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Funny Thing About Having Health insurance

Daniel Paull MD shows us how you can be punished for having health insurance.

February 28, 2023

A funny thing can happen when you have health insurance.

Let’s say that you have a high deductible, and that you and your family are healthy and you don’t plan on meeting your deductible. Also, let’s say you only have a month left before your deductible resets for the given year.

You need a small procedure done, and being the smart person you are, you ask what their cash price is, which comes out to something reasonable.

You get the procedure done, and then find out that you owe thousands more than the price that they quoted for cash. When you ask why, they tell you that you have insurance, and with your insurance that is what you have to pay.

Well, you say, why can’t I just pay cash? And they tell you that they are contractually bound to run it through your insurance, even though the insurance negotiated rate is much higher than what you would have paid with cash.

You call the insurance company, who then tells you that their right to negotiate supersedes yours.

Part of this is because they want to spend more because they can only keep 20% of premium dollars. The more they spend the more they get to keep (80/20 rule from the ACA).

The end result is that you and your company paid thousands upon thousands only for you to get a raw deal when getting medical care.

Punished for having health insurance? Exactly.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com. Do you have a compelling personal story you’d like to see published on SoMeDocs? Find out what we’re looking for here and submit your writing, or send us a pitch.

All opinions published on SomeDocs-Mag are the author’s and do not reflect the official position of SoMeDocs, its staff, editors. SoMeDocs is a magazine built with the safety of free expression and diverse perspectives in mind. Do you have a compelling personal story you’d like to see published on SoMeDocs? Submit your own article now here.

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