It is cheaper to pay for health insurance than to pay out-of-pocket for medical care. I do not need to worry about emergency or one-time events like surgeries. You receive nothing more, but … The benefits are obvious. Or what if you get hit by a truck? Ergo, what really makes health insurance cost a lot is when people get very sick it costs a lot of money to treat them. My health insurance covered the expenses for office visits, 2 operations and physical therapy. Cookies help us deliver our Services. Plans with embedded deductibles assign a deductible amount to each family member. But both collision and comprehensive insurance require you to meet a deductible (usually $500 or $1,000) before your coverage kicks in. Q: Is it better for me to pay out of pocket for dental care and not worry about dental insurance? The only time I do not get free health care is a routine checkup somewhere that is not the IHS. There is nothing wrong with just keeping your IHS insurance and paying out of pocket for some things. Unfortunately, most people don't realize this. I apologize, and have since corrected my explanation. I am not below the poverty line, I do not qualify for any special assistance beyond the Indian Health Service's health care. It often requires switching car insurance companies. A: For those who purchase their own insurance, the decision to purchase dental coverage is not always as clear-cut as the decision to purchase health insurance. Insurance companies pay next to nothing for routine maintenance. if I am stable I am transferred to my primary health facility, if I am not stable and need to stay where I am the facility I am at is considered deferred treatment from my primary facility. The deductible amount in a health insurance policy is the portion that the patient is responsible for paying before any type of insurance coverage kicks in. So you might have a very costly medical incident and pay $6,500 for a single claim before the plan takes over at 100% for you, but your spouse would also be subject to a $6,500 deductible before their claims begin to be covered at 100%. Health insurance vs. paying out of pocket. You do not receive credit for that $50 to your OON deductible or OON OOP and insurance will never base their payment off the $150, only the $100. I've been seen recently by the local hospital once a month for 4 month and was charged $600. That's the whole reason to have health insurance. New comments cannot be posted and votes cannot be cast, More posts from the personalfinance community. I have heard it's possible to negotiate prices with hospitals. Is there any reason I shouldn't just pay out-of-pocket for health care? From another (and i know how impractical this is in many ways), I can't help but think that they should have some idea of what how much what they're doing will cost, and try to be cost effective with respect to the individual patient's financial picture. You receive two procedures during … For a stupid broken finger. Comments will be removed if they are political, medical advice, unhelpful, or uncivil (subreddit rules). In the event of an emergency the facility treated me is considered referred care from the IHS. Thank you. I've been paying cash out of pocket for all doctor visits and medication, and it has been cheaper than paying for insurance. If you got a real healthy savings, maybe you want to take the gamble. Our moderation team encourages respectful discussion. Individual deductibles and out of pocket maximums are just that--per individual. You won’t approach the out-of-pocket limits, though, unless you need a … Press question mark to learn the rest of the keyboard shortcuts. Welcome to r/personalfinance! As such the concerns of needing Health Insurance is new to me (I'm almost 30). EPO: Exclusive provider organization, which allows you to choose your providers within a specific network. That's a pretty unusual plan if you go immediately from deductible to 100% covered. Taking these things into consideration: I am not legally required to have health insurance, using health insurance for check ups is very cost ineffective, large things like operations, eyeglasses, and dental I simply travel home for anyway, and the cost of emergencies get deferred to my primary care facility (IHS). Do you have $25k to pay the reduced price if something like this happens to you? $13,000 is likely the family out of pocket (or deductible) amount. However, there are some occasions when it may actually make sense to pay for medical care out of pocket rather than use your health insurance coverage. Generally speaking, nurses and doctors don't know or care how much their services cost. This has been the case for most of my life until I moved too far away from the IHS to make it worth while to make trips for check ups/routine appointments. I am a bot, and this action was performed automatically. Generally speaking, the point of having health insurance is to use it when you’re sick or need to see the doctor. Co-pay plans will still have a deductible (in some cases it will be $0) and out-of-pocket maximum. Here's a counterpoint. An out-of-pocket maximum is a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year. That is incorrect on so many levels. The out-of-pocket maximum, on the other hand, is the most you'll ever spend out of pocket in a given calendar year. If you are the only person on your plan, once you've paid $6,500 out of pocket, you will be covered at 100% until (likely) 1/1. 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