Insurance vs Cash Pay for Health Care?
Michael Reagan, CBPA
Prescription Drug Savings | Making all FDA-Approved Medications More Affordable for Organizations & Individuals | A Practical, People-First Solution that Makes a Daily Impact in Our Subscribers Lives | Enjoys Traveling!
This article includes an update to the Blue Cross & Blue Shield settlement.
In addition to not having to deal with an insurance company, there are several other advantages of having a cash pay health care network over a PPO.
One advantage is that cash pay networks often have lower administrative costs compared to PPOs. This is because cash pay networks do not have to deal with the administrative burden of negotiating contracts with insurance companies, which can be time-consuming and costly. As a result, cash pay networks can often pass on these cost savings to patients in the form of lower healthcare costs.
Another advantage of cash pay networks is that they often offer more personalized care compared to PPOs. This is because cash pay networks typically have smaller patient populations, which allows healthcare providers to spend more time with each patient and provide more individualized care. In contrast, PPOs often have larger patient populations, which can make it difficult for healthcare providers to provide personalized care.
Cash pay networks also offer greater price transparency compared to PPOs. With a cash pay network, patients know exactly how much they will be paying for healthcare services upfront, which can help them make more informed healthcare decisions. In contrast, PPOs often have complex billing systems that can be difficult to understand, leading to confusion and frustration for patients.
Finally, cash pay networks often have shorter wait times compared to PPOs. This is because cash pay networks do not have to deal with the administrative burden of processing insurance claims, which can be time-consuming and delay healthcare services. As a result, patients in cash pay networks often have shorter wait times for healthcare services compared to patients in PPOs.
Insurance companies provide the illusion that by using their in-network providers you will save money. However, during a March 6, 2023 Benefits Pro magazine article, it states "An ERISA class action suit has been filed against Cigna Health and Life Insurance Co. in Connecticut District Court, alleging the insurer is?overcharging?for medical services.
Arizona citizen Aubrey Srednicki, the named plaintiff, has a health care plan that claims Cigna negotiates lower rates with in-network providers to help those insured with Cigna to save money, the complaint said.
However, the plaintiffs allege that Cigna has participated in a “fraudulent scheme,” and the proposed class members did not save money, and were overcharged for medical services."
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In September of 2022, AMA and others joined a lawsuit alleging Cigna overcharges by ignoring discount contracts
“Patients and physicians have a right to expect health insurers to uphold their promise to provide fair and accurate payment for medical services,” says Dr. Jack Resneck Jr., president of the American Medical Association.
In October, 2022, the Erie Times-News wrote: "It's been two years since more than 35 Blue Cross Blue Shield health insurance plans, including Highmark, reached a $2.67 billion settlement after they were sued over claims that they violated antitrust laws.
Yet people who filed claims still haven't received any money, and it's still not clear when they will.
The U.S. District Court overseeing the settlement of the class-action lawsuit granted final approval on Aug. 9. However, three employers — including Home Depot — have filed appeals because of objections to the settlement, according to Reuters and the settlement's official website:?https://www.bcbssettlement.com." Here is an update to that article: https://www.bcbssettlement.com/
In summary, there are several advantages of having a cash pay health care network over a PPO, including lower administrative costs, more personalized care, greater price transparency, and shorter wait times. These advantages make cash pay networks a viable alternative to traditional PPOs for patients who are looking for greater control over their healthcare decisions and expenses.
In today's complex world, with inflation driven costs, we can all use some Health Care Relief. To learn how to access low-cost health care and prescription drugs without using insurance, contact the author of this article, Michael Reagan, at [email protected] or go to www.BenefitFixes.com
*RETIRED* CDI auditor and trainer, certified in-patient coder. Supervisor mortality and heart failure reviewers, member of coding education team.
1 个月If enough people with high-deductible insurance called around their area for the lowest cash price for their prescribed medical test (CT, MRI, lab etc), and chose to pay cash there without telling their insurance company, who would stand to lose the most money, and why? And why don’t more people with high-deductible insurance ask around for the lowest cash price for their health care??