Over the years, people have seen the cost and procedure of visiting a doctor change, especially with the appearance of COVID-19. Costs can change depending on the reason for visits, the type of treatment needed, and the type of medical facility (i.e., a hospital, pharmacy, or a healthcare center).
Because of the complexity of the way medical bills are handled now, many factors go into how they are treated and paid for. No price is absolute when it comes to how much a doctor’s visit might be.
The factors that determine the price, like your insurance plan, the reason for visiting, and the place you visit, can show you what your cost may add up to be. Whether you are insured or not, the cost of visiting a doctor can also vary in expense.
Knowing the factors that determine a cost, how much a cost for a doctor visit would amount to, and what you can do to alleviate any costly medical bills can save you time and money, while ensuring you get the treatment you need.
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What factors go into determining the cost of a visit?
There may not be anyone cost to visiting a doctor, but there are factors to help you predict what it might be. Knowing these can help you have a sense of how expensive your visit will be.
The type of treatment needed
There are several treatments and medications prescribed to patients of all illnesses and injuries. So, depending on your case, the type of treatment or medications you receive can affect the total cost of your visit.
Obviously, more serious treatments may require higher costs, and the more medications, the higher the cost. If you were to need surgery, that would be more expensive than receiving antibiotics for the flu.
Reason for visiting
This goes along with the type of treatment that is needed. If your reason for visiting is of the emergency kind, then visiting the ER will contribute to a higher medical bill.
For simple reasons such as a sickness with minor symptoms, the cost will probably be much lower. More complex reasons, such as bone breaks and severe pain that may require advanced treatment can be a bit more costly.
Type of medical facility visited
Typically, visits to the emergency room are much more expensive than a visit to urgent care or a regular healthcare provider. The reason for this difference is due to the number of medical staff and equipment or services that are more available at ERs than at urgent care facilities.
ERs are also required to give medical care to any individual regardless of whether they are insured or not. When choosing whether to go to an ER or urgent care center, consider your condition, the time of day (as most urgent care centers close in the late evening), and your location.
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How much does it cost without insurance?
On average, a visit to an urgent care or healthcare facility (that isn’t an emergency room) can be from $100 to $650 and up. Most urgent care centers charge around $100 to $150 (or more) if you are uninsured.
Just because someone has insurance doesn’t mean their medical costs will be lower or none at all. Even with insurance, there can be costs (as described below).
Without insurance, medical costs can be pretty high. Depending on factors like the type of treatment needed, location, facility, and more, the costs can vary. Essentially, it will be higher than if you did have insurance with a price that can go into the hundreds.
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How much does it cost with insurance?
If you are insured, you will most likely only need to pay the co-pay for a visit, meaning your insurance will pay the majority and you will pay what’s left. That is only the case if the medical facility takes your insurance.
Typical co-pays can range from around $15 to $25 for any primary care physician and around a higher amount of $30 to $50 for specialist care. These co-pays also vary depending on the insurance provider.
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Helpful tips if you are uninsured and need healthcare services
Everyone should be able to receive the healthcare they need, regardless of if they’re insured. Use these helpful tips to lower any healthcare costs you might have.
Check for listed prices of services
Before January 1, 2021, healthcare providers and insurance companies did not display negotiated prices for services, contributing to the fact that patients didn’t usually know what their payout would be until the service was completed.
Due to the final rules set by the Department of Health and Human Services (HHS), health care insurers and group plans in both the individual and group markets to disclose any cost-sharing estimates available to their enrollees by January 1, 2023.
Similarly, another rule regarding hospitals requires them to publish and update a list of charges for the services and items that they provide. It is important to understand that when you visit a healthcare provider, you are allowed to know the cost of how much they charge for their services before you even visit them.
Negotiate with your healthcare provider and insurance carrier
Most costs for visiting a healthcare provider can be negotiated. It can be very helpful to check out any discounts that your healthcare provider might have or discuss with them about negotiating your costs.
You can even negotiate with collection agencies to possibly lower your medical debt. Explain your situation to them (or the doctor) and attempt to negotiate a more affordable payment.
Look at financial assistance options
There are many options that can help you either clear, lower, or eventually pay off any medical bills. For medical bills, there typically shouldn’t be any interest tacked on, so a good option to help you pay it back (without taking a huge chunk out of your wallet) is to establish a payment plan.
Some government programs (i.e., Medicaid) can help you cover the costs of your bills if you qualify. Many other government assistance programs are also available and can provide you with some benefits to help you get your costs paid off.
Some medical facilities may offer discounts to you if you tell them that you are uninsured. If you are eligible for a discount, use it!
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Let’s recap
Avoiding treatment and medical care may keep you from spending money, but it can cost you your health.
Some of the factors that play into determining medical costs are the reason for your visit, the type of medical facility you choose, and the type of treatment or medications used or prescribed. You will want to make the best decision for you depending on the reason for needing medical care.
While there are no exact costs to medical visits, the average cost points from $100 to $650 (and above) for urgent care treatment and as high as the thousands for emergency room treatment.
There are some things you can do to alleviate your medical bill stress including finding federal assistance programs, inquiring about any discounts offered at your facility of choice, checking for the listed prices of services, and negotiating your payments with your doctor or debt collector.