Ask Terry Questions Insurance vs Self pay

Insurance vs Self pay

By Terry Savage on July 30, 2015 |

My question is why are the insurance co. prices higher than self pay? I am a very healthy person. I have never been sick to be in the hospital, the last time I was there was back in 1978. I do not have health insurance. I don’t think I need it yet. I know I am taking a high risk because I don’t. I was hurt 2 weeks ago with my foot. I went to the foot Dr. and they ask do I have insurance I said no, but I have no problems paying for the services. I sign all the paperwork and was treated. I paid the entire bill that day. They said when I was paying for it I get 40% off. That was great. Now the office visit if I had insurance was $187.00 I paid $130.90 The ankle with insurance $121.00 I paid $89.00. Foot with insurance $129.00 I paid 90.30. Now for the crutches with insurance $560.00 I paid $104.00 Boot walker with insurance $250.00 I paid $60.00 Total bill for me for everything $469.90 With insurance Total bill would be $1,247.00 I saved $777.10 without insurance. Plus no monthly insurance premium bill. Is the doctors and hospital overcharging the insurance co. that much. If I had insurance I still would have pay this bill at $1,247.00 because of the deductiable would have not been reached. Is this fair. This why our health care system is so screw up. This why I don’t have health insurance. I have it in black and white. I think if “We The People” should find this out.
Thank You for your time.

Terry Says:  I’m going to post your letter, because you took so much time to explain in detail.  But let me make two comments.  First, you have been lucky so far!  Your aches and pains have been minor.  If you needed a heart stent or a hip replacement it would not be so easy for you to come up with the cash and “save” money on the payments.

Second, under “Obamacare” you are obligated to have some basic insurance — or pay a penalty.  They are watching, and may ding any tax refund with this penalty if you cannot demonstrate care.

And finally, to get to the point of your email:  Yes, health insurance has for years been subsidizing those who do not have insurance or cannot pay.  All those poor people who use the emergency room as their primary physician have created a cost center that must be covered by hospitals, clinics, and physicians.  So, for sure, your insurance premiums are high because the partially cover the cost of care for people who cannot pay.

Obamacare (the Affordable Care Act) was an attempt to smooth out those discrepancies.  But as usual, when the government steps in, costs go up!

May I suggest that you not tempt fate any longer and go to and search for an affordable policy.  You will receive a “subsidy” (from my taxes) if you are low income and cannot afford to pay the full premium!

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