Giantaxe

Sure... there's no requirement that a claim go through a health insurance company:- it merely has to be unreimbursed and abide by IRS guidelines as to what is a covered expense.

cautiousjon

Exactly. However, a lot of people at my company prefer to not reimburse from their HSA and instead use it as another retirement account. In our HSA we can invest the money in certain funds, and the money will grow Federal tax-free.

morpeth

I would recommend caution whenever deciding to pay cash - I have seen circumstances where doctor's office will give you a quote, but often they might end up charging less if you they submit claim to insurance company, even if insurance company then says you have to pay as part of deductible. I have come across this several times, usually with hospitals. Though I also saw an interesting situation with someone with a high deductible plan. They needed an operation and cost was 50% less if they paid in cash as opposed to it being billed to their insurance plan, so they paid cash. Following year they had another family member who needed operation, this time worked in reverse- they chose to use insurance instead of paying cash, but for some reason because insurance used, the insurance company got a reduction below what they would have paid in cash at time of service. Crazy system.

ChocolateBabz

It's nuts right? After I spoke with my friend I was googling around to see if she was right and I did come across a few stories where (for example) an MRI was $1200 with insurance but only $400 if you paid cash. I also saw a few articles saying that if you told the doctor you had insurance they were somehow obliged to charge you the insurance rate. It's a great big stinking scam anyway you look at it.

Like I said I'm just mad because I liked the facility I was using (and their network of facilities) and now I have to go somewhere else. We are with a well known insurer and have a PPO and that's two of the top medical providers off limits to us...grumble...grumble....

morpeth

System makes no sense whatsoever, everyone knows that, but continues in this crazy manner, same with so many issues in US.

I went for a prescription recently, as doctor recommend wasn't working well and doctor said take twice the dosage then go in for a refill ( usual cost $2 , if one didn't have insurance $20). Pharmacy would not fill prescription at first because insurance company wouldn't allow it ( because taking twice the dosage it was 5 days before the original prescription expired)- pharmacist then told me it would be more expensive if I paid myself- I was expecting $20, but she said $4 since I had insurance,so I was fine with that.

Pulaski

Take a look at what prescriptions cost on goodrx.¢om - I have seen the same antibiotic range in price from $20 to over $120 at different pharmacies within a few miles of each other.

DebzinUS

Cash isn't always king in healthcare. I have worked in the US health system for the past 30 years. We classify individuals without insurance as being "Self pay" or more affectionately - "no pay." Self pay is considered the worst status. One of my jobs as a director was to identify self pay patients, and see if they would qualify for indigent care, usually emergency Medicaid or Hill-Burton Funds.

Having health insurance of any kind is no guarantee that a hospital bill will be paid. I am still fighting my husbands hospitals bills ( >$1mil). He died in 2014 after a 3 week illness.

mrken30

BCBS also dropped Providence/St Josephs for next year. It happens on cycles. Hermann Memorial may now take BCBS again.

chawkins99

My company has just changed from United Healthcare to Aetna as of August 1st.

UHC tried to force us to use their online pharmacy (OptumRX). We had several medications through them.

Today, I got an email from OptumRX. They have processed the order for my wife's Zolpidem (generic for Ambien). I can only assume it was an automatic refill.

The cost: $416. Cost from Walmart: $10.

I immediately called them and cancelled the order and told them to remove my credit card from the account.

ChocolateBabz

This is exactly the crap that needs to get sorted out, other people would just pay up and be robbed blind.

morpeth

I heard that a very significant percentage of personal bankruptcies in the USA come from inability to pay medical bills.

thinbrit

Premiums have always gone up. They are going up more because of ObamaCare.

The naive idea behind this ill conceived act was a new minimum coverage that covered a lot more things, with the cost being shared between high and low risk members. What happened is a lot of people who had previously been paying high premiums got reduced premiums or got better coverage and all the healthy and young people didn't sign up as expected.

My pre Obama health plan (the one Obama promised I could keep) was suddenly not compliant with the new act. They added more areas of coverage that I didn't want to mine and others plans, then raised the premium to pay for it. When socialism fails....

As a small employer who offers health by choice and not as a legal requirement it hurt me a lot. Suddenly my contribution to the employees plans sky rocketed.

morpeth

Your points are very valid. I had an individual policy pre Obama that was costing $400 a month, after ACA premium went to $1,100 per month for same plan.

The ACA was ill-conceived policy but, the ACA did give coverage to several million who otherwise wouldn't have had coverage. However I put the blame on both the republicans and democrats who cannot agree on a better system and don't have the political courage to attack the outrageous costs of medical care in the United States.

scrubbedexpat099

But but think about the donations received!

Steerpike

HD plans with HSA are clearly an improvement over other types of plan, but in her case, her issue is availability of doctors/medical facilities willing to take BCBS. Further - using tax-free money is more of an advantage if you are a high-income earner. 'Tax free' when you are lower on the scale is less of a benefit.