How Much Does a Checkup Cost and Tips to Save
If you’re like two-thirds of Americans, you worry about whether you can afford your medical bills. Bankrate found that one out of three Americans don’t seek medical care for services like an office visit because of the cost.
You’re probably wondering, how much does a checkup cost? It’s difficult to estimate, especially when you don’t have a health insurance plan.
But it isn’t impossible and we’re here to help you figure it all out, learn what to expect with and without insurance, as well as how to shop around for the best prices and get the care you need for less.
Budgeting for a Doctor’s Visit With Insurance
If you have insurance, the amount you’ll pay for a checkup depends on your policy. In most cases, insurance covers regular checkups as preventive care.
Many insurance companies promote preventive health measures by offering “free” checkups. Usually, this means you won’t owe a copay or coinsurance when you show up for your appointment. However, the medical practice will still send a bill to your insurance company and receive reimbursement as usual.
If you have an insurance policy that doesn’t offer incentives for preventive care checkups and you’ve met your deductible, you’ll pay your copay and/or coinsurance.
According to the 2020 Medical Expenditure Panel Survey, the average copay for a doctor’s visit in 2020 was $26. The average coinsurance is 20.4% of the maximum allowable fee. If you’ve met none of your deductibles, you may have to pay 100% of the maximum allowable fee. If the doctor charges more than the maximum allowed, the office may send you a bill for the remaining balance.
To learn more about how health insurance works, including copays and coinsurance, read How Health Insurance Works, A Quick Guide.
How Much Does a Checkup Cost Without Insurance?
In 2020, 8.6% of people in the US were without health insurance. That means that despite the Affordable Care Act, 28 million Americans did not have health insurance at any point during the year. Exact statistics aren’t available yet, but we know that the number of uninsured grew during the COVID-19 pandemic.
According to the Medical Expenditure Panel Survey conducted by the Department of Health and Human Services, the average price for a primary care visit was $265 in 2016, which inflated to 2021 dollars is $305.39.
If you’re uninsured, saving up to pay your doctor for a checkup might mean having to sacrifice for weeks or months in advance. Like many, you may be wondering, is it even worth it? Let’s explore that by outlining what a checkup includes.
What Happens in a Checkup?
Checkups, also called well visits, are an important part of staying healthy. Through well visits, you get the knowledge, tools, and advice you need to stay healthy and prevent future diseases like diabetes and heart disease.
As you age, health screenings are critical in catching diseases early when they’re easier to treat. If you have known medical conditions, you may need medical care more often, but if you’re in good health, you should have a complete physical exam once a year.
A typical checkup starts with answering a health questionnaire that covers your past medical history, family medical history, and a review of symptoms. Take this opportunity to mention any problems you’re experiencing or questions you may have for the doctor.
Next, a technician will record your height and weight and check your vital signs. These include your heart rate, blood pressure, temperature, and respiratory rate. This information, together with your age, gender, and race, helps your health care practitioner know which follow-up questions to ask and form examination priorities.
You may not realize when your checkup begins. However, your provider is already taking note of your general appearance, speech pattern, memory, and mental quickness from the time they walk into the examination room.
Generally, a physical examination will follow a head-to-toe order and usually starts with looking at your eyes, ears, nose, and throat. During palpation or gentle touching of your neck and throat area, your doctor will note the size of your lymph nodes and feel for thyroid nodules.
From there, the exam will usually proceed with visualizing, listening with a stethoscope, and palpating in the following order: heart, lungs, spine, abdomen, pelvis, and extremities.
Lab work is not standard at every checkup, but your doctor may order some tests based on the physical exam, review symptoms, and medical history. Commonly ordered labs include:
- Complete blood count (CBC), a blood test that looks for anemia, infection, blood loss, clotting problems, and more
- Comprehensive metabolic panel (CMP), a blood test that checks 14 different chemical profiles in your blood that indicate how well your organs are doing to keep your body’s chemistry balanced
- Urinalysis (UA), a urine test that evaluates your kidney function and looks for red flags for infections and diseases like diabetes
Preventive health measures like flu shots and other vaccinations and immunizations, as well as tests to check for high cholesterol, may be recommended. Annual tests for women include a breast exam and mammogram to screen for breast cancer, and a pelvic exam and pap smear to screen for cervical cancer. Screening tests for men may include a digital rectal exam and bloodwork to check for prostate cancer.
If you’re curious about the results of your blood work, ask your doctor or their staff about accessing your personal health information. Today, most insurance companies and health care providers operate patient portals where your health records live online. Information in your patient records is protected and requires permission to access.
5 Cost-Saving Tips
If you worry about how much a doctor’s visit is going to cost out of pocket and you don’t have insurance, there are several strategies to help you save money, get the best price available, and understand up-front how much your doctor will expect you to pay. Fortunately, due to new price transparency rules, it’s easier than ever to find out how much an office visit will cost.
Anyone that provides medical services such as health care providers, primary care physicians, nurse practitioners, and facilities like walk-in clinics, hospitals, emergency rooms, doctor’s offices, and urgent care centers must tell you upfront how much they charge for their services and procedures. This mandate includes pricing for annual physicals.
1. Ask about a payment plan.
Once you know how much your doctor charges for health care services, you can ask whether they accept payment arrangements.
2. Ask for deferred billing.
Sometimes you only need a few weeks to come up with the funds to pay your medical bill. Be sure to offer a specific date and agree to pay the amount due in full.
3. Negotiate a better price.
Gather information from the comparison pricing engine at Compare.com to find out how much other doctors in the area are charging for a physical exam and use that information to negotiate a better price.
For more on this, read our guide on How to Negotiate Your Medical Bills.
4. Ask for a cash discount.
You’ve negotiated the lowest price based on the amount other doctors are charging in your area, but you may have more bargaining power left. Many medical practices would be happy to settle your account for a cash payment to save on credit card processing fees and overhead associated with billing.
5. Find a free clinic in your area.
There are thousands of free and charitable clinics across the U.S. These government-sponsored health centers charge for care based on a sliding scale. They offer low-cost checkups and doctor visits, including medical services like lab tests for low-income individuals and families. The Department of Health and Human Services keeps a directory of free clinics where you can get care even if you can’t afford to pay. You don’t have to be enrolled in Medicare or Medicaid to qualify.
How to Shop for the Best Prices on a Checkup
Like it or not, whether someone gets medical care today depends more on if they feel they can afford it than if they need it. But it doesn’t have to be that way. You can shop around for better prices on procedures and tests while estimating the cost of medical services right from your couch. Comparing prices is the only way you can know for sure that you’re getting the best price.
Use Compare.com to find out the cost of checkups near you and connect directly with providers in your neighborhood.
