I'm too young for medicare, but when I asked my dr. to prescribe the heart scan, he kept stalling. When I followed up, he said my insurance wouldn't pay for it. Then I checked into pricing and it was $130 lol. If I have a family history, why would he assume I didn't want to pay the $130? I later found out that the his medical practice gets penalized by the insurance company for recommending "too many tests." So that plays into it.
If you want a CAC scan you can just go directly to an imaging center that offers it and order it yourself. It doesn't require a prescription. In most cases it won't be covered by insurance for screening purposes.
It varies. At the largest medical provider in my region they stipulate "To self-refer for a Heart Scan, you must be male between the ages of 40-65 or female between the ages of 45-70 and have a qualifying risk factor."
That's if you're going through insurance. They'll scan anyone with a check in their hand.
nope, some will reject. I had to go through 3
There are probably other imaging centers in your region.
CAT scanners are of variable cost and resolution.
Yes, what's your point? A CAC test doesn't require the most expensive CT scanner.
Wow, I would have expected something like this to be $thousand$ but a quick check with AI claims that in the U.S. the self-pay rate is anywhere from $100-$400. Still not cheap, but much more affordable than I expected.
I once tried to get some pills at CVS. I was charged something like $500, and asked for my insurance information. When I told them I had no insurance, they told me to go talk to a person a few meters away so that he can help me... I got the pills for $30.
I am not asserting that it applies in the above instance, but...
In broader medicine, one basis that can lead to the above sort of dynamic is compassionate protocol ("we are losing a little money on this deal, but you are in-need and we're here to help everyone"), as opposed to greed protocol ("we medicos are here for the big insurance money, and only charge the True Low Cost when forced").
And on balance, the nature of the people who choose the occupation of medicine tends towards the former.
drug companies themselves often have programs to offer them to the uninsured at copay or greatly reduced cost.
A lot of doctors are willing to cut their rates if you're willing to pay cash for the full amount. It's the paperwork that inflates insurance costs. I'm sure AI will cut through that and make it less a problem though. /s
Beware that some providers are in contracts prohibiting them from taking cash payments if they know a patient is covered by the contracting insurance carrier. I don't know the specifics of the business justification for these terms but they do exist.
I've had providers tell me they'd have been happy to charge me less, making less than their insurance reimbursement, but not have to mess w/ billing my insurance, but they were unable because their contract with my insurer did not allow it.
>A lot of doctors are willing to cut their rates if you're willing to pay cash for the full amount
Are pennies okay? Sorry, they're not rolled. Just let me know if it's not enough.
If you're willing to pay cash?
This sounds more like tax evasion than paperwork avoidance.
"Paying cash" doesn't mean literally that in this context. Cash, credit card, check... "Paying cash" just means paying directly without involving insurance.
Could be that. Could be they don't want to pay 3% to a middle.
It also means not paying credit card fees, not having to chase down bounced checks, etc. Cash means the money is there, which has value.
When I "pay cash" for a medical procedure it's actually with a credit card.
Just means I'm paying them directly instead of making them deal with my insurance.
I mean pay 100% of the cost yourself rather than relying on insurance. You can use a bank card or credit card.