Getting a usable price before treatment

Most people feel awkward asking what medical care will cost.

The awkwardness is misplaced: institutions employ people specifically to answer this.

Who to ask

• The billing office or financial counsellor.
• The international patient office if you are a foreign patient.
• Not the treating clinician, who often does not know prices.
• Ask the clinician what will be done; ask the office what it costs.
• Separate the two conversations.

What to give them

• The exact procedure proposed.
• The procedure code if you have it.
• The named clinician.
• Your insurance details or self-pay status.
• Any other medical conditions.
• Vague requests get vague estimates.

What the estimate should state

• The total for an uncomplicated case.
• Each major component separately.
• The assumed length of stay.
• Who else will bill separately.
• What is explicitly excluded.
• How long the estimate is valid.

Ask what would make it higher

• Longer stay than planned.
• Additional tests during admission.
• A complication requiring more care.
• A change in surgical plan.
• Ask for a realistic upper figure, not just the expected one.

Ask who authorises extra spending

• Ask who decides if more treatment is needed.
• Ask how you would be informed.
• Ask whether a ceiling can be recorded.
• Nominate a relative who can be contacted.
• Agree this before admission.

If you are insured

• Ask the hospital to confirm they accept your insurer.
• Ask whether the clinicians are also in network.
• Ask what your own share is expected to be.
• Obtain written pre-authorisation before booking.
• Ask what the insurer typically declines here.

If you are paying yourself

• Ask whether a self-pay rate exists.
• Ask whether prepayment reduces it.
• Ask what deposit is required and when.
• Ask the refund policy if treatment is cancelled.
• Get all of this in writing.

Deposits

• Pay only against a formal invoice.
• Pay only to an account in the institution's name.
• Never to an individual or intermediary personal account.
• Keep the bank confirmation.
• Ask what portion is non-refundable and why.

Payment plans

• Ask whether instalments are offered.
• Ask whether interest applies.
• Ask what happens if you miss a payment.
• Compare with other borrowing costs.
• Get the terms in writing before agreeing.

Hardship and charitable support

• Many hospitals have some form of assistance.
• It is rarely advertised.
• Ask the social work department.
• Ask about condition-specific charities.
• Ask early rather than after the bill arrives.

Ask about the cheaper clinical option

• Ask whether a less expensive approach is clinically reasonable.
• Ask what would be lost by choosing it.
• Ask whether part of the care could be done elsewhere.
• Ask whether anything can safely wait.
• Clinicians often have options they do not volunteer.

Diagnostic costs

• Ask the price of each proposed test.
• Ask whether existing results can be reused.
• Ask which tests would change the plan.
• Tests that do not change management rarely justify their cost.
• This is a fair question to put to the clinician.

Estimates for a course of treatment

• Ask for the cost per cycle and the expected number.
• Ask what happens if more are needed.
• Ask whether monitoring tests are included.
• Ask the cost of managing side effects.
• Budget for the whole course, not one cycle.

Estimates abroad

• Ask for the quotation from the institution, not an agency.
• Ask what currency and what validity period.
• Add travel, accommodation and a companion yourself.
• Add the diagnostic phase.
• Add a contingency for a longer stay.

Ask what happens if you cancel

• Ask the cancellation deadline.
• Ask what portion is refundable.
• Ask whether a medical reason changes the terms.
• Ask whether the date can be moved instead.
• Get this before paying any deposit.

Keep a written record of who said what

• Note the name and date for every figure quoted.
• Confirm verbal figures by email afterwards.
• Ask for corrections if the written version differs.
• This settles almost every later dispute.

Put it in one document

• List every component with its source.
• Mark which figures are confirmed in writing.
• Mark which are estimates.
• Add your contingency.
• Share it with whoever is helping to fund it.

Ask about the anaesthetist separately

• Anaesthetic fees are frequently billed independently.
• Ask whether the anaesthetist is in network.
• Ask for their fee estimate in advance.
• This is one of the most common surprise charges.

Set a ceiling before you start

• Agree a maximum with your family.
• Write it down.
• Decide who can authorise exceeding it.
• Keep a reserve for follow-up care.
• Spending everything on one episode is a common mistake.

Ask about the cost of waiting

• Ask whether delay changes the clinical outcome.
• Ask whether delay changes the cost.
• Some conditions become more expensive to treat later.
• Others can safely be deferred while you arrange funds.
• Only the clinician can tell you which applies.

If the price is beyond you

• Say so plainly and early.
• Ask what the alternatives are.
• Ask what the public system provides.
• Ask what happens if treatment is delayed.
• Never simply disappear from the system.

The point to remember

Three things:

1. Ask the billing office, not the clinician, and ask in writing.
2. Ask for a realistic worst case, not just the expected figure.
3. Say early if the cost is beyond you — options exist but are rarely offered unprompted.

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