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How to pay for out-of-pocket surgery costs

Learn how you can pay for out-of-pocket surgery costs and stay prepared for the future.

Getting surgery is hardly the most exciting task on anyone’s to-do list. But many people will need to pay a visit to the hospital at some point in their life for surgery, and it’s not cheap. 

Some of the most common surgeries in America like joint replacements, broken bone repairs, and hysterectomies can cost anywhere from $8,000-$33,000.

If you’re insured, your health plan can help cover the cost of surgery and other treatments. But depending on your plan’s coverage and on the type of surgery you’re having, you might still get stuck with hefty out-of-pocket costs that aren’t covered by your plan. And if you’re uninsured, you’ve got to find a way to take care of the entire bill on your own.

You want to make sure you or your loved one get the treatment you need, regardless of cost. Read on to find out how you can pay for out-of-pocket surgery costs and stay prepared for the future.

Paying for emergency surgery

In an ideal world, you’ll always know exactly what type of treatment you’ll need, with plenty of time to plan for the bill ahead.

But in reality, the most expensive treatments are usually those that come along with unexpected emergencies or unplanned accidents.

If you’re dealing with a large medical bill from an emergency surgery, here are a few ways to cover the unexpected costs:

Payment plans

Depending on the type of surgery, the hospital or emergency clinic may offer a monthly payment plan that breaks up the total bill into hopefully manageable chunks. There are even some no-interest plans out there, though options will vary, so check with your provider.

For the provider, even monthly payment plans are better than nothing, and your effort to pay something on the debt may protect against it negatively impacting your credit report.

Negotiate your interest rate

If you don’t have an insurance plan to help cover your surgery, you’re likely going to be given a higher interest rate on your medical bill than what insurers get (insurers typically negotiate a low-interest rate with health providers). 

However, you can call your care provider directly and try to negotiate a lower interest rate on your bill.

Ask everyone you speak to along the way about ways to reduce costs. People working in the billing department should know of ways to decrease your fees or of aid programs to help you pay for your bill.

Use existing assets 

You can use your existing assets to help cover the costs of your surgery:

  • Retirement savings: If you’ve got a retirement savings plan, you may be able to take out a loan against the money you’ve set aside. You may also be able to access your retirement money directly without paying taxes or a penalty on it, particularly if you have a Roth IRA. 
  • Home equity: If you’re a homeowner, you may be able to secure a loan against the difference between the value of your home, and how much money remains on the mortgage. If you’ve paid off half of your mortgage, and your home has maintained its value (or ideally increased in value), this loan can be used to pay off your medical debt.
  • Life savings: Although it’s not ideal to dip into your life savings for an unexpected medical bill, it’s better to pay off your bill before it is turned over to collections and hurts your credit.

Get an unsecured loan

You can take out an unsecured loan from a bank to pay off your medical bill. These loans are granted based on your income and credit score. A credit card is also a form of unsecured loan.

Credit card interest rates can be high, so if you use a credit card to pay off your medical bills, use the lowest rate card you can and switch your debt balances to new cards from companies that may offer zero-to-low interest plans for one to two years.

Paying for planned surgery 

If you know you’ll need an expensive surgery, test, or other treatment in the future, there are plenty of strategies you can use to cover the costs of the bill.

Decide where to get treatment

Before you schedule your treatment, research local care centers and hospitals to choose the least expensive location.

If you’ve got health insurance, make sure every entity providing care (like the surgeon, hospital and pharmacy) are all in-network. If don’t have insurance, you can still shop for the most affordable hospitals, providers and pharmacies for your treatment.

It may even be worth it to travel to a different part of the country for the best price for your specific treatment. For example, the average price of a knee replacement surgery is $38,000 less in Tucson, Arizona than in Sacramento, California.

Get better coverage

Contact your insurance provider to find out every expense that’s going to be covered, and what out-of-pocket costs you’ll be responsible for.

You may be able to change to a different insurance plan with better coverage prior to your surgery.

Some options when searching for better insurance plans include:

  • Switch to spouse’s insurance: If your spouse has insurance through their employer, find out if their insurance plan provides better coverage for your surgery, and if it would be worth it to switch to their insurance plan.
  • Inquire about changes to your employer-provided insurance: Your employer may update their insurance policy during the year. Before scheduling your surgery, ask your employer about any planned changes to your policy or coverage. It may be worth waiting (if you can) to schedule treatment until the new policy kicks in if the coverage will be better.
  • Check government assistance eligibility: You may be eligible for Medicaid or another government-assisted healthcare program. Visit healthcare.gov or call your state’s Medicaid office.
  • Shop for a better private plan: If you have a private plan that you purchased yourself, you should shop around and see if there’s a plan that’ll provide better coverage for the treatment you need. You can use the plan finder on healthcare.gov.

Consider medical tourism

Traveling abroad for surgery is becoming a popular choice for Americans, as medical costs can be as much as 75% less in other countries outside of the USA. Some of the best countries for medical tourism are Mexico, Costa Rica, Malaysia, Thailand, and Colombia.

While the savings can be tempting, your first priority should be ensuring you’ll receive the quality of care you need. Check the World Health Organization’s rating of the healthcare system of the country in question, then contact hospitals or clinics to find out how much your treatment would cost. 

Check and verify the credentials of the international provider you’re interested in, as well as the facility. Many surgeons working overseas have been trained in high-quality American schools or facilities.

If you find an international provider that can save you a lot of money, the final step is to verify that the clinic/hospital is accredited. There are a number of organizations that provide independent, reliable accreditation for hospitals abroad.

Your insurance provider may provide coverage for medical tourism, as the costs are much less for them, too.

Plan for the unexpected with accident insurance

In an ideal world, you’ll never have to worry about affording the medical treatment you need. But no matter how healthy and careful you are, accidents happen, and with them come unexpected out-of-pocket medical expenses.

Your regular health plan may not cover all the costs associated with an accident. That’s where accident insurance comes in.

If you or a family member has an accident, you can give yourself protection from unexpected out-of-pocket costs with an accident insurance plan. Your benefit is paid directly to you in lump-sum cash, which you can use to cover both medical and non-medical expenses that come with an accident. 
 

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Brought to you by The Guardian Life Insurance Company of America (Guardian), New York, NY. Material discussed is meant for general illustration and/or informational purposes only and it is not to be construed as tax, legal, investment or medical advice.
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