As the cost of health insurance continues to rise, some Americans are considering opting out of insurance and paying for medical care in cash. While this approach may seem appealing, experts warn that it can be a risky and potentially costly decision. Some hospitals and clinics offer self-pay or cash-only discounts for patients who pay without insurance, but these discounts may not always be the best option.
For example, an allergy test or X-ray may be a few hundred dollars cheaper when paid for in cash, but the cost may not count towards the patient’s deductible or out-of-pocket limit. Additionally, if the patient needs more medical visits than expected, they could end up worse off financially. Nonprofit hospitals are required to provide charity care, which is free or discounted, to people who cannot afford it, but this option is typically only available to those who are uninsured or underinsured.
Experts caution that paying for medical care in cash can be a gamble, as it leaves patients exposed to major medical bills if an unexpected emergency occurs. Insurance provides crucial protections, including caps on out-of-pocket costs, access to negotiated rates, and free preventive care. Without insurance, patients may be required to pay the entire cost of care upfront or see a different provider.
For those who are healthy, paying in cash may be a smart move for predictable, lower-cost services such as X-rays or CT scans. However, patients would not have access to their insurer’s negotiated rate, which could be cheaper than paying cash. Even if patients haven’t reached their deductibles, they still get the negotiated rate, which might be cheaper than paying cash.
The risks of paying for medical care in cash are significant. Emergency room visits, hospital stays, or surgeries can cost tens of thousands of dollars, and uninsured patients are billed the full amount. It’s generally not possible to sign up for health coverage after an emergency has already happened, and there’s a narrow period to enroll in health insurance.
Before considering paying for medical care in cash, experts recommend checking if there are federally qualified health centers nearby, which provide low-cost care to underserved populations. Patients can also research the average cash price hospitals may charge for certain medical procedures on websites like Turquoise Health. If a patient does get a lower rate from a doctor, they may need to get an agreement with the entire healthcare team involved.
Ultimately, paying for medical care in cash is not a viable option for people who are not healthy and are likely to use a high amount of healthcare. The self-pay option will be most attractive to the healthy and well-off patient, who may forgo adequate health insurance. Experts warn that this approach can leave patients vulnerable to financial ruin if they experience a medical emergency or require ongoing care. As one expert noted, “If you like Russian roulette, then you’ll like to approach healthcare this way.”