The Biggest Hidden Benefit of Health Insurance
An ACA-compliant health insurance plan covers most health-related expenses that you could come up against, sparing you from high medical bills in the event of an injury or illness, not to mention the expense of routine care. However, even before you hit your annual deductible, your Health Insurance in Las Vegas, Nevada saves you a significant amount of money. Because of negotiated rates. When you use a network provider, you may pay substantially less for care than someone who doesn’t have health insurance coverage, even before the deductible has been met.


What Is a Negotiated Rate?
The majority of health insurance companies have a contract with a network of hospitals and other providers. In this contract, there are negotiated rates for different services. This negotiated rate is generally lower and sometimes significantly lower than what a provider would charge someone who is paying out of pocket. For example, a hospital may charge an uninsured person $2,500 for a CT scan. However, a health insurance provider may have a negotiated rate of, say $500 for a CT scan for their insured members. The actual amount varies.
This practice makes sense for health insurance companies because it allows them to save money on their covered services, enabling them to provide more competitive rates to their customers. However, negotiated rates also benefit hospitals and other healthcare providers because they are almost guaranteed business from that insurer’s customer base, because most people choose a provider in their health insurance network, and large insurance companies have thousands of customers.
Different Health Insurance Company, Different Negotiated Rate
Negotiated rates vary from one health insurance company to another. Larger health insurance companies tend to have lower negotiated rates, as their large customer base gives them more leverage. This is a generalization but not necessarily a fact in all situations. If you switch to a different health insurance company, you may notice a difference in the price that you pay for the same health services. This is due to a difference in negotiated rates. In fact, negotiated rates can reduce out of pocket expenses sometimes by 60-70% or so, a reduction of hundreds or even thousands of dollars. Of course, this depends on the procedure, and the insurance company, comparing the same procedure at the same hospital without an insurance plan (with negotiated rates).


Getting the Most Affordable Care with Nevada Insurance Enrollment
Even if you don’t hit your deductible during the year, you can see significant cost savings just by being enrolled in a health insurance plan. Because you’ll pay out-of-pocket costs for a given procedure, these variations in negotiated rates have a significant impact on the value of a health insurance plan. In addition to researching whether the services at a hospital are priced high or low, you should also consider a health insurance company’s ability to negotiate for you on your behalf.
Unfortunately, it can be very difficult to compare negotiated rates for different plans. Rates vary from one provider to another, meaning that your health insurance company may pay Hospital A $350 for that CT scan but Hospital B $500. That would depend on their contract with one another.
At Nevada Insurance Enrollment, our health insurance agents help you compare insurance plans and can help ensure that you get the best value for your money.
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Recent Posts
What is a Summary of Benefits and Why Should I Read It?
A summary of benefits (SBC) is a 4-page document explaining a health insurance plan’s coverage, costs, and examples. It helps compare plans, understand costs like premiums and deductibles, and assess coverage for services like doctor visits or preventive care. Available through Nevada Health Link, the SBC is standardized for easy comparison but does not include provider networks or full exclusions. Learn how to use the SBC to choose a plan that fits your needs.
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Confused about insurance requirements for vehicle registration in Nevada? Learn why auto insurance is mandatory, with minimum liability coverage of 25/50/20. Understand how to provide proof, navigate the registration process, and avoid costly lapses. From required documents to penalties, this guide covers it all. Discover optional coverages and cost-saving tips to stay protected.
What Is a Health Insurance Carrier?
A health insurance carrier provides plans to cover medical expenses, like doctor visits and prescription medications. Understanding your insurer’s network, plan types (HMO, PPO), and costs (premiums, deductibles) is key to choosing coverage. In Nevada, carriers collaborate with Nevada Health Link to offer ACA-compliant plans, ensuring access to preventive care and essential benefits. Learn how to select a dependable health insurance company and manage costs effectively.
What is a Prescription Drug Deductible?
In the world of health insurance, “deductible” is a common word. It refers to an amount of money that you pay out of your pocket before the insurance company begins to pay. A prescription deductible is the portion you’d pay first, then after you’ve paid the deductible, you may only have to pay a co-pay when you pick up your medication.
If you are single, you would only have to meet your prescription deductible. If you have two or more people in your family, each member may have to meet their own prescription deductible which could be up to 2 deductibles in the family. A prescription deductible is different and separate from the medical deductible, unless otherwise stated. One deductible is for medical, ie: hospitalization, doctors, etc., and the other deductible is for filling your prescriptions.
