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25 Great Ways to Slash Medical Bills

Get free health exams, spot billing errors, and other steps you can take to keep more money in your pocket


a person holding up money and various medical logos and icons
Keep your finances in good shape as you take on health care in your golden years
Jared Oriel

It’s not your imagination. Getting older really does come with more aches, more checkups and, yes, more medical bills.

More than 1 in 4 U.S. adults ages 40 to 64 are in medical debt, with most owing between $1,000 and $1,999 (22 percent) or $2,000 and $4,999 (23 percent), a 2024 AARP survey found.

Among adults 65 and older who report being behind on medical bills, the average balance is an estimated $13,800, a 2023 Consumer Financial Protection Bureau analysis of Census Bureau data found. And not all of those bills are from expensive hospital stays and surgeries: A large share of older adults with medical debt attribute some of it to routine services such as lab fees and diagnostic tests, according to KFF, a nonpartisan health policy nonprofit.

Even a healthy 65-year-old who retired in 2024 faces anywhere from $128,000 to $320,000 in lifetime out-of-pocket medical costs, according to research firm Milliman.

But don’t panic. There are steps you can take to cut through medical expenses without sacrificing the quality of your health care or dipping into your retirement savings to pay a sky-high bill. Here are 25 ways to save on prescriptions, negotiate hospital bills and clamp down on other medical expenses.

1. Don’t miss out on free medical exams

One often overlooked health care benefit? Medicare Part B and most Medicare Advantage plans offer a wide range of preventive services at no cost, such as annual wellness visits, cognitive screenings, mammograms, colonoscopies, bone density scans, skin cancer checks and recommended vaccines like flu, pneumonia and shingles. “These visits go beyond check-the-box appointments,” says journalist Dan Weissmann, creator of An Arm and a Leg, a podcast about the cost of health care. “They’re a chance to catch silent problems early, when treatment is simpler and much less expensive.”

Some Medicare Advantage plans even reward you for getting free medical exams and screenings by lowering your plan’s premiums. Yet millions leave these benefits on the table: In 2022, about 40 percent of eligible policyholders failed to take advantage of their free wellness visit, according to the Centers for Medicare & Medicaid Services.

2. Correct your hearing today so you’re not paying for memory care tomorrow

“There’s a clear link between hearing loss and dementia, yet too many older people resist hearing aids,” says Carolyn Rosenblatt, a registered nurse, elder law attorney and founder of AgingParents.com, a website that addresses legal and health care issues around aging in place. A 2023 study led by researchers at Johns Hopkins showed moderate to severe hearing loss raises dementia prevalence by 61 percent. Wearing hearing aids reduces that risk by a third.

When shopping for hearing aids, consider Costco, Walmart, CVS and direct-to-consumer online outlets like Beltone, Miracle-Ear and FitHearing. These retailers typically undercut the national average prices for prescription devices — currently around $3,300 per pair — and often throw in service perks like free fittings.

3. On a high-deductible plan? Ask for a medical provider’s cash price first

If you have a high-deductible health insurance plan and don’t typically reach your annual out-of-pocket maximum, you could save money by paying for medical appointments and treatments with cash instead of going through insurance. “The cash price for a medical procedure is [often] lower than the insurer’s” price, says Bai. “If you’re never hitting the deductible, cash is often smarter.”

Her research team at Johns Hopkins analyzed 70 common services at hospitals countrywide and found that the self-pay price was lower than the negotiated insurance price nearly half of the time. That’s because some hospitals offer steep discounts to patients who pay up front. Bai’s advice: Ask health care providers, “What’s the price if I pay in full today, without going through insurance, versus the insurance price?”

4. Get help from an unbiased expert when comparing Medicare plans

With so many options and so many rules, choosing a Medicare plan can be overwhelming, which is why many people go through a broker. “The trouble is, brokers often try to upsell” clients because they work on commission,  warns Phil Moeller, author of Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs. He recommends getting free advice from an independent Medicare expert instead of using a broker.

Every state offers trained Medicare plan counselors through the State Health Insurance Assistance Program (SHIP). These experts can help you compare policies and determine the right plan for you at no cost. “Their job is to give you the best possible information to make a smart choice,” Moeller says. That could mean finding a cheaper plan, flagging Medicare Savings Programs or Extra Help programs you didn’t know you qualified for, or steering you away from options that cost more but offer less coverage. You can find your local SHIP at shiphelp.org or by calling 877-839-2675.

a person with piles of papers next to them
Use AI tools such as ChatGPT, Microsoft Copilot or Google Gemini to simplify itemized bills into clear language and highlight any duplicate or erroneous charges.
Jared Oriel

5. Use AI tools to check medical bills for errors

Quick! What’s the difference between billing codes 99213 and J1885? Perplexed? You’re not alone. Up to 80 percent of medical bills contain errors, and many are buried in language that’s difficult to decipher. Moreover, a 2024 federal audit of Medicare Advantage health plans revealed billions of dollars in overcharges and other payment errors.

Older adults are especially vulnerable to medical billing errors. With more chronic conditions and more frequent medical care, they face a greater chance of incorrect charges, according to the Consumer Financial Protection Bureau.

But there’s a secret weapon: Artificial intelligence tools like ChatGPT, Microsoft Copilot and Google Gemini can translate itemized bills into plain English and flag duplicate or incorrect charges. Use your smartphone to take a picture of the bill (after blacking out your name, birth date, Social Security number and any other identifying details for security protection), upload it to one of the AI tools and ask, “Can you explain these charges? Do any of them look unusual or incorrect?”

“If AI says something looks wrong, call the billing office and ask them to explain or correct it,” says Ge Bai, a professor at Johns Hopkins who studies health policy and hospital billing. “That can easily save you $50, $100 or much more.”

Emerging online tools like OpenHand use AI to catch billing errors and can even help patients negotiate with health care providers — so it’s worth watching where this technology leads.

6. Protect yourself when you check in for an appointment

When you arrive at a hospital or doctor’s office, you’re often handed a tablet and asked to sign lengthy consent forms. But what exactly are you agreeing to? “Ask them to print out the paperwork,” Weissmann says. Buried in those consent forms could be a waiver that authorizes the provider to bill you at full out-of-network rates even if the provider is in-network, bypassing your “No Surprises Act” protections.

Watch out for language like, “If you sign this form, you agree to give up your protections under the law.” If you see that or anything mentioning that you’re “waiving” rights or agreeing to out-of-network charges, don’t sign, Weissmann says.

However, if you are set on seeing that specific doctor or hospital, he recommends a tactic from health care journalist Marshall Allen: Cross out the “consent to treat” waiver and write, “I will pay as much as two times what Medicare would pay for this.” Then, initial the change and keep a copy for your records. Most front-desk staff will shrug and accept it without question, Weissmann says, placing a cap on how much the provider can charge you.

7. Use the magic phrase “charity care”

Many hospitals offer financial support that can reduce or even erase your bill. “Almost every hospital offers it, not just nonprofits,” says Bai. “Even if you work full-time, you might qualify.”

The catch: You have to ask and use the correct language. Instead of asking for a “discount” or for “financial assistance,”  ask if the hospital provides “charity care” — and do so up front to avoid surprises. “People sometimes forget to ask, or they feel ashamed about asking for charity, but it can lead to huge savings if you qualify,” Bai says. (Note: Some “charity care” programs are limited to low-income patients.)

Weissmann suggests reaching out to Dollar For, a nonprofit that helps patients access hospital charity care at no cost. They’ll even prepare your application, submit it to the billing department and work with you and the hospital to get debt relief, he says.

8. Ask doctors these four questions before getting a medical procedure or filling a prescription

Here’s an eye-opening statistic: Up to one-third of prescribed medical services provide little or no value, according to the Choosing Wisely campaign, a nationwide value-of-care initiative led by the American Board of Internal Medicine (ABIM) Foundation. That’s why Moeller urges patients to ask medical providers the following questions before taking a medication or opting in for a surgery or procedure:

  • “Why do I need this?”
  • “What happens if I don’t do it?”
  • “Are there side effects?”
  • “What are the lower-cost options?”

9. Take advantage of coupons and discount apps

Drug prices often aren’t set in stone. “Check all the coupon sites,” says Weissmann, such as GoodRx, SingleCare and ScriptSave. These three companies advertise discounts of up to 80 percent off retail prices for select prescriptions at participating pharmacies.

a person in a laptop screen
Online therapy services like TalkSpace, BetterHelp and 7 Cups typically offer costs that are 45 to 60 percent lower than traditional in-person therapy sessions.
Jared Oriel

10. Consider online therapy

According to the CDC, 20 percent of people ages 55 or older experience some mental health concern, such as anxiety or depression. But with one-hour therapy sessions running on average $150, “getting help can be expensive,” Rosenblatt says.

However, online therapy services such as TalkSpace and BetterHelp often charge 45 to 60 percent less than traditional in-person therapists. There are also sites like 7 Cups that let you text with a volunteer listener for free, 24/7, or text a licensed therapist for a low rate. In addition, some Medicare Advantage plans offer one-hour video sessions with a psychologist or app-based cognitive behavioral therapy from $0 to $129 per visit.

11. Ask your pharmacist this question

Here’s something most people don’t know, and it could save you money on your prescriptions. A federal program called 340B lets certain hospitals and clinics buy medications at big discounts, sometimes more than half off. These hospitals often collaborate with pharmacies like CVS, Walgreens or local drugstores to fill prescriptions.

However, pharmacies aren’t required to pass the savings on to you. In fact, you could be paying full price while the pharmacy keeps the discount. That doesn’t feel great, but it doesn’t mean you’re stuck paying full freight. “Sometimes all it takes is asking to get a price reduction,” Bai says. If you know the pharmacy is part of the 340B program, try asking, “Hey, is there a discount on this prescription through 340B?” You might get a price break just for speaking up.

12. If your bill looks weird, ask for the ‘UB-04’

Most hospitals send you a vague summary bill, which is like getting a restaurant receipt that just says “food: $1,200.” The UB-04 is the detailed bill hospitals send to insurers, listing every charge. “Always ask for the UB-04,” says Weissmann. “It’s the only way to see what you’re really being charged for, and to catch stuff that shouldn’t be there.”

Simply tell the hospital, “I need an itemized bill with CPT codes and all charges.” If the billing office resists, remind them you have a legal right to your records under the Health Insurance Portability and Accountability Act, or HIPAA. (You can even file a complaint at ocrportal.hhs.gov if they don’t comply.) Once you receive the itemized bill, compare it to the explanation of benefits (EOB) from your insurer. If there’s a charge on the bill but not the EOB, that’s a red flag. “Also compare it to your own memory,” Weissmann says. “Did they really do that MRI? Did you actually get that medication? Mistakes happen all the time on hospital bills.”

13. Experiencing flu symptoms? Try urgent care, not the ER

If you have the sniffles that you can’t shake or a small cut that needs attention, and you aren’t experiencing any concerning symptoms, an urgent care center might be a better and less expensive option than a hospital emergency room. “It’s like the difference between fast food and a fancy restaurant,” says Bai. “You’re still getting what you need, just without the extra frills.”

Urgent care clinics can handle flu, mild infections and minor injuries, often with shorter waits than the ER. No wonder they’re popular with older adults: A 2024 University of Michigan study found that 3 in 5 people between the ages of 50 and 80 have used an urgent care or retail clinic in the past two years.

14. Bypass insurance when seeing your primary care doctor

Direct Primary Care (DPC) is a growing model where you pay your physician directly each month, like a subscription, instead of going through insurance. For a flat fee — typically $60 to $90 per month — you get unlimited office or virtual visits, same- or next-day appointments, extended visits (often 30 minutes or longer) and discounted generic medications. There are no copays or deductibles. A 2020 Society of Actuaries analysis of employer claims data showed DPC members generated 12.6 percent lower total medical claims costs and sharply reduced ER use.  

pill bottles with price tags
Check with your doctor or pharmacist to see if your medications can be safely divided. Higher doses often cost about the same as lower doses.
Jared Oriel

“DPC is an appealing option for older adults who want a doctor they can actually see when they need to,” Bai says. Caveat: DPC only covers primary care, not hospitals, specialists or big procedures — you’ll still need Medicare or another insurance plan for those services.

15. Cut the pill, cut the bill

Many prescription pills cost the same or just a few bucks more in larger dosages as smaller ones. Therefore, “Ask your doctor if splitting the pill is safe,” Weissmann suggests. “If it is, you buy the higher dose, split it, and you’ve just saved 50 percent.” A 2022 systematic review found that pill-splitting, which routinely slices costs by 30 to 50 percent, can be done without harming safety for most scored, non-extended-release drugs. But get your doctor’s approval and guidance first, since not taking medications as instructed can lead to bad outcomes.

When cutting scored pills (the ones with a line down the middle), be precise and use a quality pill splitter — never a kitchen knife. (Read “Is It Safe to Split My Pills?” for more tips.)

Medicare now allows certain hospitals to treat conditions like pneumonia, heart failure and infections at a patient’s home, and the early results are encouraging, especially for the price. A 2024 Centers for Medicare & Medicaid Services analysis found Hospital-at-Home programs had lower mortality rates and lower costs compared to traditional inpatient hospital stays.

Still, do your research and find out “which services are actually covered, and check on the professional qualifications of their care providers,” says Moeller.

17. Snag small perks from your Medicare Advantage plan

Most Medicare Advantage plans include extras like monthly grocery store gift cards, gym memberships and free transportation to doctor’s appointments, according to the latest KFF data. These perks usually top out at $25 to $50 a month, but they’re nothing to sneeze at, says Moeller. And if you’re using the benefits regularly, whether to cover vitamins, blood pressure cuffs or rides to your cardiologist, “it’s money you’re not spending out of pocket,” he says.

18. Buying Medigap coverage? It’s OK to choose the cheapest option

All 10 Medigap “letter” plans (A–N) are standardized by law. That means a Plan G from BlueCross provides the same coverage as a Plan G from Mutual of Omaha or another insurer, even though the prices can vary. The takeaway: “Buy the cheapest plan,” Moeller advises. Medicare.gov’s Plan Finder pulled 2025 quotes for a 65‑year‑old Richmond, Virginia, resident that ranged from $124 to $419 per month. That’s the same Plan G but with wildly different price tags, depending solely on which insurer’s name is on the card. “The only difference is what you pay, so shop every carrier,” Moeller adds.

19. Keep a medical history cheat sheet on you

a nurse and someone in a wheelchair
Build a strong rapport with nurses, as they can guide you to more affordable medical options and help prevent unnecessary costs.
Jared Oriel

Bringing a one-page summary of your medications, surgeries, allergies and recent scans to each appointment can help doctors avoid ordering duplicate tests or prescribing conflicting medications. Think of it like bringing your car’s maintenance record to the mechanic, says Bai. “You’ll save time, money, and possibly avoid a dangerous drug interaction.”

20. Be nice to nurses. They might help you find a cheaper Rx

Nurses often spend more time with patients than doctors. That makes them a powerful ally, says Moeller, when you’re looking for a more affordable medical exam or prescription.

Suppose your doctor orders an expensive scan or prescribes a pricey brand-name drug. The nurse might know of a lower-cost test or a less-expensive generic medication that would do the trick. Nurses can also flag unnecessary extras, like duplicate lab tests or surprise add-ons, before they appear on your bill.

21. Rethink long-term care insurance after 50

Around half of men and 64 percent of women reaching age 65 today will need significant long-term care at some point, according to a 2022 study from the federal Department of Health and Human Services (HHS). A long-term care insurance policy can help offset costs, but these policies aren’t right for everyone, especially nowadays.

In the 1990s and 2000s, when generous coverage and underpriced premiums were the norm, “carriers underestimated two things: how long people would live, and dementia,” says Rosenblatt. Now, most policies allow insurers to make unlimited premium hikes, and many policyholders end up priced out just when they need coverage most.

Hybrid policies, which combine life and long-term care insurance, are gaining traction, but they’re costly, and coverage is often limited. If you don’t want to purchase an insurance plan, consider “self-insuring” by setting aside funds each year specifically for long-term care costs. Bonus: If you wind up not needing long-term care, you can spend the money on other things.

22. Fill prescriptions at warehouse clubs

Big-box retailers are great for buying toilet paper, trash bags and other products in bulk. But here’s something you might not know: You can get prescriptions at Costco, Sam’s Club and BJ’s Warehouse at steep discounts, and you don’t need a membership to buy them, Weissmann says. 

Sam’s Club sells certain generic medications starting at just $4, while Costco offers drug discounts of up to 80 percent and 90-day supplies of some common medications for only $10.

23. Prevent falls to avoid costly surgeries

If you’re beginning to have trouble walking or are experiencing balance issues, don’t wait for an accident to happen. The right mobility device, such as a cane or a walker, can help you get around safely and prevent falls that send you to the hospital and home with big bills — and Medicare might cover the cost if your doctor signs off on it. Consider: A hip-fracture surgery typically costs around $40,000 or more before insurance, plus months of rehab.

“Grabbing a cane now isn’t a sign of weakness,” says Rosenblatt. “It’s one of the cheapest insurance policies you can buy.”

24. Avoid hospitals when getting routine scans

Many hospitals charge top dollar for basic tests such as MRI scans, CT scans and echocardiograms, Weissmann says. Case in point: A 2020 UnitedHealth study found hospital outpatient imaging costs an eye-popping 165 percent more on average than the same scan at a center not affiliated with a hospital.

Bottom line: If your doctor orders a routine exam, getting it done at an independent imaging clinic could help you keep hundreds in your pocket. Just make sure that the imaging center is covered by your insurance.

25. Get free help from a medical billing expert

Feeling outmatched by a five-figure hospital bill? Weissmann suggests turning to the Patient Advocate Foundation, a nonprofit that can provide a case manager to help you spot and fight medical bill errors, negotiate payment options and qualify for financial support. In 2024, the organization provided $335 million in direct financial aid and resolved billing disputes for more than 193,000 patients, and nearly 75 percent of patients saw at least partial debt relief. You can visit PatientAdvocate.org or call 800-532-5274 to connect with a case manager.

Not everyone can use the Patient Advocate Foundation’s services. To be eligible, you must have a confirmed diagnosis of a serious health condition or be receiving testing for the condition; be in active treatment for the health condition, starting treatment in the next 60 days or finished treatment in the last six months; be a U.S. citizen or a permanent resident; and be getting treatment in the United States or a U.S. territory.

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