Do Hospitals charge un-insured patients more than insured patients?

Answer 1

All patients are charged the same.To charge patients differently is fraudulent.

Unfortunately, unlike any other business what the price charged is and what is collected are totally different things. For example, if the charge for an ultrasound is $450 the "contracted" rate with a private insurance carrier like Blue Cross Blue Shield may be only $100. That means the hospital cannot COLLECT more than $100 from that patient. This is where there is tremendous confusion regarding what is charged to different patients. The charge is the same what is collected may be different.

This initially evolved from the fact that in the 70s many carriers were paying the full rate so there has been no adjustments. But since the contracted rate may vary from carrier to carrier a hospital or physician must have a rate that is well above any contracted rate since if they would only charge $100 and insurance company B might pay $250 then they would be losing money. Unfortunately this results in the self pay patient being charged the full amount. Medicare law PROHIBITS charging people differently.

Most institutions do have programs for the uninsured. For example since most insurance carriers on average pay about 40-45% of the charge once the uninsured patient pays that amount they will write the rest of the charge off. However, they cannot simply just charge them the discounted fee. All institutions and health care providers will make exceptions for patients in need but those individuals must make the effort to inform them of their needs. Often people will just throw the bills away and when they are turned over collections say "I just didn't know". The important thing to do is ASK.

Answer 2

Most hospitals bill insured and uninsured equally, however, once the item goes to the insurance company the insurance company writes off all excesses above the contracted rate. So the net effect is that the total billed is much less for the insured patient.

There were some accusations over the past few years, however of some hospitals that billed their uninsured patients higher FROM THE BEGINNING, in order to recoup costs of the other uninsured patients. Most peole think this is not ethical and many states are attempting to pass laws making this illegal.

Answer 3

Yes and no. They "charge" the same amount to a person's insurance and then "discount" a pre-determined amount. This amount is negotiated by the insurance company, and it may be different for each insurance plan. If you have a plan that covers 80% of "wellness" visits, then the hospital may charge your insurance $150 for that charge, but discount it to $100. The insurance comapny pays $80 and the insured person pays $20. If you don't have insurance, then you have to pay the entire $150. Some hospitals will give an unisured person a "cash discount". Usually you have to ask for it, and pay while you are at the hospital.
It is very confusing, but always ask for an itemized statement, and if you see something that you don't recognize, then don't pay for it until you know what it is. I have seen hospitals charge $75.00 for a "mucous recovery system" which turned out to be a box of Kleenex.

Answer 4

Yes.

The reason why this is the case is because they have a set rate for services, and that is what you get billed for when you do not have insurance.

When you do have insurance, you pay the rate agreed upon between the hospital and insurance company. This is because the hospital agrees to take a lower rate because in turn, the insurance company is allowing more patients to deal with the hospital. Even though they are getting less money for services, they are making more in the long run because their patient volume increases.

Answer 5

Yes. Insured patients get a discount because of the Insurance company contracts....



good luck & bless

Answer 6

Hospitals are, for the most part, only allowed to charge third party payers, usual and customary charges. They are not limited to that with "out of pocket" payers. JMHO FWIW. Always check with your State's governing bodies.

Answer 7

yes, b/c they are competing to be on insurance agencies list of doctors, so they get group rates. Sometimes it can be more than twice as much for the uninsured. Pretty messed up ha.

Answer 8

Ignorant question... resting on the concept that Medicaid recipients are lazy or on welfare. My mom has been mentally ill for years, and that i won't be able to be a great deal surprised if she has to flow on Medicaid before too lengthy. i'm particular you does no longer call her lazy in my presence.

Answer 9

VERY much so . Its their opinion that they can go after you in court and get it anyway so that's why your charged 150.00 for .10 cent band aid

Answer 10

YES!!! Lots more. They assume you're not going to pay, so they bill you higher. Never pay what they bill, they will always negotiate it downward.