Insurance is designed for a sudden and expensive exposure that most of us cannot afford. If you look at those words again: sudden and expensive. It does not detail the predictable and affordable. For years, however, we had someone with more money paying the bills. Most of us had very little to pay out of pocket for our own medical expenses. At least until now.

It is common knowledge that those with the most money tend to have the most to spend without question. Insurance companies are no different; they are the ones with the biggest bag. Medical providers know this too. Over the past 50-60 years, providers raised their prices to see what they could get away with, while insurance companies negotiated higher discounts. This is how health became big business. Insurance companies took on this cost, and now we have to cover the expense of higher premiums today.

Price transparency is nil in the healthcare industry. Partly because we never need to know because someone else was paying most of the bill. The other reason is that no one bought your health care expenses like they do with other consumable items. Medical providers know it and took advantage of it. The price of something billed to the insurance company and what the ‘cash price’ is can be completely different. Which one are you going to pay?

It’s a highway robbery, if you ask me. Take a typical generic drug at your local pharmacy. One could cost the insurance company about twenty dollars, but your price if you pay the price in cash could be ten dollars. Why? It’s because they can.

The opposite is also true. If you ask for the price in cash, it could be double the price negotiated by the insurance companies. Many providers will charge the patient the amount billed versus the amount discounted. It’s as if since you asked I would charge you more.

Personal Case Study: My son injured his hand. The specialist did not know if it was fractured or not. They wanted to lean on the side of caution, but I wanted to know if it was just a deep bruise or a fracture. The doctor suggests we do an MRI on his hand just to be safe. As any caring parent would, I asked how much this would cost me if I paid cash, I have a high deductible health plan. He said the amount approved by the insurance company is $ 350 (it was a small MRI machine). He went on and said I don’t do anything with them. So if you pay cash, I would charge you $ 450.

Since many members have high deductible health plans (HDHP) or health savings account plans (HSA), many providers find that the patient is responsible for the initial expenses. This can be good or bad depending on the view.

First, there is the negative view. Many expect the insurance company to pay for the first dollar coverage. Each doctor visit, lab test or prescription is first out of pocket and applied to your deductible. Some may not like this idea.

The other side of the coin is that you have greater control of your expenses and at the same time save on premium costs. The net gain is worth it to many. They can ask more questions about your health care. Why? It is because it is your money. Most importantly, you should ask more questions about your health care.

At the end of the day, it’s your health care and your money. Finding that happy middle ground between the cost of coverage and what you get for it can be overwhelming and expensive. Finding out what’s important to you and asking enough questions so you can make better-informed decisions will save you thousands of dollars over the years. After all, it is your money.