Do doctors reject patients that offer to pay out of pocket?

[Marrila]

Not a privilege. I paid for that Medicare coverage with deductions from every paycheck I got for 50 years, and I pay $327.53 in Part B, Part D and Part G premiums every month.

A lot of coverage for comparatively low cost.
And it's also helpful this program for elders is subsidized.

 

[kdonnel]

DW had a doctor's appointment a week or so ago. Office called Monday and said "he wants you to get an electrocardiogram". We'll have the hospital call you to schedule.

When the hospital called to schedule, DW asked how much. $4k AFTER insurance. I suggested she call around. She found a 3rd party lab that would cost $400 OOP.

Not sure what my point is, or how it exactly relates to the thread, but wanted to get it out there

You are lucky they were able to tell you the price before care was rendered.

So many times no one really knows how much they are paying until after the service/care has been provided because the provider is unable/unwilling to provide the number.

I have never understood why we as a people continue to stand for how health care works in the US.

There is no other service I can think of that I regularly use that works the same way. I always know how much something costs before I commit to paying for it, except for my healthcare.

 

[tvguy]

A lot of coverage for comparatively low cost.
And it's also helpful this program for elders is subsidized.

Is it? I have no idea how much I paid in over 50 years. Yes, it is cheaper than what I was paying, but like I said, how much of that price reduction is basically coverage I prepaid over 50 years? And unfortunately I do not qualify for subsidized coverage.

 

[sam_gordon]

I have never understood why we as a people continue to stand for how health care works in the US.

IMO, because it's the system we have and folks don't know about how to go about changing it.

 

[tink2424]

As someone who now has employer subsidized insurance, through DH's job, I'm more than happy to pay a little more & have benefits reduced marginally, if it means those who were previously uninsured can also have access to health care. We'll never agree on how much others were affected, because I know too many people who grossly exaggerated the impact on their insurance, until the truth came out.

PS: I don't know anyone who had their insurance taken away, so I can't really speak to that. That said, if it happened, they at least had another option. The same wasn't true for many people previously.

Well I am happy to let YOU pay a little more. For ME I want the choice.

The "Cadillac plan" penalties were never enacted. They were delayed a couple times and finally repealed in 2019. If someone was blaming the ACA for your Cadillac plan disappearing they're not being honest.

Just the threat was enough to get companies to drop them. Not sure why they would wait to penalized. And I know for a fact a very major & large company did just this because of this planned penalty as I know the person in HR that was involved in the decision. Without the ACA they wouldn't have changed anything at that time. I don't have a crystal ball so I am not sure it would have always remained that way but 100%it was due to the ACA.

You pay then with cash or credit card….
Usually, they only provide services such as mental health, or cosmetic surgery….

Usually, they bill at TOS or just after….. if your credit card is declined you don’t book your next visit until it is paid

Umm, no... Virtually every specialty now has doctors that do not take insurance. There are many reasons for this but it is very true.

DH is retired and he's on my employer-sponsored family coverage and has been for several years. My employer dropped retiree healthcare back in the early 2000's (and I know of several employers that dropped it before then) - long before ACA came into play. It was solidly an employer cost-savings decision.

The 2 situations quoted above were EMPLOYER choices, nobody forced them. It may have been due to multiple circumstances and I agree that health insurance prices are outrageous, but dropping such coverages were not dictated by anyone other than the employer's own decisions.

That is YOUR experience. As I mentioned above, I know for a fact that the ACA changed insurance for a major corporation (I'm talking 100,000s of employees worldwide) that dropped the plans and retirees/their spouses due to ACA. And the retirees were especially screwed as they had no way to plan for this and were left with much worse insurance coverage.

Believe what you want but in my opinion it should be a free market without government intervention. We need transparency with pricing and treatment options. And trust me "free" healthcare isn't the answer either. There are plenty of people in countries with a nationalized healthcare system that would kill for our system.

There is much we could do to improve healthcare in this country without nationalized healthcare. To start we need to make sure that the doctor/patient relationship is sacred and without interference from the AMA, insurance companies, etc. We need to have transparency in pricing for treatment options and these should be on the physicians website along with laboratories, imaging & other diagnostic centers. Let people shop around for the best price for their situation.

There is so much more beyond that that we could do. It just takes breaking the insurance lobby and the AMA lobby to do so.

 

[tarheelmjfan]

Well I am happy to let YOU pay a little more. For ME I want the choice.

 

[Skip Coffee for Rope Drop]

So how do the doctors who don't take insurance and only take cash work??

I never heard of a doctor that does not take insurance for any of his/her patients except for Dr. Love (Gene Simmons from KISS). I would go to a different doctor if they refuse all health insurance.

 

[tink2424]

I never heard of a doctor that does not take insurance for any of his/her patients except for Dr. Love (Gene Simmons from KISS). I would go to a different doctor if they refuse all health insurance.

Well maybe do a Google search as there are many. My sister worked for a Nuero surgical group and they pulled out of all insurance as it was too much of a hassle. I myself have gone to specialists or even PCP's that have opted out of insurance and are cash based only because I liked the doctor.

There are even concierge doctors popping up in big cities that you pay a monthly fee and you have access to a doctor when you need them. So yeah, it is a big thing and will probably become more of a thing in the future.

Even countries with nationalized medicine have doctors that work outside of that system and are cash based.

 

[wvjules]

Well maybe do a Google search as there are many. My sister worked for a Nuero surgical group and they pulled out of all insurance as it was too much of a hassle. I myself have gone to specialists or even PCP's that have opted out of insurance and are cash based only because I liked the doctor.

There are even concierge doctors popping up in big cities that you pay a monthly fee and you have access to a doctor when you need them. So yeah, it is a big thing and will probably become more of a thing in the future.

Even countries with nationalized medicine have doctors that work outside of that system and are cash based.

Not saying I don't believe you but I just can't fathom the costs of neruosurgery OOP!

 

[Marrila]

Not saying I don't believe you but I just can't fathom the costs of neurosurgery OOP!

I'm not sure why anyone would want to be seen in such a practice. They would have to refer out most patients who need more than minimal care.

 

[tink2424]

Not saying I don't believe you but I just can't fathom the costs of neruosurgery OOP!

True, that would be expensive... Although some people (like me) have Out of Network benefits that would cover some of the cost. And they were in an area with a lot of wealthy people so that helped.

Just felt like you were saying that there aren't any doctors that are cash only. It's hard to tell tone in writing...

 

[tink2424]

I'm not sure why anyone would want to be seen in such a practice. They would have to refer out most patients who need more than minimal care.

You're making an assumption. Why would they have to refer anyone? I feel like this is an ignorant comment.

The actual cost of the doctor is but one piece. Theoretically all the other costs (hospital, lab, surgical supplies) would be covered by insurance. Only their doctor fee would not take insurance. They had a very thriving practice and were highly sought after. I know the practice still exists but not much more since it has been about 10 years since my sister worked there.

 

[Marrila]

You're making an assumption. Why would they have to refer anyone? I feel like this is an ignorant comment.

The actual cost of the doctor is but one piece. Theoretically all the other costs (hospital, lab, surgical supplies) would be covered by insurance. Only their doctor fee would not take insurance. They had a very thriving practice and were highly sought after. I know the practice still exists but not much more since it has been about 10 years since my sister worked there.

A place like you describe might be great if you only need Botox for migraines or the like.
Many neurosurgeries involve extensive pre and post operative care.
That's a lot of OOP visits. Most folks would likely move to a full service practice.
But it sounds like you prefer cash fee for service. We all have different preferences.

 

[Starport Seven-Five]

Just the threat was enough to get companies to drop them. Not sure why they would wait to penalized. And I know for a fact a very major & large company did just this because of this planned penalty as I know the person in HR that was involved in the decision. Without the ACA they wouldn't have changed anything at that time. I don't have a crystal ball so I am not sure it would have always remained that way but 100%it was due to the ACA.

That is one perspective. Considering the closest the penalty came to be enacted was 2 years away and health insurance coverage is changed year to year I'm very skeptical that those penalties were the root of any changes. There is a 500 pound gorilla in the room (cost) that seems much more likely to be why changes were made.

The actual cost of the doctor is but one piece. Theoretically all the other costs (hospital, lab, surgical supplies) would be covered by insurance. Only their doctor fee would not take insurance. They had a very thriving practice and were highly sought after. I know the practice still exists but not much more since it has been about 10 years since my sister worked there.

I could see the benefits for a PCP or Dr Office opting out because the insurance contracts and billing are a huge resource burden. You're talking more than 1 full time position per office and the insurance reimbursements are crap anyways. A regular doctor's office could charge $40-$50 per visit and be money ahead vs taking copays and billing insurance.

I've always felt that how we use health insurance in this country is a bit weird when you compare it to other insurances that we're familiar with. Like... our car insurance doesn't cover oil changes and we would think such a plan is ridiculous. For some reason we're covering random Dr visits with health insurance though? Why are we doing all this paperwork for something that is less than $100?

 

[Skip Coffee for Rope Drop]

Well maybe do a Google search as there are many. My sister worked for a Nuero surgical group and they pulled out of all insurance as it was too much of a hassle. I myself have gone to specialists or even PCP's that have opted out of insurance and are cash based only because I liked the doctor.

There are even concierge doctors popping up in big cities that you pay a monthly fee and you have access to a doctor when you need them. So yeah, it is a big thing and will probably become more of a thing in the future.

Even countries with nationalized medicine have doctors that work outside of that system and are cash based.

I just spent some time doing a "Google Search" for doctors that do not accept insurance. I could not find any. I did find several that will take patients without insurance but none that will not take any insurance. What keywords should I use to find a successful search? In the meantime, being we are in a Disney chat, which Disney doctor is your favorite? Mine is Dr. Sherman, the dentist from Finding Nemo.

 

[John VN]

I never heard of a doctor that does not take insurance for any of his/her patients except for Dr. Love (Gene Simmons from KISS). I would go to a different doctor if they refuse all health insurance.

In 2015 my cancer Dr. required Electronic Transfer before Consultation and again before treatment began. Same today.

 

[CdnCarrie]

In 2015 my cancer Dr. required Electronic Transfer before Consultation and again before treatment began. Same today.

What happens if you don’t have the money?

 

[backformore]

I never heard of a doctor that does not take insurance for any of his/her patients except for Dr. Love (Gene Simmons from KISS). I would go to a different doctor if they refuse all health insurance.

Some private practice doctors don't bill insurance companies, but will provide the patient with the paperwork to get out of network reimbursement.

 

[tink2424]

A place like you describe might be great if you only need Botox for migraines or the like.
Many neurosurgeries involve extensive pre and post operative care.
That's a lot of OOP visits. Most folks would likely move to a full service practice.
But it sounds like you prefer cash fee for service. We all have different preferences.

No, I don't prefer a cash fee for service model but I do prefer to go to the best doctor I can find for whatever condition/issue I am having. That is why I always opt for a PPO insurance plan.

And really the cash doctors that are more specialized are going to be servicing patients who have a lot of money. They aren't going to be the average Joe and so for those high net worth individuals they don't care about the cost of the doctor, they just care that they are getting the best money can buy.

That is one perspective. Considering the closest the penalty came to be enacted was 2 years away and health insurance coverage is changed year to year I'm very skeptical that those penalties were the root of any changes. There is a 500 pound gorilla in the room (cost) that seems much more likely to be why changes were made.


I could see the benefits for a PCP or Dr Office opting out because the insurance contracts and billing are a huge resource burden. You're talking more than 1 full time position per office and the insurance reimbursements are crap anyways. A regular doctor's office could charge $40-$50 per visit and be money ahead vs taking copays and billing insurance.

I've always felt that how we use health insurance in this country is a bit weird when you compare it to other insurances that we're familiar with. Like... our car insurance doesn't cover oil changes and we would think such a plan is ridiculous. For some reason we're covering random Dr visits with health insurance though? Why are we doing all this paperwork for something that is less than $100?

We can agree to disagree. I can only tell you what my experience was with one company but it definitely affected THAT company.

And yes, I agree about insurance. I was reading an article someone has written that maybe medical insurance should be for catastrophic events only (ie; hospitalizations, cancer, etc) and that your general PCP would be on you to cover as well as basic labs, prescriptions, testing, etc. The article also advocated for prices to be transparent and that is could maybe benefit the consumer more. I actually would advocate for this route as to me it seem that it is the best option for the most amount of people.

I just spent some time doing a "Google Search" for doctors that do not accept insurance. I could not find any. I did find several that will take patients without insurance but none that will not take any insurance. What keywords should I use to find a successful search? In the meantime, being we are in a Disney chat, which Disney doctor is your favorite? Mine is Dr. Sherman, the dentist from Finding Nemo.

Well for one you can search for concierge or membership practices. They are almost always cash based. I also did a search for "doctor who doesn't take insurance near me" and a few aggregators popped up. Here is one I found: https://www.cashhealthcare.com/

I also found this article which is interesting on the subject of all cash doctors (it only focuses on PCPs which in my opinion is the most likely type of doctor to go all cash): https://www.healthline.com/health-news/these-doctors-accept-only-cash

 

[momz]

Places you can go for care without insurance, and pay out of pocket: urgent care, retail clinics, ER and concierge practices.

Most providers are employees. Admittedly, there are a few group practices that still exist, these are groups that have a lot of leverage to do so....typically expensive specialties (like neurosurg). These groups contract with hospital systems for "privileges" to practice within the hospital system facilities and they rent their offices from the hospital as well. But, your average primary care provider is more likely to be an employee of the hospital physician group. These average Joes have no say in how patients are billed.

Only a tiny percentage of what you and your insurance company pays goes into the pocket of the doctor who is seeing you. Seriously, take a look at your local non-profit hospital network, you can see how much the administrators are paid. Another thing to take notice of is their capital expenditure. You see hospital CEOs crying out that their income is down, but this is in comparison to their expenditures....they are still spending billions of dollars (collectively) on new infrastructure and the costs to reorganize constantly.

Health care was not as expensive when it was simple. Over the years, it's become BIG business. While there are well paid providers, it's the administrative staff who make the BIG bucks. On the backs of the nurses, techs, environmental services, cafeteria workers, etc, etc, etc.