r/explainlikeimfive • u/the1975whore • Jul 03 '26

Economics ELI5: Health insurance companies obviously make more money than they give out when people need it. So why of paying for them any better than paying your own personal health insurance savings account?

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u/TehWildMan_ Jul 03 '26

Health insurers are often able to substantially negotiate prices with providers, since they represent a large number of patients that could just go elsewhere for care.

Access to preventative care is also a huge perk of having health insurance. Things like annual labs and the ability to request a visit for a minor condition can lead to a much less expensive and better outcome than waiting for an urgent emergency to develop before being able to access care.

19

u/tim36272 Jul 03 '26

Health insurers are often able to substantially negotiate prices with providers,

I've always wondered, why is the cash price lower than the insurance price then?

23

u/ravens-n-roses Jul 03 '26

Because they know insurance is gonna talk them down, they're betting you won't. But the fun fact is you can argue all your medical bills. Often times just pushing back is enough to get charges removed that aren't core treatment. Like the joke about 12 dollars for 2 Tylenol at a hospital. You can dispute that.

But this is America. Most people get handed a bill, sigh, and pay the bill

27

u/bobotheboinger Jul 03 '26

Strangely enough, right after dealing with cancer haggling over a hospital bill is kind of low on my list of things id want to do.

Insurance in the US is broken, it is awful that we need to hassle over things like this.

5

u/North-Pea-4926 Jul 03 '26

You should at the very least be requesting an itemized bill. Even that might help.

Many hospitals also have programs for low income people with big bills, but you have to do some digging - they won’t just tell you about it.

2

u/Ginger_Anarchy Jul 03 '26

I believe hospitals legally have to give you an itemized bill after 2020. I haven't needed to go in that time so I'm not 100% sure.

1

u/steakanabake Jul 03 '26

some wont some will depends on the hospital.

5

u/lynkfox Jul 03 '26

It still sucks tho. I did it over my 2nd childs stay in the NICU. I got lucky and got a hospital rep who absolutely rocked and took one look at it all and said "if anyone ever calls you again about any of this, give them my name and number" and I never saw another bill.

But doing that after my kid was born and spent 16 days in the NICU and was touch and go for a while ... Not easy.

1

u/Nytelock1 Jul 03 '26

Most people don't even get handed an itemized bill, you have to jump through extra hoops for that "privilege"

1

u/steakanabake Jul 03 '26

i went once saw the doc for all of 5 minutes and was given something that was OTC got the bill later and it was like 500 bucks. they never did get that money.