Tip #6 to Spend Less on Healthcare – Ask your Employer to Pay your Deductible
Josh Luke, Ph.D., FACHE
Healthcare Executive - Tap website button below for healthcare trends podcast: 2024 Topic is GLP-1 Ozempic
Yes, the title is correct. If you choose a Center of Excellence, or in this case a preferred provider or in-network facility, over an out of network provider for a surgery, hospitalization newborn delivery or procedure, while going out of network could cost you and extra $5,000 in out of pocket costs, the costs to your employer could be six times that. No joke!
When given a choice of in-network or out (in network is sometimes referred to nowadays as a ‘Center of Excellence’), if you are paying a higher share of costs, then your employer is as well. So tip #7 is to ask your employer if they will pay your deductible for a procedure if you pick a specific in-network facility or Center of Excellence. It's worth a try and your emloyer would not be the first who said yes!
And if you have not already downloaded all of the Ten Free Tips to Spend Less on Healthcare, text “JOSH” to 72000 for an immediate download and start saving today. And don’t forget to take three minutes to complete the Personal Spending Reduction Tool online at SpendLessOnHealthcare.com to see if you qualify for our $5,000 annual savings guarantee.
So let’s go into more detail here. You or a family member needs surgery. You have a high deductible plan requiring you to pay the first $5,000 of care for the year. When it comes time for your procedure, if you choose an in-network facility or Center of Excellence your out of pocket costs are $2,500, but if you choose the big, shiny hospital on the hill that your spouse wants you to go to because he or she believes (like most Americans that bigger and shinier) is better, then your out of pocket costs are $5,000.
This is a great opportunity for you to approach your corporate Human Resources Director or benefits consultant and ask them if they would be willing to pay your $2,500 out of pocket cost if you chose the in-network facility or Center of Excellence for the procedure. Ask them to confirm and share with you both your personal costs and the cost to the company at each of the possible hospitals or healthcare facilities. Often times your benefit consultant will not understand your request or the benefit until they actually document the costs to both you and the company, at each of the potential facilities. They are often shocked and pleasantly surprised as to what they learn as well.
Why would your company do that? Let me explain.
Your cost double if you do not choose the in-network facility or Center of Excellence. Let’s assume your employer’s costs for the procedure double as well. The main difference is that are usually paying about 80% of the actual cost of the procedure. Thus, in this case if you choose the in-network facility or Center of Excellence their cost would be $10,000 but if you went elsewhere their costs could be as much as $20,000.
So if your company paid your $2,500 deductible, they would actually save themselves $7,500.
Now imagine if this was a major procedure and their savings could be more than $40,000? It happens all the time. We call this becoming an EHC – an Engaged Healthcare Consumer. When you engage in the process and have this type of educated discussion with your employer, you are guaranteed to start saving significant dollars and eliminating wasteful healthcare spending for your family.
There are exceptions to this rule as every company is different, and some contracts prohibit this type of steerage. Things get particularly trick if you are covered by a PPO – but that does not change your task. Your task is to ask, inquire, check and hold your human resources or benefits consultant accountable to identify and provide these costs to both you and the company in advance. That’s it!
So if you have not done so already, implement all of the Ten Free Tips to Spend Less on Healthcare, by texting “JOSH” to 72000 for an immediate download and start saving today. And don’t forget to take three minutes to complete the Personal Spending Reduction Tool online at SpendLessOnHealthcare.org to see if you qualify for our $5,000 annual savings guarantee. Also, to learn more about our not-for-profit foundations recommended savings partners, check out the Preferred Partners Portal at SpendLessOnHealthcare.org.
The not-for-profit Spend Less on Healthcare foundation was created to provide independent resources for American families and businesses to learn how to eliminate wasteful healthcare spending and live a healthier lifestyle. Company's interested in supporting and being featured on www.SpendLessOnHealthcare.org can email [email protected].
The author of this story, Dr. Josh Luke is a former hospital CEO, award-winning healthcare strategist, Futurist, and Founder of the Spend Less on Healthcare Foundation. Dr. Luke is also the author of the Health-Wealth book series, including Health-Wealth: Is Healthcare Bankrupting Your Business? and Health-Wealth for You: 11 Steps to Save Big & Live Healthy (both Amazon #1 Best Selling titles) and host of Spend less, Live Well on the Dr. Josh Luke YouTube channel and on all main podcast outlets (audio only). Join the movement and visit www.SpendLessOnHealthcare.org today!