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What To Do When You Have to Pay a Large Deductible Up Front

About 5-7 years ago, the high deductible healthcare plan (also called consumer driven health plan, or CDHP) was the new kid on the block. Companies were promoting them, but few employees understood them or chose them.

Now, as employers look to curb their healthcare costs, some companies only offer high deductible plans. It’s important to understand what a high deductible plan means for your family’s budget so you know what to expect.

Try these 5 things if your plan has a large deductible that you have to pay up front. Keep reading below for more information.

What is a High Deductible Plan?

A high deductible plan has a large deductible amount (For example: $2,500-$10,000) that you have to pay up front before your insurance kicks in. To get more info about deductibles and premiums, check out our blog post from a few weeks ago.

Lower Premiums Make these Plans Attractive

Many people sign up for these plans because they usually have a lower premium (the amount of money you pay each month/each paycheck for healthcare). What people don’t realize is that if they do need to have a surgery or something more than the routine checkup, they’ll have to come up with that deductible amount up front.

Today, let’s talk about a few things you can do to help ease the burden of that big deductible payment.

1. Calculate Your Budget, Set Aside The Amount

The most fool-proof way to make sure you can pay your deductible is to set that amount of money aside for your healthcare. That way, when you do need care, you’ll have the money available. For some people, this isn’t possible, especially if your deductible is on the high end like $10,000. In that case, read on for other ideas.

2. Negotiate a Discount

If your doctor orders a surgery, but you’re unable to get it because of the price, you have a few options:

Talk to your doctor (not the billing department) about your financial situation and see if there’s a way you can negotiate a discount.

• Hospitals often have financial counselors who review your finances and discount their services according to what you can pay.
Note
: Many ambulatory (non-hospital-based) surgery centers won’t do this.

3. Set Up a Payment Plan

If you have a large deductible, it may be very difficult to come up with that large chunk of money up front. Especially since most surgery centers only notify you a few days in advance.

Contact your surgery center and ask to set up a payment plan. They may allow you to pay only half up front, or to set up a payment plan.

4. Shop Around

A recent Kaiser Health News story shows that it’s important to shop around for care – especially if you’re footing the bill. The price of an MRI, for example, can range from $900 to $5000 at local providers in your area.

5. Just Say No

We always encourage patients to wait until they have an EOB (Explanation of Benefits) and a bill in hand before they pay. That way, you can review your bill for errors and make sure your benefits were applied correctly. Unfortunately, 50-80% of all medical bills have errors, so you always want to check.

We had a member who was asked to pay for her entire doctor-based maternity care before the baby was born via payment plans. Instead, the patient opted to sign a release saying she would pay the amount in full within 30 days of receiving a bill. That way, she could review her bills and EOBs for accuracy.

Work With Your Providers

The reason hospitals and surgery centers are being so up front with their payments is because they are simply not getting paid. About half of the bankruptcies in the US are related to unpaid medical bills. Your provider needs payment, and you need care. Work with your providers to meet in the middle.

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