A growing body of research has found that as people pay more out of pocket for their healthcare, they’re likely to put off treatment instead of seeking a lower cost option. One in five Americans with health insurance report having trouble paying medical bills, according to a Kaiser Family Foundation/New York Times survey.

Patients typically don't think to discuss cost with their doctors or they may be embarrassed disclosing money issues. But maybe they should.

“A doctor can often help you but only if the doctor is aware of the financial burden you are under,” says Peter Ubel, a physician and professor of Business, Public Policy and Medicine at Duke Fuqua School of Management. "A doctor also knows whether a particular strategy is medically safe for you."

Research led by Ubel shows that conversations about cost occurred in 30 percent of visits, with doctors as likely as patients to bring up the topic. In a study published last month in the healthcare journal Medical Decision Making, researchers analyzed recorded conversations of 1,755 outpatient doctor visits from 2010 to 2014. The visits included patients with breast cancer talking to their oncologists, people with depression meeting with psychiatrists, and those with arthritis visiting rheumatologists. In all these meetings, the patients were faced with potentially high out-of-pocket costs.

While the study didn't explain how much consumers were able to save, patients have reported feeling most squeezed by copays to see doctors and specialists, prescription medications, and expensive tests and procedures.

Simple advice about where to buy your medication, for instance, can lead to big savings. Consumer Reports last year showed that prices on prescription drugs varied widely from store to store. We found, for example, that if a patient needed the medication, Metformin—used to treat type 2 diabetes—it would cost just $4 for a month’s supply, or $10 for a three-month supply, at stores such as Target and Walmart, while a co-pay for a month’s worth averages about $11. The retailer you choose can end up costing up to 10 times more than if you had gone to another pharmacy. In another case, in Raleigh, N.C., the cost for a month’s worth of the generic Cymbalta ranged from $249 at a Walgreens to $43 at Costco.

Money Saving Strategies

While that kind of advice can be helpful, the study showed that meaningful savings can be found in other ways too because the strategies to cut costs are often simple, says Ubel. Here are some strategies to keep in mind to help lower your costs:

  • Switch pharmacies or schedule tests when deductibles have been met 
  • Change to a lower-cost therapy or test 
  • Use co-pay assistance or drug coupons 
  • Switch from a brand name drug to a generic equivalent 
  • Change your insurance plans