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Not correct. You need to negotiate with the doctor (or dentist or laboratory or hospital) explaining that you are paying CASH TODAY so that the doctor doesn't have to wait for payment or file an insurance claim form.
If the doctor still says no, maybe it's time to find a new doctor. I've had reductions for 30-60% using this strategy.
I think it depends. For example with my OB visits, I paid $40 one time for the entire pregnancy. There is absolutely no way that for me negotiating myself I would have been able to pay $40 for 15+ visits, lab work, ultrasounds, vaccines, etc.
There are doctors here who are no longer accepting insurance, but have a sort of membership program where you pay an annual fee/subscription and get a physical with labs and an extra office visit, that kind of thing. A couple of our old doctors went that route. The one plan I mentioned is about $500/year. Of course, if you develop a problem that needs a specialist or an X-ray, MRI, or CAT Scan, or require hospitalization, that would need to be covered by some type of insurance or you will run out of money very quickly.
Since we've always had to participate in DH's employer health plan in the past, we have never gone that route, but if we get an option for a high deductible plan with an HSA this year, that may be the way we go. I think paying out of pocket for basic services is cheaper than the almost $600/month we pay now for our portion of family health coverage. We also know that you can utilize Minute Clinic and Urgent Care for some other things.
The only thing I am worried about is prescription costs, and costs for those other tests too. When you participate in an insurance plan, you get a discount. So an X-Ray that may cost $200 out of pocket is negotiated down to $90 with the insurance discount, for example, and you typically pay 20% of that, assuming your deductible is met. If you are on a high deductible policy, and not participating in a group plan, you are essentially paying the cash price for everything, so the bill you would get for the X-ray would be $200, not $90.
I think lab work is where you can really get screwed if you don't have insurance or if you have a high deductible plan. A friend of mine works as a lab tech manager for a hospital in the Triad. A few months ago she became inexplicably very ill. Her doctor ran a bunch of tests to rule out that she didn't have cancer. Because of the way her health insurance is set up, she ended up having to pay out of pocket for most of those tests. $1500 just in test costs. She said the thing that really made her angry about it is she knows it's just Labcorp ripping people off since she runs the same sorts of tests in the hospital daily and knows what the supplies/labor costs are. And good luck negotiating a significantly lower payment with Labcorp. They don't really care.
When you participate in an insurance plan, you get a discount. So an X-Ray that may cost $200 out of pocket is negotiated down to $90 with the insurance discount, for example, and you typically pay 20% of that, assuming your deductible is met. If you are on a high deductible policy, and not participating in a group plan, you are essentially paying the cash price for everything, so the bill you would get for the X-ray would be $200, not $90.
I know with my high deductible plan, I do get the negotiated rates if I go in-network with BC/BS - at least for doctors, but I assume with tests as well. Since your out-of-pocket counts toward the deductible I'm sure the insurance company wants a say in what is "usual and customary." For bloodwork you can look online and get the tests that way - MUCH cheaper, and your blood is still drawn at a local lab.
My $10K deductible plan is $77.40 per month - not bad for a 48 year old female. Especially now since preventive care is covered. If/when I work full-time again, I'll definitely sign up for the highest deductible plan possible.
I know with my high deductible plan, I do get the negotiated rates if I go in-network with BC/BS - at least for doctors, but I assume with tests as well. Since your out-of-pocket counts toward the deductible I'm sure the insurance company wants a say in what is "usual and customary." For bloodwork you can look online and get the tests that way - MUCH cheaper, and your blood is still drawn at a local lab.
My $10K deductible plan is $77.40 per month - not bad for a 48 year old female. Especially now since preventive care is covered. If/when I work full-time again, I'll definitely sign up for the highest deductible plan possible.
THIS THIS THIS ^^^^^^
And, as I explained before, I have had success getting doctors to reduce the fee BELOW the contract amount from the insurance company if he/she doesn't have to file forms and if I pay that day, on the spot. I get the receipt and IF I ever reach the $5,000 deductible, I can submit to the insurance company myself.
As far as prescriptions, shop around. Use generics whenever possible (and sometimes you may need to change the medication you are taking to do that, so consult your physician).
I agree with others. Our family plan (5 of us) is $260/month through BCBS. We have 10k deductibles, so keep a savings account funded with that amount. It would be ~$800/month with standard deductibles. That is almost 7k a year that would be up in smoke.
I agree with others. Our family plan (5 of us) is $260/month through BCBS. We have 10k deductibles, so keep a savings account funded with that amount. It would be ~$800/month with standard deductibles. That is almost 7k a year that would be up in smoke.
Is that 10k deductible EACH or is it a family deductible so that your medical expenses are combined to meet the deductible each year? That's about half what we are paying with employer-provided insurance.
And, as I explained before, I have had success getting doctors to reduce the fee BELOW the contract amount from the insurance company if he/she doesn't have to file forms and if I pay that day, on the spot. I get the receipt and IF I ever reach the $5,000 deductible, I can submit to the insurance company myself.
That's insurance fraud on the part of the doctor. Regarding "filling out forms" it's a single click of the mouse. I've never quite understood the rationale behind cash patients asking for a discount. Do you know where your discount is? You're not paying premiums like those who do have insurance have to do. I actually think some believe we don't report that cash and thus they are doing us a favor saving us the tax. It gets deposited just like any other payment.
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