r/HealthInsurance • u/MenuRare9880 • Apr 28 '25

Claims/Providers Illegal to not bill through insurance?

I just got insurance for the first time in 3 years. My treatment that cost me $190 cash (self-pay) is now $520 until I meet my $3,500 deductible which would take me 11 months, soo.. pointless.

I told my Dr’s office I am no longer going to go through my insurance & the billing lady said that’s illegal… I am going to look for a new Dr now anyway but is there truth to this? Would I face repercussions as an individual patient if I simply chose not to disclose that I have insurance & pay the cash price?

FYI: the self-pay price was NOT subsidized by a grant or aid.

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u/buzzybody21 Apr 28 '25

There’s nothing illegal about this. Does the doctor take your insurance, or are they charging you the cash price because they don’t?

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u/MenuRare9880 Apr 28 '25

They do take my insurance, but my insurance won’t cover it until I meet my deductible.

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u/buzzybody21 Apr 28 '25

So essentially, they’re billing your insurance toward your deductible, instead of giving you the cash price? Nothing illegal here unfortunately.