”

The Bigger Picture

Nat says in the beginning, he was curious about the extent of the religious component. 

“In the end, I’ve found it to be a Christian organization that is a big group of people supporting one another,” he says. “There’s not a profit motive.” 

In retrospect, Nat says he wishes he would have known about HealthShare sooner.

“Before, I had 350 employees in the restaurant business. Had something like this existed—or had I known it existed—I could’ve covered everyone at 100 percent, purchased supplemental insurance, and still not have to ask for their financial participation.” 

If someone who was in the business of providing health insurance didn’t know about this option, odds are that this is your first time learning about HealthShare, too. We want to be clear: this option is not for everyone, but if it turns out to be for you, you could be on the receiving end of some big savings.

*Remember that not all HealthShare programs are the same. For more information the company Nat and his wife decided to use, visit Solidaryhealthshare.org. To find the right option for you, visit HealthSharingPlans.com.

Overpaying for Your Prescriptions? Here’s Proof You Don’t Have To

Prescriptions are expensive, but you have more resources available to help you cut those costs down than you think. Here, we’ll look at how one man saved $422 a month on his medication by leveraging a Patient Assistance Program (PAP)–and how you can get similar results.

(Yes, you did read that correctly: $422 a month!)

No one is immune to the high prices and feeling of bureaucracy that can sometimes shroud the world of healthcare and big pharma—not even Scott Heiser, who literally wrote the book on the subject.

The difference is that Scott knew what to do—and, by being here, that means you can, too.

In the past, Scott was hospitalized with deep vein thrombosis (DVT) and subsequent pulmonary embolism—i.e., a blood clot in the lungs. Scott recalls that the whole thing was a shock, kind of a “freak incident.” He talked with the physicians, who said he needed to be on a blood thinner for a year. 

Together, they discussed options: there was Warfarin, an older and relatively inexpensive prescription, or Eliquis, a newer-generation drug that was more costly. Each drug—as is true for them all*—had pros and cons: Scott learned it was easier to control bleeding and coagulate more quickly with Warfarin, but he’d also to test his blood often. With Eliquis, he wouldn’t have to test his blood, and he’d have the convenience of only taking one pill a day. Although an uncontrolled bleed was not likely in his case, if he faced one, it would take him longer to coagulate.

Because Scott’s risk factors were low for needing quick coagulation—and taking into account he only needed to be on the precautionary medication for a year—he and his doctor decided Eliquis was the best choice.

The problem? It was $432 a month. Because Scott knew about PAPs to reduce consumer costs, though, he was able to get that cost down to $10 a month.

That’s that mega monthly savings we’re talking about! Hardly chump-change. 

Let’s take a closer look at PAPs. 

PAPs: What You Need to Know

PAPs are offered by pharmacy manufacturers to provide financial assistance to those taking a particular drug and who meet certain requirements. While each PAP is different, they generally provide assistance to those who meet one or a combination of the following criteria:

  • Have a high deductible health plan
  • Have an income of at or below a certain point
  • Do not have health coverage

Just as qualifications for each PAP are different, so are their means of providing assistance and reducing consumer costs. Some will cover your copay. When this happens, the pharmaceutical company still bills your employer (if they provide your insurance) the full amount—that’s just business.

“Our whole philosophy is that you, as a consumer, should understand the cost being borne by the system and be aware so you can try to minimize that cost. Why? Easy: it will pay dividends to you in the long run by keeping your premiums low,” Scott says. “If your employer’s premiums don’t go up, they don’t raise them for you, either.”

How Scott Saved Over $5,000 

In the short game, though, Scott knows that money talks. And $10 is a whole lot more digestible than the alternative—which is an example of what makes PAPs so attractive.

Here’s how Scott secured the reduced rate:

  • He searched for the phone number of the manufacturer and called to ask if they offered any type of assistance program. (Spoiler alert: they did.)
  • He talked with the representative to see if he met the program requirements due to his high-deductible health plan. (Spoiler again: he did.)
  • The representative said he’d notify Scott’s pharmacy of his discount, which was good for 24-months. (That’s all, folks. Discount received.)

It took all of twenty minutes—for the online search and the phone call combined—for Scott to save more than $5,000 for the year he was on the drug (that, due to the timing of his hospitalization, he would’ve paid 100 percent out-of-pocket). 

Today, it’s not even necessary to do your own online investigation. Instead, you can simply visit RXHope.com. This free, reference-based website lists over 330 drugs for which PAPs are available; it’s all right there for you.

Note that your drug may or may not be on the list—and if it is, you may or may not qualify for the PAP—but isn’t taking a few minutes to check worth the effort? 

Discount Cards: Save $5, $50, or More!

Sometimes, a PAP may not be available for a drug you’ve been prescribed. In that case—and, really, in any case—Scott says he recommends utilizing a prescription drug coupon card. 

He recalls having a prescription for Fluorouracil, a mild chemotherapy topical. He brought his coupon card (SingleCare, in this case) to the pharmacy, knowing what discount he was eligible for. The pharmacist (from a big chain store) said the cream would be $200, but—good news!—the store offered a $50 coupon. 

Scott knew that with his coupon—one the pharmacist said he may not be able to accept because he couldn’t file it electronically through the store’s system—could save him $100. Ultimately, Scott requested the paperwork to file on his own, saving himself the extra $50.

The pharmacist wasn’t trying to pull a fast one; he was simply dispensing drugs and offering discounts in the manner in which he was trained. In fact, Scott even had a brief chat with him—to the benefit of others within earshot who were obviously listening—about the way the card worked as well as other ways to save on prescriptions (like visiting RXHope).

Had Scott not had the discount card and the pharmacy not offered its coupon, he would have had to pay the full $200 for the cream—in essence, meaning there was $100 that nobody would have known about that the insurance company was keeping. This shows that insurance companies aren’t passing down all the rebates to pharmacists—all the more reason to be an engaged consumer of healthcare.

Scott had a similar situation in which his wife went in to pick up a prescription for Estradiol, a hormone replacement patch. The brand name was $140, and the generic was $80. With the drug discount card, they were able to drop that price to $45—a substantial savings on any long-term medication.

What’s Next?

At the end of the day, you want to save money on prescriptions, right? Rebates go on in the pharma world to employers and insurance carriers all the time. How do you get your own rebate? The true examples above are here to show you that it is possible to get in on that game.

As we’ve illustrated, with certain specialty or single-sourced drugs, manufactures will deal directly with you in the form of PAPs (if you meet their requirements). With other, more generic drugs, a discount card might be the way to go. 

The bottom line? There is no downside to looking at your savings options—a little time could go a long way to the bank.  

How much could you be saving? Once you get your prescription costs down, tell a friend. Help them. The more we speak up as consumers of healthcare, the more premiums will come down, and the more we can be a part of changing this industry.

How To Save $10,000+ On Your Healthcare Bills

The following is an excerpt from a conversation I had with Kirk Chisholm on The Money Tree Podcast

Are you happy paying thousands of dollars in healthcare costs you don’t use? Are you angry at the medical bills you incur for services that should cost a fraction of that amount? Are you looking for answers?

This week we interview a healthcare industry insider, Scott Heiser. He spills the secrets on what is actually causing the problems in our system. He also gives us some simple tips and tricks to save yourself thousands of dollars with only a few minutes of your time...

Listen to the entire episode to learn insider negotiation techniques on The Money Tree Podcast!

7 Insider Tricks To Save Big On Prescription Drugs

Now, more than ever, prescription drug prices are expensive—especially if you have high out of pocket costs.

Specialty drugs, single source branded drugs, and repack- aged generic drugs are all escalating in cost (7 percent per year, two times the Consumer Price Index). Remember the EpiPen story? A low-cost generic solution was repurchased and repackaged by Mylan. Then, the drug manufacturer increased it from $70 to $600 without offering any product enhancements—just price increases! 

If you aren’t aware of how to mitigate those costs, you might be needlessly throwing away thousands of dollars a year. Even if your insurance plan offers drug coverage, you can still use these tips to save even more money. The first step is to understand how drug manufacturers price their drugs and why they’re being prescribed.

The Questions To Ask Your Doctor To Save Money

If you’ve been to the doctor recently, you know that most visits end with you getting a prescription. 

Why is that? 

If you stop and think about it for a second, it makes sense. You go into the doctor expecting to be cured, and you want to walk away with something tangible that tells you you’ll get better. There are other things you could be doing to feel better, but that’s a topic for another post.

So when it comes to prescriptions, what can you do to save money?

Where To Start: Ask Your Doctor These Questions

  • How much does it cost?
  • Can the pharmacist substitute a cheaper, generic form of the medicine?
  • Are there cost-effective alternatives to this medication?
  • Does the drug company offer any discount or rebate programs?
  • Does the drug company provide a prescription drug assistance program?
  • Can you prescribe a half-year or year supply so I can buy in bulk?

Insider Tricks To Save Money On Prescriptions

So, how can you get the best price on your prescriptions? Think about it like anything else you would buy and SHOP! Here are some insider tips and tricks to save money:

Turn to big box stores.

Wal-Mart,Kroger,Costco,and even Amazon are getting into the drug business. Their goal is to get you in the door (or on the website) by any means necessary. For example, about a decade ago, Wal-Mart accomplished this by selling generic amoxicillin for just $4. Consumers came for the dirt-cheap drugs and, while they were there, bought orange juice, milk, and chicken noodle soup. It’s a straightforward model, and it still works today; you can find good deals on basic drugs at big box stores.

Use Price comparison tools

Check with your insurance plan for comparison tools. If you don’t have one with your plan or are uninsured, check with the following: GoodRx, One RX, or use our partner SingleCare’s tool on our How to Save page. They all will provide pricing for prescriptions at their negotiated prices. Compare them all. You’ll be surprised to find they are different. Also, compare one pharmacy location with one in another area of town. Sometimes there is different pricing, so it pays to look.

Note: When using one of the discount cards with your health plan, make sure the drug is on your formulary (approved drug list). Research the discount programs for the exact drug. Ask you pharmacist what the cost of the drug is through your health plan. If the discount card is lower, use it instead of your health plan. Then file that drug as a claim. You can access claims through your health insurance carriers’ web portal. It’s worth the extra effort. Check it out.

Use Over-the-Counter (OTC) First, Then Generic, Then Compare Brand vs. Brand 

Generics are generally cheaper than brands. Unfortunately, you need to be aware of the industry’s trend to “patent stack” generics, significantly increasing their price (EpiPen). Therefore, check the over-the-counter alternative. Many times, the prescription for a generic scripted drug is about convenience (for instance, take one pill a day instead of two or four). Remember, you pay for that! 

Also, check multi-source brand drugs (where there are multiple branded drugs, no generics, treat- ing the same symptom) and determine which has the highest efficacy: best price, similar medical outcome.

Get Your Prescriptions Through Mail Order

If you’re on a maintenance drug and your plan offers a mail order program, you may be able to save some money. If your plan has copays for a thirty- day supply, check what the copay is for the mail order at ninety days. It could be less, so it’s worth trying.

Also, the mail-order pricing may be more attractive than the retail.

Buy In Bulk. Get Your Doctor To Prescribe For Longer Periods

Did you know your doctor can prescribe a years’ worth of maintenance medication versus a thirty- or ninety-day supply? They can, and it can save you a lot. Use the highlighted shopping tools for a twelve-month supply. Currently, you can buy a year’s supply of atorvastatin, a generic statin heart medicine, for 20 percent less than buying a thirty-day supply each month for a year.

Buy In Higher Dosage And Split The Pills

Getting a higher dosage and splitting the pill may be less expensive. Ask your doctor, pharmacist, or insurance company if higher dosage and pill splitting would work in your situation.

Use Patient Assistance Programs (PAP)

RX HOPE is a website that lists over two hundred single source drugs that offer patient assistance programs based on income or for those participating in a high-deductible plan—i.e., 50 percent of the country in 2017. 

These plans will offer coupons with sometimes dramatic price reductions for a set period of time. I previously highlighted the Eliquis savings, which was through a PAP ($4,440 savings/year). You can also contact the manufacturer of the drug directly and ask for avail- able coupon plans. 

These are real techniques that can save you hundreds, even thousands of dollars on your prescription drugs. If you’re worried about talking about costs with your doctor—don’t be. It’s a conversation that is non threatening to them, it’s not like you’re challenging their diagnosis or treatment. Plus, they want to provide you with the best service possible, and if that means facilitating you saving on prescriptions they absolutely want to do it!

Navigating the health care system isn’t always easy, but this checklist gives you the tools you need to start saving.

Authority Magazine Feature: The Future of Healthcare

The following is an excerpt from a Q&A session I had with Authority Magazine’s Christina D. Warner

As a part of my interview series with leaders in healthcare, I had the pleasure to interview Scott Heiser. Scott has more than twenty years’ experience as a consultant for clients in the insurance and healthcare system. Scott was a partner and owner of a commercial insurance brokerage, in which he led and developed an employee benefit practice that managed more than half a billion dollars in health benefits. Scott is a strategic innovator who knows the ins and outs of what can feel like the overwhelming world of healthcare and insurance. Today, he is dedicated to sharing his knowledge to help educate and empower his readers. His goal is to improve your health outcomes while lowering your costs.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Afew years ago, I was meeting with a large multi-state client representing 16,000 employees. We were discussing ways to reduce costs for their prescription benefit program…

Check out Authority Magazine’s Medium Page to read the full article!