X-rays and Health Insurance

I have a high deductible health insurance plan.  If you work for corporate America, chances are you do too.  To paraphrase the HR representative of the company I’m retired from, “we switched to high-deductible, account-based health benefit plans, because, frankly, we can’t afford not to.”   In my interpretation, these plans are intended to:

      1.  Reward preventative health maintenance – most of these plans pay preventative services such as annual physicals and lab work as well as preventative medications – at 100% with no deductible,

2.  Protect against catastrophic loss.  If I’m looking at a $500,000 medical bill, my out-of-pocket maximum of $5,000 seems quite reasonable, and

3.  Drive responsible spending on the part of the patient.

When I went to the hospital to get my foot x-rayed last week, I told the admitting clerk that I had a high deductible plan and would end up paying the bill anyway – and asked the cost of the x-ray.  She smiled, said she had a high-deductible plan, too, and proceeded to tell me that she didn't know and couldn't accept payment anyway.  “Just wait for the bill to come and pay it,” she advised.

How am I supposed to spend responsibly when I don’t know what the cost will be?  Granted, I had only the one hospital that would accept my insurance plan (or so I was told), but surely they know the price of an x-ray.  Even though I was a captive audience, it would have been nice to know what to plan for.  

Just for fun, I went to the web site of the hospital where I had the x-ray.  The only reference to cost – anywhere on the site – was a mention that uninsured patients that did not qualify for any other discount could get a discount of 25%, with an additional 15% off if they paid the bill in full at the time of service.  Good to know – but because I technically AM insured, I suspect they wouldn't have offered me a discount anyway. 

As more and more people find themselves with high-deductible health plans, we’re going to want to know what we’re paying for – before we pay for it.  We may choose to decline tests – or at least defer them – based on our own cost/benefit analysis.  My own example – I really wanted to know whether or not my foot was broken, so I went forward with the x-ray even though I still have no clue how much I’ll end up paying for it.  But if I had to pay for the cholesterol test my doctor ordered, I would have skipped the test this year.  My cholesterol levels were just fine last year and I have no risk factors for any of the diseases that high cholesterol would indicate.

Turns out that cholesterol testing is considered preventative.  Now we know.  

Epilogue:  Fast forward about six weeks.  The hospital dutifully billed the insurance company, which dutifully told them to apply their agreed-upon discount and send the bill to me because I had not yet met my (high) deductible.  The bill was about $176, which is less than I had anticipated.