Wednesday, August 5, 2009

Medical Insurance Or Cash? Which Is Better?

I got up bright and early for my skin cancer surgery appointment this morning. I had to be on the other side of town by 7am. I checked in and helped myself to some free packets of oatmeal and hot chocolate.

You see, my old dermatologist stopped taking my insurance last Spring. After much searching, I found the Cancer Center which does take my insurance. I went there in May and they took two biopsies. One came back as a basal cell skin cancer but they do not do the MoHS procedure which is used in these cases. They referred me to Dr. Smith who specializes in the MoHS surgery. The Cancer Center told me that he took my insurance. I waited two and a half months to get an appointment and went in this morning. AFTER they had numbed my head, the billing lady came in the room and said, OOPS, we don’t take your insurance after all. The Cancer Center had written down a different branch of my insurance, not the one I have, and Dr. Smith accepts that other branch but not mine.

So, the billing lady said that if they were in-network it would cost me around $1,000 but since they are out of network it will cost me around $2,000. She gave me the option of leaving but I didn’t want to start my search over after all of this so I asked her what the cash price would be. She came back with a price of around $1,000. I said fine and they finished the procedure. The total bill came to $1,042.

I contacted my Human Resources representative to see if there is anything that she can do for me. Maybe it can go towards my deductible or I can get some money back from the health insurance allowance we get each year. I don't know. My insurance is complicated. Maybe that's why so many doctors refuse to accept it.

It is only because I have read so many stories on other personal finance blogs, and know a few people who have tried it, that I thought to ask for the cash price. I am glad that I did. For a second I thought I was going to cry because my insurance is so frustrating. Luckily the cash idea popped in to my head and also luckily, I have the means to pay cash. The billing lady was happy, the doctor was happy and I was happy. Now I just have to squeeze $1,042 out of my budget. I think I'll be eating beans and rice for the rest of the year.

14 comments:

Over the Cubicle Wall said...

I don't follow politics much, but I wish somebody would find a way to make health care easier and more consistent.

I hope the actual work they did for you went well.

Daizy said...

There is much too fix but I'm afraid I don't have much faith in the government to do it. Glad they are trying though.

The Dr. and office were great. I've had 2 skin cancers removed from the same side of my forehead. I need to have one on the other side to even it out before I get a permanent quizzical expression. :P It's like a mini lopsided face lift. (I'm looking on the bright side here)

Lizzie said...

You make me feel better about the NHS, for sure. Although my dad has been witing months for somethng that sounds very similar. I was hoping for botox for my migraines to look young again with be vain, on the subject of face lifts!

Mark said...

You'll be able to deduct the $1042 either way as a medical expense.

Petunia said...

Daizy,

Does your employer realize that your insurance is not widely accepted?

Mark,

Medical expenses have a floor of 7.5%. You must spend 7.5% of your AGI first, then amounts over that are deductible. Unless Daizy has many other out of pocket medical expenses, there is nothing to deduct.

Daizy said...

Lizzie, my nephew had botox injections in his legs for cerebral palsy. Made his legs look so young (or maybe it was because he was only 8 at the time).

Daizy said...

Mark, it would be nice if I got some sort of deduction but since the mortgage interest on my rental house isn't deductible, I never get any where near the standard deduction level. I guess that's a good thing really. I'd rather not have a lot of medical expenses.

Daizy said...

Petunia, I hear it a lot from coworkers that our insurance is great until you have to use it. It's very cheap. I just wish they would update their provider catalog once in a while. I bet 3/4 of those listed don't accept the insurance. When trying to find my dermatologist it seemed like most of the numbers were disconnected.

rinter said...

Daizy your insurance does remind me of some cheaper auto insurances out there where the plan sounds great but once you get into the accident the nightmare of getting the claim paid begins. I had no clue about cash basis. Why would it be cheaper than out of network insurance? Does that seem flipped?

Daizy said...

rinter, maybe I got the 'I'm going to burst in to tears' discount. I can imagine a weeping woman leaving through a waiting room full of patients would look bad. Haha, no, but really, I am not sure. I know that when I have looked at my explanation of benefits before, my insurance severely discounts all of the charges. Up to 75%. The billing lady said the total cost of my little surgery was $4k so $1k would be 75% off and they got paid right away, no extra staff time, no paperwork and no waiting period. A good deal for the doctor I think.

KoBold said...

Compulsory nationwide health insurance does have dark sides, drawbacks and problems, but it is for sure much less complicated.

bugbear said...

@ "The billing lady said the total cost of my little surgery was $4k so $1k would be 75% off and they got paid right away, no extra staff time, no paperwork and no waiting period. A good deal for the doctor I think."

So the extra $3000 is what it costs them to do paperwork?? Clearly the "cost" of the surgery is well below $4000, so why are they billing the insurance company for $4000?

There is so much that seems wrong about insurance billing in general, and this is one of the things that is wrong with it.



LOL

Daizy said...

KoBold, we will rise to the challenge and make it more complicated than it needs to be. That's a promise!

Daizy said...

bugbear, I don't know what kind of deal insurance companies have with doctors but some of my old bills say stuff like: charge $100, negotiated amount $15. Somehow the insurance company pays a tiny amount. Maybe the prices are inflated to get more payment. It's crazy.