New young professional seeking some insight on medical insurance. I went with a high deductible plan and recently did a few things. One of those things was seeing a new dermatologist to check a spot for melanoma. I was charged $250 for the biopsy and $250 for a new patient fee. Insurance covered half of both those costs. Is this normal on a high deductible plan? Will my bill always be this expensive? Any advice? Worried about seeking medical attention for other health issues with all these cosrs

like
Posting as :
works at
You are currently posting as works at
Highlighted IconHIGHLIGHTED

That’s typical for high deductible. I’d recommend creating an HSA and saving up for those costs tax-free. If you don’t go to the doctor that often, it’s often still cheaper to pay those costs + your insurance premiums than it would be to pay for a higher-priced insurance plan. If you find yourself going to a lot of doctor’s visits, you might want to reassess for next year and see if it’d be more cost efficient to go on a more expensive plan. In the meantime though, just set aside money for those costs and don’t stop going to the doctor if you need to.

I did this for each provided and what they told me I’d get billed was completely different from what I was actually billed. That’s why I feel like I was kind of cheated and feel powerless with this insurance stuff/my health 😢

like

Welcome to the wonderful world of for profit healthcare! If you have not met your deductible for the year (~$2,000) then insurance doesn’t pay for anything. The $250 charges are basically arbitrary. The insurance company didn’t pay for half of it; the “discount” is the negotiated rate between the doctor’s office and the insurance company. You owe whatever the negotiated rate is. There’s not a whole lot you can do other than complain and escalate. I’ve done this before and received a discount. I would definitely ask about the new patient fee bc that sounds like bs.

FWIW a HDHP makes sense for most people, but in some situations it doesn’t. I’m on a PPO plan with a $500 deductible because I was not blessed with good health genetically. Finding doctors and comparing costs is not worth the hassle for me. I did the math to compare what I spent on the PPO last year vs if I did the HDHP instead and it was about the same cost to me. The only benefit to a HDHP is having an HSA. But for me that financial benefit isn’t worth the stress.

like
Recent IconRecent

high deductible means your insurance doesn’t help out much until you hit that deductible with your own money (out of pocket). it also sounds like you went to a specialist, so this type of assessment wouldn’t be part of some yearly well-being check so to me, it doesn’t sound too unreasonable.

maybe give your insurance provider a call and have them walk you through the billing

like

i got high deductible too, under the assumption that i probably won’t even be spending much money on medical visits other than the covered yearly assessments. im keeping high deductible so I can use the free HSA money to invest. But if you think you may be racking up a personal fee in medical expenses, maybe a medium tier would be better? I don’t really have too much advice other than what I know for myself :/

One thing i am always cautious of though is to talk about fees BEFORE going in for an appointment. that new patient fee is BS - sucks that they didn’t tell you on the phone

If you're on a high deductible, make sure to max out your HSA ($3500/ year individual).

likehelpful

Does PwC match? EY does not.

I’m a bit surprised your insurance company paid anything for these dermatology activities if you were below your deductible. Are you sure that this wasn’t your benefit for using an in-network provider? For example, if the dermatologist billed $250 but they have a contract with your insurance company to only charge $125 for the procedure, then your EOB will show an insurance adjustment of $125 but the insurance company didn’t pay anything, you just got the advantage of the insurance company’s negotiated rates. Make sure you go to an in network provider to get this benefit. If you go to an out of network provider, that can charge you anything they want. You could go to a lower deductible plan but look at the difference in those costs. At my company the lower cost plan costs more than the deductible difference.

likehelpful

If you were billed $250 for the office visit and $250 for the biopsy and your insurance company negotiated that to 125 and 125, that’s pretty fair. The insurance company has already negotiated for you. If you want to see a line item billing, look at your EOB, it will show each charge, the amount billed, the negotiate amount, the amount paid by insurance, and your responsibility. The point of high deductible insurance is that you take care of these “small charges” and insurance covers when you need surgery or hospitalization. You should use your HSA to save tax free to cover your deductible and co-pays. You could spend your time fighting this but this is a completely reasonable charge for a dermatology procedure and biopsy.

Call insurance to understand why they didn’t cover more and then call the clinic back and tell them you’re willing to pay half (assuming insurance doesn’t pay more). I’ve done this a few times at dermatologists and they typically accept.

like

Tell them they need to give you a line item bill of the cost of all the items.

First of all, a “new patient fee” is weird. I have never never been charged that. Some providers will make you be an existing patient before you see the doc for something like a biopsy, so you need an initial exam to be a patient— but you should have gotten something for that $250. So, the first thing here is you need to learn to ask questions at the office ahead of service— what do they charge, how do they bill, etc. You’ll get the hang of it.

Secondly, though these fees sound high, remember you are paying way less per month in deductibles than the alternative plan. Once you have some $ built up in HSA account these fees won’t seem so bad and won’t deter you from getting care. On a high deductible plan, your best move is to put the max into your HSA each month.

like

You have to make your own decisions, but the way I do it is map out a year of premiums in an excel sheet to compare the various options. Then I add in costs for treatment for my likely expenses and see what is cheaper.

Then I do the same analysis but with a “reasonable worst case” medical situation thrown in there. Could I manage that? Would it wipe me out?

Remember, you can always use something like care credit or well fargo health advantage to pay a big bill. And, you don’t have to pay that big bill at once. You only have to pay a small bit at a time in good faith to not be sent off to collections.

I have a family of 4 and a lot of complex health issues. I still choose the low premium/high deductible plan. Just food for thought. Don’t make a choice out of fear.

like

You should get a higher tier of insurance. Your reasoning for getting a high deductible plan has changed. In an earlier comment you just riddled off wanting to see 3 specialists. GI will be expensive as you can go down a rabbit hole easily.

like

Yes that’s normal for a specialist and for pretty much all plans until you hit a deductible. New patient fee is weird to me, sounds more doctor specific than standard practice

High deductible health plans assume you don’t go to the doctors frequently, and would rather have less money taken out of your paycheck each month, with the trade off being that you’ll paying more per doctors visit. You also can start an HSA that is direct deposited from your paycheck and then you can use that money tax free to pay for those more expensive drs visits as needed, and invest those funds if you don’t.

It's a numbers game, a higer deductible plan will be for people who rarely need medical care, to minimize annual spend on premiums and deductibles. Not a good fit for individuals or families that need Healthcare throughout the year, as you'll have to exhaust that deductible every year before coverage kicks in. With just a handful of visits per year the HDHP still makes sense, you'll have to forecast next year's needs, and then weigh each option against another.

Max out the HSA in all cases.

Most likely your plan didn’t pay anything since you haven’t hit your deductible, but what you saw on your bill was the “plan discount” (the special rates negotiated between your insurance company and the provider).

You’re almost always better off with a high-deductible health plan (HDHP) *and* an HSA where you contribute at least your deductible vs. a PPO/HMO. Obviously this depends somewhat on how much your employer contributes to your plan premiums.

Thanks for breaking that down!

like

Related Posts

I’m a technical consultant but sick of the low pay and bad benefits at SI firms. I have some opportunities at Big 4 with better pay & benefits. Will it derail my career to move to Big 4?

like

I wish I would have had this bowl ten years ago 😔 I recently was diagnosed with ADHD. I have been able to manage this far with coping mechanisms but I recently got divorced, have four kids and a busy job with a lot of aspects that are new to me. Now I may get fired for “lack of attention to detail” and “missing deadlines.” I wish I had looked into this so much earlier. I’m two weeks into taking Wellbutrin but I think it takes awhile to kick in, my psychiatrist suggested starting with that…

like

Happy New year 2022, dear Fishes!

May this new year fullfill all your wishes and give you all the happiness & health you wanted 🎊🎉🥳.

"May the force be with you"🖖


Thank you for being Awesome.🤝



Thanks & Regards
Your Friend

like

I am an RN with a total of 11+ years of experience on hospital and corporate RN insurance accounts. I was away from bedside nursing for 10 years. I recently accepted an offer at a mid-city Rehab facility to reintegrate myself back to bedside practice. The institution offered me a $40/h rate. Is this a good offer?

like

Need to leave for Canada in roughly a month because of US visa expiry but worried about potential travel restrictions in Canada given the bad covid situation. Are there any provinces that are not as hard hit by covid? Any advice is appreciated. Thanks.

It's that time...🦃

What's one thing you're grateful for in your life or career at the moment?

Drop it below! 👇

like

I know I’m not the only one burned out on insurance. Has anyone thought of moving into a different career? If so, what?

likesmart

Health stuff (beyond anxiety and depression) getting me down. Want to take med leave (dr has said yes), but am afraid of internal politics and YE. Need courage to go through with it

like

Can state Medicaid estate recovery take deceased term life insurance policy?

like

I am in a period of growth in my role (in house and getting more exposure to top management) - im grateful for it but I also have constant anxiety during and after work hours. Does anyone who’s been in a similar position have tips for riding this wave? Hoping it’ll get easier.

like

Which holding companies do you think have the best health agencies right now?

How do you all motivate yourselves to grind through the more boring aspects of our work. I'm so sick of investment management and my productivity is tanking because of it.

like

My parent is sick with dementia. I can tolerate high level of stress when I'm called names, sent to h... etc.. but I keep everything inside. It's been that way for a long while now. Today my cup of tolerance has overflown when I was giving my parent a bath. I was so angry that I was shaken and I forced my parent to bath... I yelled and said things I would never say otherwise. I know I'm wrong and it's a disease, but I just couldn't help it... now.. the work time comes... I couldn't concentrate... tears just flowing from my eyes. Which I totally deserve. I'm glad I was working from home today. It got to the point that I just don't want to see that anymore... I just don't want to wake up. I just want to escape of my thoughts and my feelings...

I have experienced a lot of progress in the field of mental health since I began my career as a Licensed Social Worker, 25+ years ago. We've come a long way educating others about mental health and increased the focus on addressing individual needs. But, at least in my profession, we are doing this at the cost of the case manager's mental and physical health. I am definitely familiar with high caseloads, but they have increased significantly. Federal policy and guidelines have created unreali

like

Currently interviewing for a remote account manager position with USI Insurance in NC. I have over 20 years experience in personal lines as an agent. Can anyone provide insight as to the average pay for this position?

like

Associates, how did you balance your morning sickness and fatigue in early pregnancy with work? Thankfully I’m still WFH, but worried about receiving insane turnarounds that require me to stay up late/all night and the effect it might have on the baby. I’m past my hours for the year and feel like I should be able to say no, but the team I’m on has a tendency to push past no’s.

like

Hi all, I’m looking to re-enter the workforce. I had to take a career pause @ the beginning of the pandemic because I had a child. I have 5+ years of experience in life science (bench top, pathology in a hospital, startup, and most recently clinical research). I’d like to make a slight pivot into a health informatics, clinical data or data analytics position but I’m also open to non clinical research positions like regulatory/quality assurance etc. Does anyone have any recommendations? TIA

like

Qualys is very bad company, nothing positive, only good thing medical insurance and 1 month np

Hello,
I graduated in June with a dual BSBA in healthcare management and human resources management/organizational management and two associates degrees in business and arts. I have twelve years of experience as a certified clinical medical assistant.

I'm having trouble finding my first job as a healthcare manager. After submitting many applications and receiving so many rejection emails, I've become frustrated. Any advice anyone can give is greatly appreciated.

like

I am a clinical research coordinator working in Austin, Texas. I have my Masters in Cell & Molecular Biology and have a year of laboratory research experience.

I’ve been in my position for 5 months now. I make $27 hourly which amounts to about $51,000 yearly. Am I being under paid? Are all coordinator positions hourly? As a laboratory researcher I was salary :(

How do I go about asking for a raise or should I explore other companies or medical schools that have clinical research?

like

More Posts

Does Accenture reimburse cellphone bills and internet?

like

I presented with my CCO in a pitch and it went really well. When we left the meeting he kissed me on the top of my head (in a patriarchal way, not sexual at all)... I froze and ignored him. Thoughts?

like

How important is hitting your utilization at Salesforce? Been waiting five weeks for a SOW to sign and my útil is now below target... will I be let go at the end of the year?

like

My 2 yo toddler has been waking up at night a couple of times sometimes. I can’t function on the next day properly. I’m too tired and getting depressed. Afraid to lose my job. Tips pls?!!

like

I am feeling naughty since morning! Anyone sharing the feeling?

like

We've been importing most of our goods from Europe, but with the cost of everything going up, this has become unsustainable. Should we look to Asia or South America in order to lower our overall costs?

like

Chances for HBS r2 as a Sri Lankan female, 1.5 YOE in consulting, 2.5 YOE in impact investing research, good story and LORs, 160Q/162V/5.0AW, and 3.53 STEM from t20 UG?

like

Does anyone here find the headrest on their office chair super helpful? I've never had one, and can't imagine it's necessary as I shop for a new chair, but want to make sure there isn't something I'm missing.

like

Merry Christmas! I’m looking for a mentor in product marketing/product management. I am really passionate to make the switch ASAP so wanted some advice. Happy to chat further via DM! Thank you

like

I'm an new joiner in D usi, What is meant by "member firm level" in DPN ? Is it any level of competency or expertise? For some I'm seeing associate 5,6 and XIN specialist also??

like
like

Guess the veggie

Post Photo
like
like

Has anyone had experience in both the nonprofit and corporate sectors? Most of my experience in college was with nonprofits but I’m currently working in corporate retail. There are a lot of things I miss about the nonprofit sector and I am considering about making the move back but want to weigh my pros and cons. I am one year out of grad school so any knowledge regarding how to navigate the workforce as a newbie is welcomed. Thank you!

likehelpfulupliftingsmartfunny

Looking to move into a fraud/forensics field. Currently in Financial Services Consulting for 3 years and hate it. What are some possible paths that might be a good place to start?

like

Hope to all enjoyed the meet up, I will post more links soon.

Post Photo
like

29M Boston, athletic fit. Looking for something serious. DM me

like

Taking REG in a couple of weeks! What kind of SIM did you guys have?

like

Recently got engaged but I really don’t fantasize about having the perfect wedding. My extended family (grandparents/aunts/uncles) are back in my home country, Australia, but my boyfriend has a huge family so the wedding will consists of 75% his family (and our friends). Am I the only girl who just wants a small wedding ceremony and call it a day 🥲

like

Anyone know whose logo this is? A vendor gave me this sweatshirt at a lunch-and-learn and I wear it errryday. Need to throw them some business 😊

Post Photo
likefunny

Additional Posts in Consulting

When your dad is a consultant plastic surgeon and you tell him you got promoted from analyst to management consultant >>>>

likefunny

Why Dulles must you make me walk through the glorious smell of bacon and steak on my way to the security line every Monday.... 😔

like

Any suggestions on best restaurants for a Rostov evening with wife on/near time square?

like

That moment when you're the only female at the team lunch and your coworkers start start speaking “bro-talk”

like

Experiencing significantly more back pain since the last month. The work setup hasn’t changed. It’s a generic desk, footrest and ergonomic chair. Suggestions welcome on what I can add to my setup to make it more comfortable. I do take breaks and stretch once in two hours.

like

So how are the Performance Calls going at Accenture? What is the Promotion process now?

like

When leaving KPMG for another company, what are the payouts, if any? (Unused vacation days, etc) And is a 401k rollover required, or can you stay with Merrill Lynch?

like

What do you guys think of Netflix adding ads in exchange for a cheaper monthly price?

like

Rest In Peace and Power Chadwick Boseman...gone way too soon

likehelpful

TFW you step into the foyer of a NY studio and you realize it's the whole studio!

like

Does Apple use O365 or do they use their version of those services (Numbers, Pages, etc)? Apple

like

Am I missing something with this corona virus? I saw a statistic the other day that for anyone between the ages of 10 - 60, the death rate is ~0.2%...so what is the big deal? I assume just media hype?

like

I live in the Bay Area with my wife. We spend ~$1600 per month on food. Is that too much?

Our combined cash comp is ~$290K.

like

Before starting job: Friend - "what do consultants do?" Me - "¯\_(ツ)_/¯". 1 year into the job, friend - "WTF DO YOU DO?!" Me - "¯\_(ツ)_/¯ :'( ¯\_(ツ)_/¯"

like

What's Accenture labs (cyber security) like? Do you have to be an engineer for that line of work?

like

Accenture: what is the difference in work between ASDP and CDP? I know pay is probably better for ASDP, but I wanna know the difference in projects and all of that.

like

What are the starting salaries for an EY-Parthenon Consultant? Additionally, what would be an appropriate signing bonus and yearly bonus?

like

I just started a new job. I left my previous job because the environment wasn’t healthy and almost all of my colleagues left. The team at my new job is nice but the nature of the work doesn’t align with my interests/is not as unexpected and I’m struggling to stay motivated. I realize I made a poor decision. How bad would it be to quit after only 2-4 weeks? Or, instead of quitting should I ask if I can move internally?

like

Accenture peeps what is typical raise % from C to M in strategy?

like

What tips do you recommend to calm one's nerves during in-person meetings? I get very nervous to the extent of almost shivering. I wasn't always like this, but the pandemic and wfh have completely thrown me off my game. I'm fine in virtual meetings, but live meetings get the better of me.

like

New to Fishbowl?

Download the Fishbowl app to
unlock all discussions on Fishbowl.
That was just a preview…
Sign Up to see all discussions
  • Discover what it’s like to work at companies from real professionals
  • Get candid advice from people in your field in a safe space
  • Chat and network with other professionals in your field
Sign up in seconds to unlock all discussions on Fishbowl.

Already a user?
Login here

Share

Embed this post

Copy and paste embed code on your site

Preview

Download the
Fishbowl app

See what’s happening in your industry
from the palm of your hand.

A phone with Fishbowl app

Send download link to your phone

OR

Scan your QR code to download
Fishbowl app on your mobile

By continuing you agree to Terms of Use and Privacy Policy.

Messaging rates may apply

Download app

Sign up for free to view this conversation on Fishbowl

By continuing you agree to Terms of Use and Privacy Policy

Already have an account? Log in

Sign up for free to continue using Fishbowl

By continuing you agree to Terms of Use(New) and Privacy Policy(New)
Messaging rates may apply

Already have an account? Log in

For account settings, visit Fishbowl on Desktop Browser or

General

Legal