Your Network Discount is Key to Keeping Your Health Care Expenses Down

Your Network Discount is Key to Keeping Your Health Care Expenses Down
Eileen St. Pierre, The Everyday Financial Planner

Recently my husband had a major health issue while we were working in a different state for an extended period of time. I had to take him to the emergency room. Unless we wanted to travel an hour away to the next closest hospital, I did not have a choice as to where to take him. I really did not have time to research whether the hospital was in our network. We just prayed it was, and that they could treat him.

It seems that more and more of us are doing a lot of praying nowadays. You never seem to fully know if the hospital or doctor is in network; that information is not always kept up-to-date. Our prayers were answered. The hospital, the blood testing company, and all the doctors who treated him were in our network. We had to pay very little for the prescribed drugs.

The value of these medical providers being in our network was HUGE.

Here are the numbers:

For my husband’s trip to the hospital and related services, we ended up owing slightly less than 20% of the billed charges. Everything we owe in the table above will go towards our deductible, which now stands at $5,000 per person.

  • Our biggest discounts were applied to the two rounds of blood testing (90% and 92%).
  • Our lowest discount was for the trip to the emergency room (66%).
  • We just had to make the specialist co-pay for six follow-up doctor visits, a savings of 55.5%.

It would have been heartbreaking to have to pay the full amount of the billed charges.

But I can understand why these health care providers bill so much. The waiting rooms are full and you just know that not everyone can pay their bill. Someone has to make up that difference. When companies have uncollectable accounts, they raise their prices for everyone. A hospital or doctor’s practice is no exception.

When considering a health insurance policy, look for insurers with the widest network.

Look at all aspects of the policy. In addition to the monthly premium, consider

  • the deductible
  • the out-of-pocket maxim um
  • the costs of prescription drugs, and
  • the list of providers in the network locally, statewide, and nationally – especially if you travel a lot.

Even if the monthly premium is a little higher to have access to a larger group of network providers, our experience proves that it may be worth the extra money if you do have a health emergency.

Visit my Health Care Reform page for more information.