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I just learnt about nearby hospital's "uninsured patient discount" policy document that states:

The Uninsured Patient Discount will not apply to any item or service provided to a patient for which the Facility is required to collect a co-payment, coinsurance or deductible.

It seems that there is no low income requirement to qualify for this discount.

Do I understand correctly that for someone who went to ER and incurred $2,000 hospital bill:

  1. If he or she was under HDHP, then they would need to pay whole $2,000 as they would be ineligible for "uninsured patient discount"?
  2. whereas if he or she was uninsured, then they after 40% discount would need to pay only $2,000*60%=$1,200.

So, in other words, the break even point when HDHP makes more sense than simply being uninsured is actually much higher than deductible+premiums as uninsured patient discount also must be taken into account? Or am I missing something?

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    Note that if you can get a high deductable plan with Health Savings Account, the HSA is an excellent savings vehicle -- money goes in untaxed, grows u taxed, and comes out untaxed as long as you're spending it on health. There is a limit on how much you can add to the HSA each year, but I still consider it a "too good to pass up" savings opportunity.
    – keshlam
    May 2, 2023 at 3:06
  • Uninsured has a limited upside (premium savings) and an unlimited downside (expensive illness or accident), so it's a bad bet regardless of where the breakeven point might lie.
    – stannius
    May 5, 2023 at 22:24

1 Answer 1

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If you have a high deductible health plan and you haven't met the deductible, then even the in-network bills are set not at the billed rate but at the negotiated rate between the insurance company and the hospital.

Do I understand correctly that for someone who went to ER and incurred $2,000 hospital bill:

  1. If he or she was under HDHP, then they would need to pay whole $2,000 as they would be ineligible for "uninsured patient discount"?
  2. whereas if he or she was uninsured, then they after 40% discount would need to pay only $2,000*60%=$1,200.

In your example you specify a $2,000 hospital bill that is discounted 40% or reduced to $1,200. The question is what is the negotiated rate if you have insurance?

For example I recently went to see a Specialist Eye Doctor. The billed amount was $941, the negotiated rate was $277 for an about 70% discount. That means that the visit only cost me $277 towards my deductible.

Not all the procedures get the same discount. It also depends on the insurance company.

In another case this year the negotiated rate was an almost 90% discount. It went from $1,569 down to about $150.

Having a high deductible plan isn't the same thing as having no-insurance. You do get reduced rates if you go in-network. Once you hit the deductible the savings are even more. If I was between the deductible and out of pocket max then I would have only been responsible for 20% of the $277 in my first example.

The big protection is the out of pocket max. That can turn a $100,000 ER bill into a bill for $7,500 or lower.

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