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Saving Money on Health Insurance With Negotiated Pricing

by | Dec 2, 2024

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.

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Saving Money on Health Insurance With Negotiated Pricing

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).

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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.

You Can Still Buy Health Insurance From a Local Agent

You Can Still Buy Health Insurance From a Local Agent

The way health insurance is being marketed may give you the wrong impression that Nevada Health Link is the ONLY place to buy health insurance these days, but that is NOT the case. You can continue to buy your health insurance from the same agents and agencies you’ve always bought your health insurance from.

Is Health Insurance Worth The Cost?

Is Health Insurance Worth The Cost?

If you experience a more extensive medical emergency and require hospitalization, hospital bills may quickly become a burden. A three-day stay, for example, could set you back about $60,000 depending on what tests are ordered and what happens during your stay.

What is Co-Insurance?

What is Co-Insurance?

Co-insurance means two parties will be paying for the bill. “Co” means joint, mutual, two, or more. The health insurance company will usually pay the larger amount (example 70%) and you as the member will usually pay the lesser amount (example 30%). This would be considered co-insurance 70/30. This (co-insurance) usually happens AFTER the deductible is met.

 

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Things Potentially NOT Covered By Your Health Insurance

To be fair, in recent years, health insurance companies have made strides towards transparency. If you have an ACA-compliant plan, there are many services that your health insurance is legally required to cover, taking some of the guesswork out of budgeting for health expenses.

Medical Loss Ratio

This Medical Loss Ratio states that when a family or individual buys a medical plan, 80% of every dollar collected and paid to an insurance company MUST pay medical claims/research. So that leaves the insurance company to pay ALL of their expenses with the remaining 20%. .20 cents on the dollar for their employees, buildings, broker costs, etc.

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