Talking About the Cost of Care
With Your Doctor
You can lower your out-of-pocket costs
without sacrificing good care
Talking to your doctor about the cost of your care may feel
strange to you. You may believe that your doctor should not
be thinking about money when helping you decide the best
test or treatment. But many patients and families are now
paying more of the cost for their care in deductibles, co-pays,
and bills not covered by their insurance. And sometimes, they
are paying for services they did not need or at a price that is
higher than they could have paid somewhere else.
Your doctor wants the very best for you—including being sure
that you can afford all the care that you need. Asking
questions about cost-saving options is an important part of
making good health care decisions.
Did you know?
The same test or treatment may have a
different price somewhere else.

How Health Costs Work
Doctors and other health care professionals usually charge a
fee for every health care service they provide, even if you only
pay a single co-pay for a visit. Blood tests, x-rays, and other
tests and procedures that help decide what additional care
you will need are also services that have fees—both for giving
the test and another for reading the results. Every service has
its own price, and even something that seems simple can
include a host of expensive charges.
A higher cost may NOT mean better health
care.

Starting the Conversation with Your Doctor
The conversation about costs with your doctor may start by
letting your doctor know that cost and quality are BOTH
important to you. You may say something like:
“My first concern is that I get the most effective treatment
that fits my health needs and my priorities. But I am also
concerned about my costs. Are there ways we can approach
this that will lower my costs, but still give me the best care
available for my condition?”
There is no standard price for most health
care services. The same lab test, office
visit, medical device, operation, or medicine
can cost you a different amount, even in
the same city or in the same hospital
system, so call different providers to
compare prices.
Health care is different from the other
things we buy. With health care, a higher
price may not mean that the care you are
receiving is any safer or better, and often
more expensive care can be care you do
not need. Please beware: Cost is not an
indicator of quality.
You may have more options than you think.

In many cases, the same quality test,
treatment, or service is available to you at a
lower cost, which can reduce your co-pay or
the amount you may owe after insurance.
Three Important Questions to Ask Every Time You Get Care
Is this test or treatment something I really need? Sometimes patients get tests or even treatments they may not need.
Health care services may be ordered out of habit rather than necessity. Ask your care provider to identify each service
and explain its importance to your overall care and its potential impact on future tests and treatments. You may find
some treatments and tests that are costing you money, including care the medical community used to believe were
essential, can be eliminated without any impact on your overall health.
Will talking about cost
offend my doctor?
Although doctors have not
traditionally had conversations
about costs with patients,
these conversations are
perfectly appropriate and
becoming more common. Most
doctors are willing to discuss
costs and can help you think
through cost as another factor
when deciding the best test or
treatment for your health.
What’s the cost to me for that service? The cost of a given service to you
depends on a variety of factors, including whether or not you have insurance,
your insurer, your specific plan, and whether or not you have met your
deductible. Physicians often do not know what the out-of-pocket cost to you
is, but staff in the office’s billing department can usually help you find the
specific costs to you. Additionally, many insurance companies, including
[links to large insurers in area/employers’ insurance options] offer tools to
help you identify what you will be required to pay out of pocket. Additionally,
there are local and national resources included below that can help you
identify which providers typically have lower costs.
Is the same service available at a lower price? Prices for tests and
treatments can vary even within a single city. For example, the very same
MRI can cost $1,200 in one facility and $2,400 in a different facility. Yet,
typically MRIs are of equally good quality. It is perfectly appropriate to ask
about the cost of a treatment or test before receiving it and to see if the
same quality service is available at a lower cost. Prescription medications
are another opportunity for inquiring about prices and alternative options
that can provide you with huge cost savings.
Get Informed
You can find information on the average cost of health
care services from national resources, such as the
Healthcare Blue Book (www.healthcarebluebook.com),
FAIR Health (www.FAIRHealthConsumer.org), Pricing
Healthcare (www.pricinghealthcare.com), and Clear Health
Costs (www.clearhealthcosts.com). If you need surgery,
check out state or local reports that compare hospital
quality, such as [link to public reporting website].
About the Author
American Institutes for Research (AIR) provides
technical assistance for the Robert Wood Johnson
Foundation’s Aligning Forces for Quality initiative. AIR
is working with Aligning Forces communities to support
consumer engagement efforts to promote high-quality
health care at a low cost.
With good information in hand, you’ll be better prepared to work with your health care
professionals to make the choice that’s right for you.
LOGO and pub information