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/MSPRC1492 Apr 29 '25

It’s a racket. Having insurance doesn’t help with medical costs. It makes them higher.

People need to accept this and stop playing the game.

I cancelled my old policy and told my doctors I’m now uninsured. I bought a policy where I have to pay $6,500 out of pocket before it pays a dime- and told nofuckingbody. It will never be used unless I have a serious emergency, and not “I need a mammogram” emergency, but an I’m airlifted off the scene of an accident emergency in which case paying $6,500 won’t be my biggest problem.

4

u/Alternative-Sweet-25 Apr 29 '25

$6500 is a drop in the bucket when it comes to healthcare costs.

3

u/[deleted] Apr 29 '25

Yep. I just had an emergency surgery on my back and it was $600,00

1

u/MenuRare9880 Apr 29 '25

This is what I’m going to do once I find a new provider. Do you think there’s any way they can find out you have insurance & you get in trouble??

3

u/MSPRC1492 Apr 29 '25 edited Apr 29 '25

No. Make sure the new provider is at a different system, not associated with the one you gave your insurance to. But even if they somehow found out you had insurance you won’t get in trouble. The rule she was referring to applies to them, not you.

1

u/MenuRare9880 Apr 29 '25

thank you!!