Good luck getting out of the hospital for $25k, though.
How much do you think cash payment would be for a 2-night stay with 3 X-rays and 1 MRI? Back when we were on even better insurance, I paid $7,250 for that event in addition to the $8,400 paid in premiums throughout the year (that was early in the year, we cancelled insurance after that). That was the only major medical event that year. I had a long-time friend who worked in that hospital's billing department run through the numbers if we had agreed to pay in cash over 12 months. Had there been no insurance in the equation, she would have been able to do 12 payments of $1629.00 without even getting supervisor's approval, lower with permission. Considering that (and basically all other hospital stays for young people) is a statistical outlier, and we paid for 5 years of insurance with no major incidents other than that one, we come out WAY behind by having insurance.
People get sticker shock when they see a 84k bill for a hospital stay, but its artificially inflated pricing to get the numbers high enough to still turn a profit after the insurance companies pay out 1/3rd of that. People can (and regularly do) get pricing at the same levels as the insurance companies, especially if you call ahead for agreed amount and pay in cash.
FWI- I have done the math on his before. Until the medical market and insurance markets get fixed, my family won't be doing insurance at all.
Insurance Breakdown
2013 - $1768 Principle (YAY!) - $950 Deductible Per Person - $3500 Deductible Total - 25% copays beyond
2014 - $2178 Principle (Eh...) - $1100 Deductible Per Person - $4500 Deductible Total - 30% copays beyond
2015 - $3248 Principle (Boo.) - $1100 Deductible Per Person - $4500 Deductible Total - 30% copays beyond
2016 - $4504 Principle (Yuck) - $2500 Deductible Per Person - $4500 Deductible Total (May have been 5k here, but unsure so I'm going with the lower number). - 30% copays beyond
2017 - $8376 Principle (Ugh.) - $5000 Deductible Per Person - $5000 Deductible Total (NOTE: We didn't pay this. This is the year we said FU to the medical insurance industry) - 30% copays beyond
2018 - $10380 Principle (....) - $5000 Deductible Per Person - $5000 Deductible Total then copay. (Note: Again, we aren't paying.) - 33% copays beyond
Medical Spending had it been cash totals:
2013 - 1 ER visit - 4 doctors visits - 0 Hosp stays - Cash cost would have been about $420 to $720.
2014 - 1 ER visit - 5 doctors visits - 0 Hosp stays - Cash cost would have been about $665 to $965. ER was X-rays for broken collarbone. Total cost without insurance would have been $380 as it was quick and there was no cast. "Sticker price" was around $1200 but could have been drastically reduced per friend.
2015 - 0 ER visits - 5 doctors visits - 1 Hosp stays - Cash cost would have been about $225. PLUS OBGYN and birth costs would have been $9500 pre-agreed (we considered it).
2016 - 0 ER visits - 6 doctors visits - 0 Hosp stays - Cash cost would have been $270.
2017 - 1 ER visit but rolled into a hospital stay - 8 doctors visits - 1 Hosp stay - Cash cost would have been $19,550 for the hospital, MRIs and CAT scan. Doctors visits were higher due to specialty. $225 plus $495. $20270 cash cost for the whole year.
2018 - 0 ER visits - 4 doctors visits - 0 Hosp stays - Cash costs (have) been $180.
Medical spending WITH insurance...
2013 - $1768 + 4x$30 (Dr Copay) = $1888.00
2014 - $2178 + $75(EM Copay) + 5x$30 (Dr Copay) + $450 x 25% procedural copay (ER XRay Copay) = $2515.50
2015 - $3248 + 5x$30 (Dr Copay) + 14x$45 (OBGYN Copay with ins) + 4500 x 30% (Birth procedural copay) = $5378.00
2016 - $4504 + 6x$30 (Dr Copay) = $4684.00
2017 - $8376 + 5x$30 (Dr Copay) + 3x$45 (Specialist Copay) + $5000 max deductible + $7500 x 30% copay beyond deductible = $15911.00
2018 - $10380 + 4x$30 (Dr Copay) = $10500.00
So a true comparison of
all costs in on an insurance plans vs
cash pay comes out as follows:
2013 - $1888.00 on insurance vs $720.00 (worst case)
2014 - $2515.50 on insurance vs $965.00 (worst case)
2015 - $5378.00 on insurance vs $9725.00 (includes birth costs in both)
2016 - $4684.00 on insurance vs $270.00
2017 - $15911.00 on insurance vs $20270.00 (worst case)
2018 - $10500.00 on insurance vs $180.00
2013 - Cash wins by
$1168.00 (though, if anything had happened, 2013 insurance was MUCH better than now). (This includes an ER visit)
2014 - Cash wins by
$1150.00 (This includes a broken collarbone ER visit...)
2015 - Insurance wins by
$4347.00 (Due to childbirth being expensive... lol)
2016 - Cash wins by
$4414.00 2017 - Insurance wins by
4359.00 (NOTE: This includes an extremely expensive 2 night, CAT scan and MRIs hospital stay. A "worst of the worst" by medical cost standards aside from something like cancer, and insurance still only wins out by 5k or so. That should be VERY telling to people. After this fiasco I started running the numbers and we killed off the insurance bill. We paid a fee for it but it still came out ahead.)
2018 - Cash wins by
$10320.00 (Note: nothing happened to make insurance worth it. Some people might claim that if we had insurance in 2018 that we might have made different choices but we really wouldn't. We used regular kiddo's doctor when they got sick. We wouldn't have gone to the ER either way, because thats expensive and wasteful. Overall, I'm VERY glad we turned off the insurance leech...)