Fear no more. due to ever decreasing insurance reimbursement, many doctors are opting to get out of network and offer cash discounts for those who are without coverage. Discounts are hefty enough that sometimes, cash discount fee could be less than that of copayment.
For example, someone with $3000/year covereage with $2500 dedictible may have to spend $2500 at regular fee schedule and start receiving discounts after $2500 out of pocket has been met. So if an individual visits doctor's office with back pain, one may end up paying hundreds of dollars in exam and treatment cost. However, those without coverage may receive cash discount fee that is far lower than what insurance patient has to live with without ever having have to pay monthly premium.
The insurance patient from above needs to spend $5500 ($3000 premium + $2500 deductible) before any benefits kick in. Average Americans without medical conditions requiring regular visit spends fraction of that if at all. Over just a few years, one may be spending 10's of thousands on premium and deductible. So it is pretty obvious that for healthy young individuals, health insurance is just a bad deal.
Now that you may have decided to ditch your self-paid insurance coverage, how can you survive? Just ask for the discount. Many healthcare practitioners offer hefty discount these days. Managed care organizations are increasingly denying claims unnecessarily while decreasing the reimbursement, that doctors end up spending more money to collect less than previously. So if someone walked in without insurance and wants to pay cash, doctors can give administrative discount since they are saving good amount by not having have to fight the insurance adjuster for months.
Depending on how sick of managed care doctors are, discount amount can vary. Don't be afraid to ask the receptionist of your doctor, what the initial visit will cost you and if there are any discounts available for payment at the time of service.
So, would you like to know where all the healthcare dollars are going to? Doctors are getting paid less for more work and end up spending more to run a clinic. So medical care cost isn't increasing at all. It's been decreasing rather. Then why the big rise every year? Health insurance companies spend more money than ever before in fighting claims not to pay doctors and spend millions on their on executives.
Insurance benefits have dwindled so much and premiums increasing so high that it has become unnecessary expense for most of us who are healthy. So don't dispair if you do not have coverage. For those who have children, most states have additional program for kid's with serious condtions and do not qualify for medicaid program. For those once in a blue moon visits do doctors office, you'll never spend as much as the cost of premium.
Published by Tony K. Kim, DC, QME, IME
I am a doctor of chiropractic specializing in injury prevention and wellness. I have a general practice where I also treat injuries arising out of auto accidents, sports, and work place. I also do some QME... View profile
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