YSK: Even if your health insurance has a very high deductible, you still have access to incredible discounts

Many people feel their health plan is useless because they have a very high deductible. While it may be true that until you meet your deductible, your plan will pay nothing, there is one very important thing to note. When the service gets billed through your insurance by an in-network provider, they apply a very large discount.

For example - I needed a PET scan of my brain recently. My plan has an $8000 deductible, so I knew I was on my own. I called around to a few local hospitals and radiology centers to get their cash price. The range was $3500-$8000. Then I went to my insurance website and located a list of in-network providers, along with estimates for the cost of the PET scan. I chose the lowest one, at a local reputable facility.

I just received the statement from my insurance company:

• Amount submitted to Insurance - $5500
• Approved amount $1087
• Applied to deductible $1087
• You owe $1087

So even though my insurance paid nothing, I saved thousands of dollars by having access to their negotiated discounts. I ended up paying far lsss than any cash price I was offered. Since the provider is in-network, they can only bill me the $1087, and nothing more.

A few more tips:

• Check with your insurance to see if their website allows you to compare the discounted rates with different providers in your area. My insurance did that, allowing me to pick the one with the lowest rate

• If you have a large deductible for your medicines, check the price with your insurance, then head over to GoodRX. While Cigna does get discounts with your local pharmacy, some drugs are cheaper than others. GoodRX compares discounts from many different pharmacy discounters, so often times, you can actually get a much better price using the GoodRX coupon than going with your insurance. The main caveat with GoodRX is that it won't go through your insurance, so what you paid wont get credited towards your deductible. Still worth it if you end up saving tons.

• With most insurance companies, if you are seen by a doctor that is not part of the plan, and it was not under your control, you can call them and they will pay that bill under your in-plan benefits. This includes the doctor that saw you in the ER, the ambulance, the anesthesiologist that treated you in surgery, etc. They won't pay the bill correctly right away, you have to call them after you get the bill and request it

• Hospitals are almost always significantly more costly than private, dedicated providers. If you have to have blood work, xrays, surgery etc., you are always going to get a better rate if you go to a private lab, private surgery center, or local x-ray facility. Your doctor will probably give you paperwork and send you to a specific hospital for your blood tests or xrays. Don't get pushed around. You are the patient, you have the right to choose where you get treated. Check with your insurance and pick a provider that is in the plan that is not a hospital and your cost is almost always significantly lower. From my experience, Quest Diagnostics and LabCorp have much lower discounted fees for blood tests than the lab at your local hospital. Find out from your insurance if they are in your plan.

Source: My wife used to work for Blue Cross - I can't do a formal AMA, but feel free to ask insurance related questions in the comments and I will try to answer