This week are going to talk about a specific way to save on insurance by NOT always using your insurance plan, if you have a high deductible, are healthy, and don’t plan to meet the deductible at the end of the year. If you do have health concerns or upcoming surgeries, next year, it may be wise to think about changing your plan to a lower deductible if you know you’re going to have high usage.
Let’s discuss one instance where you can save money on health insurance by not utilizing your insurance, and this is labs. Labs are one of the aspects of health care where the labs charge exorbitant fees for tests that do not cost them very much to run. If you remember from one of my previous blog posts, you will know that I managed medical offices for 25 years. And in those 25 years, I handled lab billing. A lot of what I learned had to do with how the labs bill the doctors for their services. Primary care doctors and even specialists have agreements with certain labs where the lab can bill the doctor directly for a service instead of billing the patient. The doctor then needs to upcharge for the test because they are reading the results, and that takes their time. This makes sense. However, the insurance companies, if you ask the labs to bill your insurance directly, often charge exorbitantly more than the doctors do. Knowing this can save you a lot of money.
An example of this is a lipid panel, which is a test for cholesterol. If you were to go to any of the big labs, you would probably pay at least $85 for a lipid panel. If you say you have insurance, they would charge your insurance $85. – which usually would be an out-pocket cost for you since you have a high deductible.
I’ll give you a little inside tip- do you know what they typically bill the doctor’s office for a lipid panel? $3. Yes, you read that correctly. .$3. Consider that the labs are making money, otherwise they wouldn’t charge the doctor for $3. I’ve been told by someone who used to price labs, that labs don’t even cost a penny). This of course refers to most basic labs, I’m not talking specialty lab work because those can be expensive. Knowing the labs bill the doctor $3, I would suggest that you go to a doctor that lets the doctor’s office bill you for the labs which cost would usually about $200 (upcharge for their time).
Because if I had allowed the lab to bill it to insurance, it would have been $1,900! Crazy, right? Paying the doctor $200 instead of receiving a bill from your insurance to pay $1900 is really a good deal because if you had a plan with a large deductible, that’s not going to be covered and the labs would be out of pocket. You’re really saving a lot of money by allowing the doctor to bill those labs, and then just paying the doctor directly and not utilizing your insurance.
This sounds crazy – but this exact thing has recently happened to a client of mine. She wanted to use her insurance, because she didn’t understand how this all works, and got the lab to bill her insurance. So, agreeably, paying the doctor directly does not go towards her deductible, but she is healthy, has no planned surgeries, and doesn’t intend to meet her deductible this year. This makes a lot more sense for her as she’s saving around $1700 on the bill.