Calculating medical costs can help guide what plan to choose

  • Michelle Singletary / The Washington Post
  • Saturday, October 21, 2006 9:00pm
  • Business

As much as many consumers hate shopping for cars, that’s nothing compared with trying to price out a medical procedure or a routine visit to the doctor.

There’s really no reason you shouldn’t get the best deal on a car.

There are many resources available with the most up-to-date dollar figures on how much it cost to buy a certain model and anything in it. You can find the price of a high-tech navigational system you’re dying to have or an engine block heater, whatever that is, which by the way costs $42 (invoice) on a 2007 Buick LaCrosse.

But try finding out the cost for a knee repair or giving birth by a cesarean section. More people probably know the whereabouts of Osama bin Laden than the average cost of their health services.

In fact, one consumer health care survey found that the typical consumer could predict the price of a Honda Accord to within $1,000, but was off by about $12,000 in estimating the average cost of a four-day hospital stay. People guessed an average of $7,762 when the cost was $20,000.

When it came to the cost of a routine doctor’s office visit, respondents guessed an average of $95, according to a survey conducted by Harris Interactive for employee benefits provider Great-West Healthcare.

The actual average cost for a doctor’s visit? It was $200. For emergency room visits respondents estimated $680. The cost was actually lower, $400.

According to the survey, more than half of those who responded did not know the cost of treatment until it was received (68 percent), and 11 percent revealed they never found out the cost.

Many people fortunate enough to be covered by a employer health plan haven’t been paying attention to health costs because we counted on our health insurance carrier to negotiate the price. We pay our annual premiums and, if required, fork over our co-payments and let the insurers deal with the rest of the bill.

But increasingly, workers are being pushed into consumer-directed health plans that are supposed to encourage people to look for lower-cost medical services. These plans often come with high deductibles, meaning that more employees will have to pay larger amounts out of pocket before benefits kick in.

And this means more people will need to know what their medical services cost to determine if it’s worth switching to a consumer-driven plan.

But where do you get that information on medical costs? It’s not like there’s a handy dandy price guide sold in bookstores. To determine what you will pay, you’ll have to do some research, and perhaps pay for the pricing information.

So before you decide which health plan, try the following resources:

* Humana Inc., in partnership with advocacy group Consumer Action, has created a free Web site, www.familyhealthbudget.com, that includes a family health budget planner. The site was developed in response to a survey commissioned by Humana and conducted by Harris Interactive that found two out of three respondents said they needed help budgeting for health care.

On the site you will find a number of tools to help you choose the best health care plan and benefits. The planner takes you through a step-by-step questionnaire asking for information such as your current insurance status, how many times members of your family go to the doctor, how often prescription medicines are purchased and how often the family visits the dentist, eye doctor or other specialists.

Once you’ve inputted the information, you get a calculation of how much you need to set aside for health expenses for the year.

WageWorks Inc., www.wageworks.com, a provider of consumer-driven tax-advantaged spending accounts for health and dependent care, has a health care flexible spending account or FSA calculator. An FSA lets you set aside a certain amount of money before taxes to pay for qualified medical expenses. The calculator helps you figure out if this type of account is right for you.

* eHealthInsurance, www.ehealthinsurance.com, is a good source for people not covered by an employee health plan and who need to buy their own insurance. On this site you’ll find a large selection of health plans and the ability to compare costs.

* www.HealthDecisions.org, will give you information on 1,300 health plans and tens of thousands of agents and brokers nationwide.

* HealthGrades Inc., www.healthgrades.com, is a health care ratings company based in Golden, Colo., that sells reports on the cost of 55 medical procedures, based on regional averages of payments made by health plans. One report cost $7.95 but if you are facing a high deductible, it’s worth the price to get detailed price information. You can also get physician reports, which include the amount individual physicians are paid by Medicare for more than 100 types of procedures and visits.

HealthGrades also offers hospital ratings of 28 procedures and diagnoses at more than 5,000 non-federal hospitals free of charge. If you know you’ll need to be hospitalized, for $17.95 ($2.95 for subsequent reports) you can a more detailed hospital report that looks at the price of nearly 100 procedures.

Before you buy a report, check with your employer because HealthGrades works with 125 major corporations to provide them for free as a benefit, according to Scott Shapiro, HealthGrades vice president for corporate communications.

There’s no question figuring out your annual medical costs and what health plan is best won’t be easy. It’s definitely not as easy as pricing out a Honda Accord, fully loaded. But when it comes to your health care, spend at least the same amount of time calculating the costs as you do pricing out your new ride.

Washington Post Writers Group

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Business

FILE — Jet fuselages at Boeing’s fabrication site in Everett, Wash., Sept. 28, 2022. Some recently manufactured Boeing and Airbus jets have components made from titanium that was sold using fake documentation verifying the material’s authenticity, according to a supplier for the plane makers. (Jovelle Tamayo/The New York Times)
Boeing adding new space in Everett despite worker reduction

Boeing is expanding the amount of space it occupies in… Continue reading

Paul Roberts makes a speech after winning the Chair’s Legacy Award on Tuesday, April 22, 2025 in Tulalip, Washington. (Olivia Vanni / The Herald)
Paul Roberts: An advocate for environmental causes

Roberts is the winner of the newly established Chair’s Legacy Award from Economic Alliance Snohomish County.

Laaysa Chintamani speaks after winning on Tuesday, April 22, 2025 in Tulalip, Washington. (Olivia Vanni / The Herald)
Laasya Chintamani: ‘I always loved science and wanted to help people’

Chintamani is the recipient of the Washington STEM Rising Star Award.

Dave Somers makes a speech after winning the Henry M. Jackson Award on Tuesday, April 22, 2025 in Tulalip, Washington. (Olivia Vanni / The Herald)
County Executive Dave Somers: ‘It’s working together’

Somers is the recipient of the Henry M. Jackson Award from Economic Alliance Snohomish County.

Mel Sheldon makes a speech after winning the Elson S. Floyd Award on Tuesday, April 22, 2025 in Tulalip, Washington. (Olivia Vanni / The Herald)
Mel Sheldon: Coming up big for the Tulalip Tribes

Mel Sheldon is the winner of the Elson S. Floyd Award from Economic Alliance Snohomish County

Craig Skotdal makes a speech after winning on Tuesday, April 22, 2025 in Tulalip, Washington. (Olivia Vanni / The Herald)
Craig Skotdal: Helping to breathe life into downtown Everett

Skotdal is the recipient of the John M. Fluke Sr. award from Economic Alliance Snohomish County

Helion's 6th fusion prototype, Trenta, on display on Tuesday, July 9, 2024 in Everett, Washington. (Olivia Vanni / The Herald)
Helion celebrates smoother path to fusion energy site approval

Helion CEO applauds legislation signed by Gov. Bob Ferguson expected to streamline site selection process.

The Coastal Community Bank branch in Woodinville. (Contributed photo)
Top banks serving Snohomish County with excellence

A closer look at three financial institutions known for trust, service, and stability.

Image from Erickson Furniture website
From couch to coffee table — Local favorites await

Style your space with the county’s top picks for furniture and flair.

2025 Emerging Leader winner Samantha Love becomes emotional after receiving her award on Tuesday, April 8, 2025 in Everett, Washington. (Olivia Vanni / The Herald)
Samantha Love named 2025 Emerging Leader for Snohomish County

It was the 10th year that The Herald Business Journal highlights the best and brightest of Snohomish County.

2025 Emerging Leader Tracy Nguyen (Olivia Vanni / The Herald)
Tracy Nguyen: Giving back in her professional and personal life

The marketing director for Mountain Pacific Bank is the chair for “Girls on the Run.”

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.