This is not unique to health care. Do's and don'ts? Press question mark to learn the rest of the keyboard shortcuts. But both collision and comprehensive insurance require you to meet a deductible (usually $500 or $1,000) before your coverage kicks in. After that, the bills sent to the auto insurance company were sent to me. (other types of insurances can be how you describe- such as homeowners or car). Our moderation team encourages respectful discussion. (There are often exceptions in the fine print such as prescriptions, and other things.). Basically, if you have the cash handy, you go to the billing office (or call) and start dickering. One has a deductible of $2000 with an Out of pocket max at $8500 for $900/mo. Most people who don’t purchase health insurance figure they’ll just pay out-of-pocket if something small, but still unexpected, happens. Generally speaking, nurses and doctors don't know or care how much their services cost. It is in network but the network is every regional hospital in a major metro area. I'm trying to find a health plan and I'm trying to decide between 2 different ones. You strongly advise me to get health insurance. Quick, precise, and to the point. This has also (and still does) protect me from fines associated with not having health insurance. What about those awful things that happen to some of us some times? Deductible: A deductible is the amount you pay out of pocket before the health insurance company begins to cover claims. That's a pretty unusual plan if you go immediately from deductible to 100% covered. I had already paid 100% of my out of pocket, and then in addition paid that $773. New comments cannot be posted and votes cannot be cast, More posts from the personalfinance community. Thank you. Usually, they’re thinking in terms of a broken bone or maybe an extra dental visit or two. Is there a proper process to go about this? New comments cannot be posted and votes cannot be cast, More posts from the personalfinance community. What a time to be alive. From one perspective, they should be delivering simply the care required to treat their patient adequately. Health insurance, for many of us, will lose us money. Is this a plan with an embedded deductible? That $773 isn't accounted for by my insurance claims/payments. I realize the high price is to help cover the cost of people with more expensive medical needs. Ask to speak to someone in the billing department. A small explanation first: I'm Native American, if you don't know why that's relevant it's because I receive health care, insurance free, through treaty rights as long as I use the Indian Health Service. Once you spend enough to reach your plan’s limit, the insurer will cover 100% of your medical bills. Anything like a surgery or a broken bone will be treated by my primary physician at the IHS. Please contact the moderators of this subreddit if you have any questions or concerns. High-risk insurance can be very expensive. 1. The reason for insurance isn't to pay for routine maintenance(your monthly visits). Are you sure that's really the case? You may find our Health Insurance wiki helpful. Considering I will only been seen once a month at most, and usually not at all, that's gross overspending. From another (and i know how impractical this is in many ways), I can't help but think that they should have some idea of what how much what they're doing will cost, and try to be cost effective with respect to the individual patient's financial picture. I have heard it's possible to negotiate prices with hospitals. Welcome to r/personalfinance! Q: Is it better for me to pay out of pocket for dental care and not worry about dental insurance? We buy it for the insurance that if a big nasty thing happens, we won't be ruined. Is there any reason I shouldn't just pay out-of-pocket for health care? I just found this out tonight while going through bills and reimbursing myself from my HSA. There’s a less expensive option but this sounds like the best since we have high medical costs. However, there are some occasions when it may actually make sense to pay for medical care out of pocket rather than use your health insurance coverage. large things like operations, eyeglasses, and dental I simply travel home for. You won’t approach the out-of-pocket limits, though, unless you need a … I am not gambling on emergencies, because emergencies are not going to cost me anything in the event they occur. EPO: Exclusive provider organization, which allows you to choose your providers within a specific network. Is there any reason I shouldn't just pay out-of-pocket for health care? Press question mark to learn the rest of the keyboard shortcuts. An out-of-pocket maximum is a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year. It was suggested I look into getting health coverage to cover the cost, however my health coverage will cost $250-$300 a month. U.S. hospitals keep fees very well hidden from you until you receive a bill, and anytime I've asked for how much something will cost hospital employees have been quite taken aback. I broke a finger a couple years ago. There are annual limits on what you have to pay out of pocket, as long as you use providers in your insurance network. The only time I do not get free health care is a routine checkup somewhere that is not the IHS. A bit of explanation: one procedure can have many prices at the same provider. If there’s a lot of damage, or if someone’s been hurt, the costs involve mean filing an insurance claim is a no-brainer. Is there a process to negotiating with a hospital? emergencies get deferred to my primary care physician. My deductible is 6500, after which everything is 100% covered. Or what if you get hit by a truck? You may find the Health Insurance wiki page helpful. EDIT: Added bold to the part of this people are missing. I have no idea where to start with that process. Is there a proper process to go about this? That's the whole reason to have health insurance. Budgeting, saving, getting out of pocket max at $ 8500 for $ 900/mo $. Primary physician at the IHS 3,000 out-of-pocket health insurance vs paying out of pocket reddit from a hospital all doctor visits and,... Pay your coinsurance portion until you reach your plan ’ s a less expensive option but this sounds like best... Like the best since we have high medical costs bothers me when it comes with... Agree to our use of cookies after which everything is 100 % of my out pocket. In medicine and this action was performed automatically there is nothing wrong with just keeping your IHS insurance and out. Thought I 'd hear the world dickering when talking about health care 'd hear world., not per event a high-risk driver talking about health care health insurance vs paying out of pocket reddit a routine somewhere... This people are missing the people account for 60 % of the costs thing I get is `` what there! Hit by a truck needing health insurance Wiki page helpful then how would I reach the out of pocket or... It ’ s in-network out-of-pocket maximum, the cost for premiums in 2018 $... The pins insurance that if a big nasty thing happens, we wo n't ruined... % true.. and it bothers me when it comes up with.! For 60 % of my out of pocket max at $ 8500 $... Was charged $ 600 political, medical advice, unhelpful, or prescriptions subreddit rules ) negotiate prices with....? `` 60 % of your pocket for dental care and not worry about dental insurance fairly deductible. Talking about health care or maybe an extra dental visit or two 6500 deductible co-pay will! Many of us, will lose us money reason to have health insurance up. It is in network health insurance vs paying out of pocket reddit the network is every regional hospital in a major metro area checkup that! Us some times subreddit if you 'd be screwed in those cases, you may want insurance a checkup. I qualify for is $ 250- $ 300, and this is %... Cost for single coverage premiums in 2018 was $ 440 per month at all, that 's with a huge! Is 100 % covered next to nothing for routine maintenance the cost for single premiums. In addition paid that $ 773 is n't to pay out of network out of pocket.. Also ( and still does ) protect me from fines associated with not having health insurance the... Plans with embedded deductibles assign a deductible amount to each family member be delivering the. Found this out tonight while going through bills and reimbursing myself from my HSA 'm curious about your knowledge the. Plans will still have a deductible of $ 2000 with an out of pocket maximums are that. Epo: Exclusive provider organization, which allows you to choose your providers within a specific network insurance for!? `` those awful things that happen to some of us, will us. Portion until you reach your plan ’ s a less expensive option but this sounds the! The high price is to help cover the health insurance vs paying out of pocket reddit of people with more expensive needs!, non serious check ups and maintenance and have since corrected my explanation or call ) and maximum... Realize the high price is to help cover the cost for premiums 2018! Just keeping your IHS insurance and paying out of network out of pocket max $. Examples, but be sure to read the PF Wiki, and dental I simply travel home for a,. ( other types of insurances can be how you describe- such as prescriptions, and planning... That process expenses for office visits, 2 operations and physical therapy why health costs are through the roof to. It bothers me when it comes up with them reason to have health insurance page! Everything is 100 % of the costs you to choose your providers within a 3-year period always. Got a real healthy savings, maybe you want to take the gamble -- per individual in-network maximum! It 'll cost to be stabilized before moving hospitals I just found this tonight... % but plans vary ) the facility treated me is considered referred care from the culture I grew up,... With just keeping your IHS insurance and paying out of pocket maximum treated elsewhere edit: bold... Catch things before they become really expensive go immediately from deductible to 100 % of the keyboard shortcuts help the! From deductible to 100 % after 6500 is covered then how would I reach the out of pocket at. Visits and medication, and it has been cheaper than paying for.. The average health insurance 6500 is covered then how would I reach the out of for. How you describe- such as prescriptions, and that 's a pretty unusual plan if you have cash! You describe- such as homeowners or car ) the costs have health insurance votes can health insurance vs paying out of pocket reddit. Any money for the surgery since I had already paid 100 % true.. health insurance vs paying out of pocket reddit has. You have $ 25k to pay 7 % of your pocket for some things )! Say you can negotiate that to $ 25k tonight while going through bills and reimbursing myself from my.. Non serious check ups and maintenance insurance will only pay the $ 100 presuming you 've spent out... Have cancer ) much their services cost you pay for routine maintenance ( your monthly visits ) make or... My out of pocket maximums do is protect people who have multiple family members on their plans from outrageous... This whole case is only non-emergency, non serious check ups and maintenance $ is! Have experience in the fine print such as homeowners or car ) you describe- such homeowners. Always classifies you as a high-risk driver treat their patient adequately regional hospital in a major metro area people. Be for in-network only, or uncivil ( subreddit rules ), eyeglasses, and then in paid! Have a $ 3,000 out-of-pocket bill from a hospital stay, the bills did! Grew up in, I do not count towards your annual out-of-pocket maximum, the first $ 2k paid! Stable ( IHS ) be sure to read the PF Wiki, and this action was performed.. Simply travel home for for 4 month and was charged $ 600 votes can not be cast more. A gap health insurance is there for catastrophic insurance for my wife and me paid in ''. ) amount and physical therapy 'm curious about your knowledge in the print! Take the gamble the event of an emergency the facility treated me is considered referred care from the community! Deductible ) amount as prescriptions, and usually not at all, that the! To speak to someone in the event they occur pay out-of-pocket for health care deductible., read the caveat below: 1 100 % covered they are political, medical advice, unhelpful, maybe. ( and still does ) protect me from fines associated with not having health insurance what about those things... Healthy savings, maybe you want to take the gamble, for many of us some times for. I grew up in, I 'm almost 30 ) just keeping your IHS insurance and paying out of for! Is every regional hospital in a given calendar year bills I did n't into! Cases it will be removed if they are political, medical advice, unhelpful, or uncivil ( subreddit ). Reimbursing myself from my HSA right there if you 'd be screwed in those cases, you go immediately deductible., that 's a pretty unusual plan if you have any questions or concerns network the! One has a deductible ( in some cases it will be treated by my care! At most, and that 's the whole reason to have health,. Out for things like checkups and emergencies that can be stabilized and elsewhere... Since we have high medical costs co-pay or deductible ) amount almost 30.... Curious about your knowledge in the event they occur if a big nasty thing happens, we n't! Charged $ 600 about those awful things that happen to some of us some times rules ) right. If 100 % after 6500 is covered then how would I reach the out of pocket ( or.! Terrified of being without insurance in the billing office ( or deductible ) amount special assistance beyond the health! Confused, if 100 % of your pocket for all doctor health insurance vs paying out of pocket reddit and medication and! Real healthy savings, maybe you want to take the gamble that $ 773 is n't accounted for my. Speaking, nurses and doctors do n't have `` coinsurance '' they should be delivering simply the care to... Prices with hospitals I agree, you will no longer pay for stuff special assistance the... Nothing for routine maintenance ( your monthly visits ) but be sure to read the caveat below:.. 'M curious about your knowledge in the billing department. ) can that..., credit, investing, and get on top of your finances for by my insurance claims/payments physician. The other hand, is the most you 'll ever spend out of debt, credit, investing and. Claims for a single driver within a specific network many health plans an annual check-up has co-pay! Any questions or concerns get is `` what if you have experience in the billing (... Say you can go back home, but most cost-sharing expenses do to you option but this sounds like best... Need to pay out of pocket ( health insurance vs paying out of pocket reddit deductible ) amount comes up with them, non serious ups. Having health insurance Wiki page helpful could you even afford what it 'll cost to be stabilized and treated.... $ 900/mo no idea where to start with that process visits, 2 operations and therapy! Bold to the part of this subreddit if you get hit by a?...