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Saturday, July 9, 2022

Game Changer Paying for Healthcare!

 Good morning!  

I know it's been a while.  I've had a lot on my plate, but I had to share something I just discovered!

***This is my disclaimer.  I can't say all insurances do this.  Ours does.  I can say it's worth it to give them a call, and it's worth it to price compare between paying for a medical service yourself or having your insurance pay it for you.  What follows has been a slow start to a rapid eye opener I can tell you.  

You guys know I switched to a new Primary care physician about 8 months ago.  I haven't regretted it at all.  He doesn't file insurance, but is instead a direct pay for services physician.  It's amazing the kind of care you get when the Doctor in question knows his livelihood is dependent on doing a good job.  Plus he's awful nice and just a good all round doctor.  

Anyhoo, I've had bad circulation in my legs for years; my left leg being the worst offender.  Ah the joys of motherhood, obesity, and jobs requiring long hours on your feet.  The bad circulation got to the point where my left leg was aching and heavy.  My Doctor referred me to a vascular surgeon in my area.  My husband and I have a health insurance plan that's a High Deductible plan with a Health Savings Account.  That means our insurance does very little until our deductible is met.   It does, however, have negotiated amounts with physicians in their network; what they call "Usual and Customary".  Mistakenly, this vascular surgeon's billing office filed a claim with our insurance company, even though I was referred as a self pay.  The claim was around $450 for the doctor visit and $430 for the leg scan.  The insurance came back with a negotiated amount of $330 and $327.  $657!!!!!  Of course when I noticed this, I spoke to the Vascular Surgeon's office about it.  One of the best moves I've made!  The office corrected the mistake, and instead of the $657 the insurance said I should have to pay, my bill became.....$236.  I saved $421 dollars by NOT filing with my insurance!

BUT!  It gets better!  The procedure to fix my leg would be a self pay amount of $1268.  That's high I'll grant you.  Fortunately we have the amount in savings and some in our health savings account.  Not gonna lie, it about wiped out both.   Got to pull out the Black Belt Frugality measures to refill the emergency fund as fast as possible.  The repair needs to be made, however, because, with this bad circulation, I'm at risk for blood clots.  So there is that.  I knew I was going the self pay route, but hated the thought of so big a bill not going towards my deductible.  So I called the insurance company.  I asked if I can submit the receipt to go towards my deductible.  I was told I could, but to do so I would need to file a claim.  This means I get the best of both worlds.  I get the discount of being self pay, and the payment for services going towards my deductible!  In fact, had I paid more than my deductible, they would reimburse the difference!  

Why aren't customers told this!!!!!!!

So lest I lose you with a bad explanation; my point is this:

1)  Always ask what the price is for a self pay patient. Self pay is usually less than what insurance says is owed

2)  If you opt for the Self pay route; check with your insurance carrier to see if you can file a claim yourself to have the amount paid put towards your deductible.  

3)  Health Savings accounts are awesome things.  

A)The money comes out of my husband's paycheck pretax.  That means it comes out before they figure the amount of  taxes for that pay period.  It lessens the amount of income we're taxed on.  That means the $150 we have taken out of his check for a HSA isn't reflected in $150 less on his paycheck.  It's like paying $120 for a $150 gift card! 

B In addition, that money is never taxed as long as we use it for Medical/Dental/ Prescriptions, and even some over the counter things.  

C)  Also, as with any saving account, we do accrue interest if we leave it in the account.  We'd like to get back to that, but for now, the account still serves us well.  

D)  This account will go with us where ever we go.  When my husband retires, that account is still ours.



It's worth checking into.  

We're doing this from now on!  

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