Your Medical Expenses - Pay Cash

RicInOR · May 24, 2018

So, I'm not an accountant, but I do have a pretty decent math background, and applying only the tiniest bit of advanced math, I realized that meant they were giving me roughly a 92 percent discount for paying cash. Or, looking at it the other way, that the insurance company price was marked up roughly 1200 percent.

How to Reduce Healthcare Costs by 92 Percent

For those of you on ACA
For those of us with Cadillac plans, use a health savings plan, and pay cash.

clearconscience · May 24, 2018

I have a friend who's family is fairly well off. The dad is a lawyer, and they have 3 boys. They have never had healthcare. Boys are out of high school now.
They just paid cash for everything.

WWShooter · May 24, 2018

That's because billed charges are a fantasy. Look at any EOB (Explanation Of Benefits) you get from and insurance company and you'll see that the billed amount is often 2, 3, 4, 10 times higher than the amount the provider actually accepts for full payment. The system is rigged so that those without insurance (or the ability to negotiate in advance) pay the most.

The Heretic · May 24, 2018

Use the HSA to pay the deductible/out of pocket and IIRC you can use it to pay for premiums too?

The problem is once you go on Medicare, you cannot contribute to an HSA anymore.

My employer was just absorbed by a larger outfit, and now we can do HSAs. I will start one next year when I switch over (or maybe this year - have to check on that). The good thing is once you have an HSA you can take it with you, and after age 65 you can use the funds for anything (but then you have to pay taxes on the withdrawls that are not for healthcare) - but I will use them for healthcare.

This year I have almost $25K in healthcare expenses, about 20% of which are my out-of-pocket/deductible. I expect more expenses to come before the year is done, but I am approaching my max out-of-pocket so once I get there I should have much less to pay. So now is the time to do all the expensive stuff; having a sleep study done, and an endoscopy for my GERD - both pretty expensive.

When you get old is when your health insurance investment starts paying off.

NW Backpacker · May 25, 2018

RicInOR said:
How to Reduce Healthcare Costs by 92 Percent

For those of you on ACA
For those of us with Cadillac plans, use a health savings plan, and pay cash.

First comment under the article nailed it: They should post a list of cash prices for the various procedures. Would be good if they also posted the "with insurance" price.

Such a simple thing. If posted on the internet we could force lower prices through competition.

Congress and the president got rid of the ACA penalty tax, but I think it's still basically illegal for an insurer to offer non-ACA compliant policies. We need free market, no state or federal rules, buy across state lines policies for those who prefer them. Keep the ACA for those who want it. Win/win for all. Easy. They can't accomplish this simple task. Pathetic.

Geardo · May 25, 2018

I dump as much as I can afford into my HSA. Trying to build up a couple years of max out of pocket.

The Heretic · May 25, 2018

Taco_lean said:
I dump as much as I can afford into my HSA. Trying to build up a couple years of max out of pocket.

Wise action. I am going to put the max in, including the extra I can for being a decrepit old codger. Figure it will at least save me paying taxes on that money and I know that I will spend it sooner or later for one healthcare expense or another.

It always pays to put resources aside for a "rainy day". I have yet to regret doing that. As I get older the "rainy days" become more frequent (even though it is usually my daughter that I am helping). When I started out to be an adult, very few people had health insurance, mostly only people who worked union or government jobs, or "professionals" working white collar jobs for large corporations - today even burger flippers get insurance.

One of the reasons I don't retire right now is because I would not have health insurance. Come next summer I will turn 65 and at least have Medicare.

Member 5605 · May 25, 2018

If they just opened up 'insurance' across state lines prices would drop.

billdeserthills · May 25, 2018

WWShooter said:
That's because billed charges are a fantasy. Look at any EOB (Explanation Of Benefits) you get from and insurance company and you'll see that the billed amount is often 2, 3, 4, 10 times higher than the amount the provider actually accepts for full payment. The system is rigged so that those without insurance (or the ability to negotiate in advance) pay the most.

I believe you, but in my state of Arizona, nobody can place a lien on real property you own, for medical bills, so in other words I pay what I like and the bill collector can mail & call all they want, cause I just don't give a damn

clearconscience · May 26, 2018

I remember getting a ace bandage for a rolled ankle years ago.
I think insurance was charged around $120, for a $5 ace bandage.

I use a HSA and usually put enough to cover the years copays. Bought new glasses last year.

We take the kids to the doc fairly often. So it helps

The Heretic · May 27, 2018

RicInOR said:
How to Reduce Healthcare Costs by 92 Percent

For those of you on ACA
For those of us with Cadillac plans, use a health savings plan, and pay cash.

If I remember correctly, you can only get an HSA if you have a qualifying high deductible insurance plan.

Also, just got an email notice of more billings/benefits from my insurance co.; I have met my max out of pocket of $4500, and they just paid some of the billings; another one from a hospital for $15K, where they allowed ~$7500.

I also noticed that specialists (like cardiologists) charge a lot more for an office visit; like about $500 v. $100 for a GP.