After I graduated from grad school, I paid my teaching dues by working as an adjunct instructor at three different community colleges and working part-time at a social services office.
The pay for all of the jobs was lousy, and I had no health insurance.
I wasn’t brave enough (or stupid enough, depending on your view), to go without health insurance completely. I paid for a catastrophic insurance policy that was fairly low cost, but would only pay for incidents over $5,000. I was sick a few times that year, and though I would have liked to have gone to see the doctor, I simply didn’t have the money to pay for the entire doctor’s visit myself.
Unfortunately, many others are in this same position.
The Health Insurance Crisis
When we think about the health insurance crisis, we often think about those without insurance or those who go bankrupt thanks to outrageous medical bills.
As consumers, what we often fail to see is the flip side can be just as frustrating for doctors.
Doctors have to spend hours and hours documenting for insurance purposes, and they need to hire office staff to deal with mountains of paperwork. There are delays in payment. (My husband’s insurance comes from our state, and they are routinely paying bills 10 to 11 months after the fact. I’m sure not too many doctors are pleased to wait that long for payment.)
Overall, insurance is often as much of an inconvenience for doctors as it for consumers.
Some Doctors Are Taking a Different Path
Recently, Dr. Michael Ciampi made news because he decided to no longer accept health insurance. Even if you have health insurance coverage, he won’t accept it.
First, he can offer lower costs than the insurance company would allow. Now, he’s offering a flat fee of $50 for office visits.
Second, he gets payment immediately, which makes a difference in his office’s cash flow.
Third, he doesn’t have to hire extra workers to handle all of the insurance paper work.
As a result, he’s lost plenty of patients, but he’s also gained some.
Is a Doctor Who Doesn’t Accept Insurance Right for You?
If your doctor stopped accepting insurance, would it be in your best interest to continue seeing her? What is the advantage for a patient?
Obviously, if you don’t have insurance, it’s to your benefit to see a doctor like Dr. Ciampi who doesn’t accept insurance. His fees are low, which will save you money, especially if you typically wait until your condition gets so bad you have to go to the emergency room.
However, just because you have a doctor who will accept your payment out of pocket, you still should be concerned if you face a major medical issue or have an accident. One event like that could wipe you out financially. At the very least, you should have catastrophic coverage.
But what if you do have insurance?
Should you only go to a doctor who takes insurance?
Well, that depends.
Here are a few questions you’ll need to consider:
- How high is your co-pay?
- Will you pay less overall if you pay out of pocket?
- Do you get more flexibility in your care if you don’t have to have everything approved by the insurance company?
Of course, you wouldn’t want to eliminate your insurance entirely, but just because a doctor quits accepting insurance doesn’t mean she’s no longer a good choice for your care.
The Darker Side of Doctors Who Don’t Accept Insurance
While Dr. Ciampi sounds altruistic, that isn’t always the case when doctors stop accepting insurance.
In some areas like New York City, doctors have stopped taking insurance because they want to charge more than the insurance companies will let them.
The New York Times raises an interesting question: “The cash-upfront trend raises an uncomfortable question. Can the Affordable Care Act, intended to widen access to health care, succeed by expanding insurance coverage if primary-care doctors are walking away from insurance?”
While Dr. Ciampi wants to make health care MORE affordable, many other doctors are dropping health insurance to make more money. Their wealthy patients can afford the change, but what about the other patients?
The more doctors who stop taking insurance, the more difficult it may be for some in certain regions of the country to get adequate care.