True story.... 6 months ago I needed an MRI for a procedure. I go to imaging place, fill out paperwork, give them my BCBS insurance and take a seat.... young lady comes over and says, "Mr Banker, if we file with your insurance your fee today is $900. But.... if you're uninsured and paying outta pocket, the fee is $500." I said, "ma'am, I just became uninsured" and gave her my CC.

What a perverse system.

Old May Banker said:

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True story.... 6 months ago I needed an MRI for a procedure. I go to imaging place, fill out paperwork, give them my BCBS insurance and take a seat.... young lady comes over and says, "Mr Banker, if we file with your insurance your fee today is $900. But.... if you're uninsured and paying outta pocket, the fee is $500." I said, "ma'am, I just became uninsured" and gave her my CC.

What a perverse system.

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Many generic drugs can be cheaper (cash) using goodrx.com coupon, compared to paying using insurance.

AccountantAg said:

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Funky Winkerbean said:

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Quote:

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Any uninsured guy who walks in off the street and is actually paying 'list' prices for medical services is getting bent over and having the broomstick broken off in him. I'd hate to be that guy.

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They pay less than your "negotiated " price.

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Call and ask for the paid in cash immediate discount. After insurance I've gotten 20% off my bill when I had kids

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Let me see if I've got this straight. And no, I'm not trying to be obtuse, as I'd really like to find a new way to reduce costs, I assure you. OK.

You're saying that the next time I get a bill from my provider telling me I owe say, $550 (which happens to be the insurance-company negotiated rate for that service and not the provider's inflated no-insurance 'list price'), I just need to call the provider (who has already said I need to provide payment in 30 days, either by credit card or ACH), and tell them I'll pay today (rather than in 30 days), and then they'll offer me an immediate a 20% cash discount off of my insurance company's negotiated rate (ie - $440)?

If that's true, and works every time, regardless of procedure or amount of the bill, I'll try it. If I misunderstood what you're saying, please correct me. Thanks.

EDIT: And if all this is correct, why the hell don't the medical bills just plainly state on them: "Pay this today and you'll get one hell of a deal?" That sure would simplify things, I would think.

EDIT #2: (yes, so many questions) And, let's say a man goes in without any insurance at all. How can he be absolutely certain he is getting billed a rate that is at least as good as the insurance company negotiated rate and not some other figure?

The few times I have had to call those medical billing departments I've found those people don't really know much about pricing other than whatever the computer pulls up.

If I understand what your saying you want the discount after they ran it through your insurance? Then no they won't take a discount. At least in my experience. When I've gotten discounts in the past it's because I had a high deductible plan and shopped things like imaging before they filed it. For instance I broke my foot. It would be $800 for an MRI through the place that accepted my insurance. I called around for a cash price and paid $300. Also like my ER bill I mentioned they ran it through insurance and they flat out denied it. So then I was able to negotiate a flat out cash price because there was no middle man aka insurance to deal with.

and yes you can go in and say no insurance and they can bill you $20k from the 20 different entities that will bill you. The ER, the ER docs, the imagining, the pharmacy. At that point when the bills start rolling in you call and say hey I cant afford this all at once or this full price. Most of the time they will be like okay can you pay this $ in full or handle $ this payment. And it's like 1/5 the price bc at that point they want to be paid anything vs nothing

TA-OP said:

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Honest question (not trying to get into a defending ObamaCare debate): The chart shown is nearly linear since 2000. Doesn't that suggest ObamaCare isn't the problem?

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There was a step change in 2010, so yeah the slope is about the same, but it raised the cost and continued from there.

Second, Obamacare was supposed to bend the cost curve down.

Third, that is just premiums. Co pays and deductibles have gone through the roof since Obamacare passed.

Beckdiesel03 said:

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and yes you can go in and say no insurance and they can bill you $20k from the 20 different entities that will bill you. The ER, the ER docs, the imagining, the pharmacy. At that point when the bills start rolling in you call and say hey I cant afford this all at once or this full price. Most of the time they will be like okay can you pay this $ in full or handle $ this payment. And it's like 1/5 the price bc at that point they want to be paid anything vs nothing

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If you go this route, make sure you get it in writing, including that they won't tag your credit score.

For sure. When I would call, I would have the bill in front of me. I would write down the date I called, and the person I talked to. When paid in full I would write the rep name and the confirmation number. Kept those bills for YEARS just to be safe. Document everything.

Also to add, the worst thing you can do is to ignore the bills or be afraid to call. I was shocked the timeline they gave me to deal with the insurance denial and then when 6 months later it was finalized they still were super nice about payments and timelines. Just don't be afraid to call and talk to them. And to the above poster our premium went from $400 a month for 3 people with $2500 deductible to $1800 a month and $8500 deductible with no hospitals or doctors close by accepting our Obamacare plan. We lost doctors and coverage every year.

_mpaul said:

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Dan Scott said:

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Companies pay for health insurance because it's tax free income to the employee and deductible expense for the company.

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But why? What led us down this path? What was the impetus?

(I know, and like everything else that seems to get screwed up in the economy, the answer is government interference with the free market.)

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Well, back in the 1930's, there were a bunch of people unemployed.

Then one Sunday morning, Japan decided to bomb Pearl Harbor, bring the USA into World War 2. And suddenly, there was a massive demand for manpower, both to go fight the war, and to build all the weapons and vehicles needed for it. And so, unemployment was virtually wiped out. At one point, the official rate was down to 1.2%. It had never been less than 3% before.

With labor in short supply, businesses had to offer higher wages in order to compete. Which was great for the workers, but that, in combination with the scarcity of consumer goods, was starting to cause inflation.

So the Federal government decided to fight inflation by imposing price and wage controls (and a ban on sliced bread, but that's besides the point). But employers still needed to do something to attract workers, so they looked for a loophole. While wages were capped, benefits were not. So companies offered increasingly generous health insurance plans.

After the war, the government looked at this employer-financed health insurance system that they had accidentally incentivized, and said "Yeah, we meant to do that. Let's make it tax-advantaged so it sticks around."

And he we are 80 years later.

Alan Stanwyck said:

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Sims said:

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Alan Stanwyck said:

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I am actually a commercial broker focused on benefits and unfortunately a single digit increase is something organizations are happy about these days. This broken system has in turn created some new healthcare options and carriers that are disrupting the market and we are moving a lot of clients to some of these unconventional options with great results. Our firm is actually moving to one in particular that is Texas based with a nation wide network.

These medical carriers make billions of dollars a year and it's time we fought back. If any of your firms need assistance let me know. Education is paramount when it comes to this stuff.

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We looked at an unconventional option last year, Health Benefit Alliance. They had some very attractive MEC plans as well as some upper tier coverages.

We ended up going with BCBS.

The feedback we got from our broker earlier this year was be very thankful we didn't go with HBA. He said the folks they put on those plans have been very dissatisfied. There have been lots of coverage issues and they had to change TPAs mid year which caused a whole host of other problems and communication issues.

The other options are out there, but it sounds like they are having growing pains.

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Yeah you have to be careful for sure. We don't dabble in MEC plans which is probably what that group pushes, but the fact remains this market is creating some options from new carriers that are financially rated or we wouldn't be able to offer them. There are options out there if the group fits.

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Alan - Contact me. I am interested. @sanangelolive on the X or insta or FB

agracer said:

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Old May Banker said:

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Tying insurance to employment was as awful as conflating insurance with Healthcare.

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Americans don't have health insurance, they have health maintenance plans.

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Yep. High deductible plans with HSA's are the answer.