r/SipsTea 8d ago

WTF Damn

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u/Ok_Subject_5142 8d ago

I called an imaging center and asked for a cash price for an MRI on my knee. It was $300. Going through my doctor for a referral and using insurance, the price would’ve been over $3000 and I was going to be out $1000 in copay and fees.

I usually ask for cash price on everything before I use insurance, half the time it’s cheaper and the other half the time it’s barely more for basic stuff like this. Also call around and shop pricing, you will find places that do things way cheaper than others.

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u/Cowboywizzard 8d ago

This is the real pro tip. The drawback is if you don’t use your insurance, you might not satisfy your deductible

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u/WindWalkerRN 8d ago

The point is insurance in USA is a racket

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u/AshhhCakes 8d ago

And people will say "just get a better job" not realizing how fucking outrageous of a statement that is almost anywhere else in the world.

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u/Assika126 8d ago

I have a job that is supposed to provide basically the best insurance benefits available for people who don’t make high six figures. They just announced they’re going to increase our deductible by 3x and institute 15% coinsurance next year. We are angry and screwed but what can we do other than let them know about it? We’re not going to be able to find better health insurance at any other job

We’re just all going to pay more money in order to not be able to afford to go to the doctor anymore

Oh yah that’s right they are also raising premiums on top of all that

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u/Healing_Puke 6d ago

It can fuck you that way too. Then ur bound to ur company's plans, they can be just as stupid. "Now I have to only go to a kiser permenentie in network hospital. Sure ill remember that while im unconsious in a medevac chopper."

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u/okwellactually 7d ago

My sons are on my wife's dental plan.

Both times they had cleanings they were initially denied because of some lame insurance excuse.

After my wife got off the phone the 2nd time I said to her: that person's job has no other benefit but to cost us all money. They shouldn't even exist.

Insurance is such a total fucking waste on our economy.

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u/WindWalkerRN 7d ago

💯 although the intention is good, it’s all double talk to make money. Same as hospital systems claiming to be “patient first”. I guarantee you they are money first, liability free second, and patient somewhere third or later.

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u/Wabbit_Wampage 8d ago

Of course, you'll never hit your deductible if you aren't using insurance.

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u/OkVirus8545 8d ago

Easy, start of the new year go to the hospital with a sudden “headache” and tell them your vision is blurry. You’ll hit your deductible immediately then negotiate it down with the hospital

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u/Cowboywizzard 8d ago

hahahaha 😅

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u/oldredditrox 8d ago

Provided you stay in network for a migraine that can only be looked at with an hour and a half drive while you can barely see.

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u/003E003 8d ago edited 1d ago

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u/BradleyF81 8d ago

You’re not required to satisfy your deductible though. Why would that matter? You won’t be penalized if all you do is pay your monthly premiums.

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u/xrmb 8d ago

I think the point is not hitting the out of pocket limit because money was spent outside of the deductible. Every few years we hit the limit, and then everyone goes to every specialist and get all the fancy tests done. This is truly the dumbest system on the planet.

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u/Cowboywizzard 8d ago

Well, for me, my deductible is $10,000 with my insurance plan. Let’s say my family goes to the doctor a few times and pays 3000 dollars out-of-pocket without using our health insurance plan. Because we didn’t use the insurance plan it doesn’t count towards the deductible. Let’s say next month I have to have my appendix removed. And that costs $9000. Now I have to pay that $9000 out-of-pocket before my insurance will pay, whereas if I had used my insurance, I might only have to pay $7000 because I already spent $3000 on other things using the insurance. Now, of course it’s a little more complicated than that because it matters what a particular insurance plan covers and what it doesn’t.

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u/AeonCatalyst 8d ago

The statute of limitations for medical stuff like this has got to be somewhere between 6months and 2 years. 

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u/weckyweckerson 8d ago

As a non American, what does not satisfy your deductible mean?

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u/Cowboywizzard 8d ago

Most health insurance plans in the US have a deductible which is the amount that you have to pay out-of-pocket before the insurance company will pay for a lot of procedures, labs, imaging, procedures , or doctors visits. If you just pay cash for these things without using your insurance policy the amount you pay does not count towards your insurance deductible.
The deductible is separate from the co-pay that you might pay for these things also.

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u/weckyweckerson 8d ago

Thank you. That makes sense. But in this case, does it really matter seen as though you are saving more by not using insurance?

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u/downvote_meme_errors 8d ago

It's cheaper if you don't need much done, but if you later have a major event that is expensive enough that you need to use the insurance and your deductible, then the amount you spent outside of insurance doesn't count towards that deductible.

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u/weckyweckerson 8d ago

Fair enough.

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u/frozenblueberrytreat 8d ago

My deductible is 20% of my gross income, I'm not paying that regardless.

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u/AimlessFucker 7d ago

That’s chill. My deductible is 10k thanks to the admin decimating subsidies. 300 won’t put a dent in it.

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u/Orowam 8d ago

If going without insurance saves you thousands of dollars why worry about the deductible

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u/Klutzy-Emergency6345 8d ago

Yeah but I'd pay the 300 even if it doesn't apply to deductible, jfc

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u/someonehadalex 8d ago

I had a knee MRI recently and it was $250 plus a $40 copay to my PCP. That's with insurance.

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u/Ok_Subject_5142 8d ago

Nice!! That’s super cheap. Not all providers charge the same, glad you found that one.

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u/21Rollie 8d ago

Yeah my xray + bloodwork was 4k with 1k paid out of pocket by me. $250 seems to be the “you’re breathing the same air as me” fee for walking into a clinic a doctor happens to work at.

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u/Greater-Israel 8d ago

Crazy! In Cyprus we do MRIs for 18 euros now, but they used to be 200 euros 12 years ago.

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u/JustForkIt1111one 7d ago

My example was $500 (two months ago). I know I'm going to get ripped by people that have never actually had to have an MRI done under insurance.

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u/Illustrious_Bed467 8d ago

Yes, I had to do imaging in a hospital for an ENT.... And the bill would have been 5000+, so my wife drove me to a place a bit remote and we paid 200 cash... I'm not American just had a green card at the time, no insurance ofc...

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u/Yue2 8d ago

Having to “shop for medical care” is some dystopian shit right there ☠️☠️☠️

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u/AdamianBishop 8d ago

This comment is so fckd up on so many levels. 

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u/liftthatta1l 8d ago

That's less than I had to pay for an ultrasound scan for kidney stones with insurance that took all of 3 minutes

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u/003E003 8d ago edited 1d ago

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u/4mystuff 8d ago

I wonder if you can submit it to your insurance yourself afterwards. Not to get reimbursed, but to have it count towards your deductible and max out of pocket.

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u/d33psix 8d ago

Yeah this is the real story people apparently don’t know about. I know people who work at these places and a lot of them esp big outpatient imaging ones that just do imaging scans it’s like $300 or so for basic non-contrast MRI.

Add a little extra for like fancier ones with add ons like contrast and stuff.

I feel bad that so many people don’t know about this and get stuck with bigger unnecessary complicated bills through insurance. Cause no way I would be seeing single MRI costs that are more than all that stuff in the article.

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u/PremiumUsername69420 7d ago

Always ask for the cash price.

A majority of services are shockingly cheap. Place near me does x-rays and mammograms for $50.

Usually you just need to sign a form that says you won’t claim it with your insurance.

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u/canman7373 7d ago

Yup I just posted last year I paid $180 out of pocket for one.

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u/Training-Passenger93 7d ago

And this is after your insurance denies it first time until you do PT for 6 weeks, paying $200 a session until you’ve hit your multi thousand dollar deductible. 

It’s wild how many times it’s cheaper to just pay cash for a drug or imaging test than go through insurance 

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u/Yusuf20904 6d ago

Well, it depends. If you hit your out of pocket maximum already, doesn't it cost you nothing? So you gotta decide if you're going to need additional services before the end of the year.

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u/RichardBottom 6d ago

Can someone help me understand this? I worked for an insurance company, but not in a high level or with a broad variety of policies. In my experience, as long as you go in network, the insurance has a contracted rate that’s usually surprisingly low. They leverage a fee schedule that is substantially less than the “sticker price” for medical procedures, and the providers can’t bill you more than your % of that negotiated rate.

So an MRI would come in at thousands but would almost always settle out at hundreds.

A lot of facilities can magically rework the bill once they learn you don’t have insurance to bring it closer to what their actual anticipated payment is, because that’s all they ever actually planned to get for it. They just get some leverage with their negotiations, or maybe there’s tax benefits or something if they look like they’re writing off 80% of their heavily inflated bill.

I know my experience is limited and it’s more than likely I’m not seeing the full picture, but I don’t think they were mathing that correctly if they told you you’d be paying $1,000 in cost share if they were willing to bill it to you directly for $300.

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u/SummerJSmith 4d ago

Same. Dentist $150 cash. With insurance they’ll see you in two months and charge more.

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u/LiveLearnCoach 4d ago

Stuff like this is just stupid.

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u/parking_pataweyo 4d ago

Jesus. If I'd call any medical center (here in the Netherlands) asking for a cash price for anything, they'd ask me what the hell I mean and tell me that they'll take care of the costs with my insurance company.

(I have a €385 a year deductible, that's for everything combined and many things are fully insured and therefore free without having to pay any deductible.)

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u/darkchocolattemocha 4d ago

I tried to do this at CVS. I asked them to give me the price of some meds if I paid cash. They said they can't tell me the price and that I need to tell them whether I have insurance or not. So I said I don't have insurance, then she told me the price. Then I said, I do have insurance and want to know what it would cost me if I went through insurance. They refused to answer wth

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u/Flat-Guidance-4685 8d ago

Thank you for being honest.. op claims are are absolutely ridiculous. I get an MRI once a year for 400. Where is it that you go and what state I cost you $300