With more and more consumers getting high deductible health plans now, there’s an interesting phenomenon afoot. Consumers are paying for medically necessary procedures as though they were cosmetic procedures – completely out of pocket. In the past, you bought health insurance so that medically necessary procedures were paid for. Paying out of pocket was only for services that were not considered medically necessary, like a cosmetic procedure. Not so anymore.
Why are high deductible health plans more common now?
Just to clarify, high deductible health plans are pretty much what it sounds like. When you have a high deductible health plan, there’s a certain amount of money, sometimes up to $6000(!) that you have to pay out-of-pocket before your insurance benefits start to kick in. That means you’ll be paying for any lab tests, X-rays and maybe even surgery before you hit your deductible. Why would someone get a health plan like this? Mostly it’s because the premiums you pay each month are less expensive (but not inexpensive and certainly not more affordable). Also. these types of plans are good for young healthy people that typically won’t need any medical services anyway.
Now that you know you’re responsible for the first portion of your care, you need to be smart about how you spend your money. For example, it’s well known that services provided at a hospital or an emergency room are always more expensive than services provided by an outpatient lab or surgery center. Why you ask? Quite frankly, because they can! The way Medicare is set up, hospitals get higher payment for services provided and most private insurance companies follow Medicare’s lead.
With that knowledge, consider what you would do if you had a surgical procedure that was a fairly minor one. Let’s say you have a fatty non-cancerous tumor also referred to as a lipoma. The removal of the lipoma in a hospital will be way more expensive than in an outpatient surgery center and even more expensive than what you’d pay in a plastic surgeon’s private office-based operating room. If you go to a hospital, I guarantee your bill will be so expensive that you would quickly fulfill your deductible but that would mean you’d have to pay about $6000 out of pocket. Why not go to a facility that will only charge you $2000 for the same procedure? You just saved $4000 for the same procedure and probably will have the same result!
Today’s patients have to be better shoppers. Click here to find pricing on surgical procedures that you might be considering.
Click here for the original blog post written by Dr. Jonathan Kaplan for BuildMyBod.
