Level easy discounts for healthcare needs

The FI person and Health Care

Level easy -

No matter what service you get always ask what the prompt pay discount is. If you are willing to pay upfront, the discount will be significant. One facility I worked at was 20% and another was 30%

I went to the website for a clinic here in the Seattle area and they even offered a prompt pay discount a of sorts on the sliding scale fee. If you qualified for the lowest step on the scale and If you paid at time of visit it is $15. If you met the lowest tier but asked to be billed it would cost $20 for that visit.

If you have a surgery, remember you might need to prompt pay the hospital/facility and the performing doctor and any specialist such as the anesthesiologist.

In the Seattle area we get a lot of out of town/country guests having babies. Our hospital had a quote for vaginal delivery of $15,000 with a prompt pay discount that brought it down to $11,000, facility charges only. At the same time, another area hospital quoted $17,000. But that included doctor, prenatal and a post-natal doctor visit and the anesthesiologist along with a few other things. It was a package deal of sorts.

And package deals are common on everyday services. You do need a doctors order for the visit, but a colonoscopy or a mammogram (along with other regular services) should have a package rate that may be lower then the prompt pay rate.

Going to a standalone/free standing clinics for things like injections, colonoscopy, lab or diagnostic tests can also reduce costs significantly. You might also save on using the doctor’s office for injections. You could have the infusion/drug delivered directly to the doctor’s office and avoid the buy and bill upcharge at a facility. These are things to plan. Don’t have a $4000 drug shipped to the doctor and then explain what you want to do after the fact. No one will take a drug that is hand delivered for injection. And the injection may be more then the office can handle.

Level hard - Where the cost of not having insurance is the emergent services.

Cardiac cath $100,000 for a 23 hour visit and its not like you can wait and ask for quotes. Or $23,000 for that retina detachment. And $70,000 hip fracture (or any fracture) has a couple weird things that could put your life or recovery at risk if you wait.

This is where the contracted rates along with max out of pocket come into play. Lets say hospital number one gives you a 30% discount for the cardiac cath of $100,000. Now your surgery cost you $70,000.

If you paid an $800 a month premium on the exchange for a commercial insurance, it would take you 7.3 years to offset $70,000.

But if you paid the insurance you would only pay the out of pocket of $6700 with a high deductible plan, and that plans contracted rate, which some are in the 65% range – dropping the cost to $65,000. And if you had that H S A already stacked, you could pay the $6700 without touching the FI money.

The Medi-share programs.

They are cheaper, but I have seen someone have a $15,000 surgery and even a year later they were having issues with getting the bill paid. Also, you need to be in a very narrow demographic to qualify. There can be a pre-existing condition clause. Most will not pay for everyday screening and doctors visits. So you still have to look for those prompt pay discounts for your out of pocket.

There are other products out there that claim to be insurance, but they don’t cover anything. Had one card presented to me. It had MEC in the group number. For a cardiac cath this MEC plan would pay the patient $500 a day for up to 5 days. Cardiac cath is a $100,000 procedure. After the insurance the patient would only have $97,500 left to pay.

There might be other insurances for high net worth individuals that I don’t know about. I know there are concierge doctors and practices. They cost more than if you paid out of pocket for your regular doctor once a year. They may even charge you a monthly fee to be part of the group.

I have a lot of questions of my own to answer related to the idea of insurance and the FI concepts. There are a lot of priority things to do the next couple of weeks for me, but I am going to put on the calendar to look at the FI health insurance question. And I will ask questions of the people I know at work what they think is out there that I have not heard of.