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Cash Rates vs. Health Insurance Rates

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Not long ago, health care providers charged patients their highest rates. But according to a recent article, a new trend in healthcare is emerging: instead of using health insurance, consumers are paying cash to score deep discounts at hospitals and outpatient surgery centers.

What’s causing the shift? First, new state and federal rules are now in place to protect the uninsured from price gouging–a pejorative term referring to when a seller raises the price of a service or commodity to a level considered unreasonable. Second, many hospitals are saving on administrative and collection costs by offering day-of-service discounts to patients. Cash discounts are unofficially geared toward the uninsured, but no one who is insured is legally required to use it.  As deductible costs continue to skyrocket, both the insured and uninsured are taking advantage of the cash option.

While cash payments typically do not count towards deductibles, many consumers are willing to take the risk for the opportunity to actually afford their healthcare costs and mitigate bad debt. Just how significant are the savings? For a routine tonsillectomy performed at Banner Desert Medical Center in Mesa, AZ, the insurance rate is $5,442. The self-pay rate? A steal at $2,858. Similarly, an MRI of the foot at Regional Medical Imaging in Flint, MI is $445 through insurance, but a reasonable $379 at the self-pay rate.

As Wisconsin’s only independent and completely insurance-free Direct Primary Care clinic, Solstice Health is ahead of the curve. Since day one, we have made it our mission to put the control back in the hands of our patients by offering Direct Primary Care memberships. Among other benefits, memberships offer unlimited access to the primary care physician and may be paid tax-free from an HSA. The payoff? The best, most affordable, and most convenient care possible.
To learn more about our Direct Primary Care memberships, call or visit our office today.