With health care costs increasing and medical insurance premiums rising, patients and providers have had to become creative when it comes to finding ways to save money. For many patients, choosing between taking care of their health care needs and things like rent or food can be a daunting decision. Furthermore, with deductibles often times being in the thousands of dollars, even having health insurance does not always mean you can afford to utilize the benefit.

Fairfield County consumers are exploring alternative ways to minimize costs. One unique option are coupon deals found on the internet. Remarkably, today you can search online for promotions offered by providers from almost every medical specialty. From routine care to various elective procedures, many web sites are now promoting affordable health care.

Some common health related services can be found on a websites such as Groupon and LivingSocial. For example, a dental exam, cleaning and x-ray can be purchased for as little as $39, while a laser toe nail fungus treatment can be bought for around $40. Another popular procedure is Botox and fillers (treatments for wrinkles). These too, are frequently offered at deep discounts. Likewise, body sculpting, laser hair removal, teeth whitening and eye exams and prescription eyewear are offered on-line as well. Patients seeking these elective and cosmetic procedures can indeed benefit from the many advertised discounts, however many of these deals are limited to one per customer or one visit per year.

Patients often ask me why care is offered at a discount by these providers in the first place. As in any business, physicians and ancillary health care providers need customers. Advertising, in all forms, is designed to create traffic. Although savings can often be substantial, the quality and follow-up care is one important issue to consider. There is also another significant concern for individuals utilizing these coupons. Should an issue be discovered during an exam or treatment, will they receive a discount for that additional evaluation or procedure as well? Generally, the answer is no. Furthermore, what happens if a patient has health insurance which would have covered further evaluation and treatment for the abnormal finding? If they chose to continue to seeing their “coupon” provider, in many of those cases, the cost will still be out of pocket as the patient is usually charged for the additional fees. Moreover, costs and fees associated with these coupon offers cannot typically be submitted to insurance and will therefore not be applied to a patient’s deductible, especially if the provider is out of network or the procedure is deemed “elective.”

For the health care providers, there are many legal and ethical questions. In many states it is considered illegal to “share” a fee with a third-party referral source; especially if the provider accepts Medicare or Medicaid. Furthermore, physicians offering discounts and coupons could be violating state and federal anti-kickback laws, third-party payer contracts, and their relevant professional codes of ethics. As such, patients must be careful when purchasing a coupon which they may later learn they are not able to use. Accordingly, you will rarely find coupons from primary care providers or general medical specialists.

For patients who have no insurance (or for those seeking elective medical procedures), there might be a benefit in obtaining some of these discounted services. However, it may be possible (in some cases) for your own provider to legally offer a discounted rate for services as well. You have nothing to lose by asking. Moreover, medication discounts are plentiful and should always be utilized if possible for drug cost savings.

Dr. Michael Schwartz is board certified in internal medicine and is affiliated with Soundview Medical Associates with a private practice in Darien. For comments or questions, visit his website at drmichaelbschwartz.com.