Self-Pay Health Care: A Great Option for Many of Us

That time of year is fast approaching....time to renew your insurance deductible. Many of us cram all of our health services into December for this very reason. Would you believe that for those of us with deductibles over $1000, it may be more cost-effective to pay directly for some health services rather than use our insurance? It's true! I never would have believed it myself if I wasn't already using
self-pay lab and prescription services.

Those of us with high deductibles already know the pain of paying for your monthly insurance premium, and paying thousands of dollars out of pocket before the insurance kicks in and your healthcare if "free", all the while hoping that happens before the deductible renews again in January. This is where the value of self-pay services comes in.

Like many of you, I have a very high deductible ($7,000) and a very high monthly premium. Nothing I do for my health is "free" or "covered" until that high deductible amount is met. Over the last 4 years, and even with four small children, I have never met my deductible. This means I personally pay thousands of dollars per year for health care services towards my deductible and my monthly premium, and my insurance never receives a medical claim or bill!

Remember, I use the same hormones and need the same lab follow-ups that I recommend to my patients, and I take the same supplements (okay, I take a lot more supplements) than most. I feel the same painful pinch when I pay for the things I need to maintain my wellness. I am so dedicated to wellness, disease preventation, and living my life optimally, that I have tried to find ways to make wellness more affordable.

Over the years, I have researched self-pay costs, and have used many different labs and pharmacies  to determine value, quality, and price. I compared the self-pay cost to my medical and insurance premiums/deductible.  I discovered that paying as a "self-pay" patient for many simple services can save me and my family a substantial amount of money.

I want to share with you what I have learned after paying thousands of dollars towards my deductible--year after year.

Example:
1. Laboratory work can be very expensive.

I have found that Aspen Clinical Research (www.aspenclinicalresearch.com) in Orem has the lowest price for self-pay labs. I have been using their services personally for more than 3 years, and started recommending them professionally to my patients soon after. I have been sharing my discovery of such tremendous lab cost savings with my patients ever since.

The lab costs at Aspen are about 80% less than what I would pay using my insurance. For example, the typical hormone panel that I run on myself 3 times a year costs more than $1400 at my hospital lab, cash out of pocket, paid by me. With my $7,000 deductible, this means that I could repeat that blood panel many times and never reach my deductible! I am billed the entire $1400 after every draw! Can you say ouch? (My husband can..)

Imagine how relieved I was to find Aspen labs, and have the SAME PANEL drawn for around $250!
This is a huge savings for me and my family. It might be for you, too. I just completed an updated listing of Aspen lab costs compared with the next least expensive lab. If you would like a copy of the comparative price list for Aspen labs, email me at wellness@kristierosser.com.

2. Prescriptions, vitamins, hormone therapy and supplements can be expensive.

My prescription deductible is also very high. I have found that paying "self-pay" for my hormone, vitamin and supplement therapy is more cost effective than billing it through my insurance. For example, Prometrium (Progesterone) when billed through my insurance, is $200 a month. A compounded bioidentical progesterone that I pay cash for is around $32 a month. HUGE SAVINGS!

I use MedQuest pharmacy (www.mqrx.com) Salt Lake City for that very reason. I can order more than a 3 month supply of all of my hormones, vitamins, supplements and more, for less than half the cost of a 30 day prescription of prometrium!

3. Office visits and pap smears can be expensive.

My office has a separate system for self-pay patients that is cost-effective for those with high deductibles, health savings accounts, or without insurance. Patients of mine will attest to the time I spend with each of them, listening to their concerns, explaining tests results, educating them about their health, disease prevention, and helping them achieve their optimal wellness. The provider time with patients in my office is a rarity not seen in many medical practices, and translates into a valuable experience for the patient. I also use a self-pay lab for pap smears, saving my patients more than $150 over the insurance price. Yet another cost saving tip and service directly passed on to you!

When my patients have a good understanding of what their health insurance benefits are, and when they compare those costs to the self-pay options that I offer, many choose to use self-pay. They find out quickly that they can have their full hormone & blood work panel drawn 4 times per year (if necessary) for less than $1000 and pay for all of their hormones and supplements for less than $600 per year. This is just a few hundred dollars more than a single blood draw would cost them on  a high deductible plan. What wise, incredible, helpful savings for them!

This information is also helpful to those of you with health care plans that include a health-savings account, a flex spending account or a Benny's card. Why pay more than you have to out of that savings account? Price checking for services becomes a very important part of your plan in these cases.

If you aren't sure about your insurance benefits, I encourage you to call your insurance and ask about your deductible, your percentage to be paid once deductible is met, and compare these costs to the self-pay options I offer my patients. You might find the savings to be astronomical like I did. With deductibles renewing in January, self-pay can be a smart decision for many of my patients.

I love passing this incredible cost-saving information on to my patients, friends and family!

Thank you, and as always, healthy living!