Self-Pay in Healthcare: What It Means and What to Ask Before You Pay
What does “self-pay” mean when you’re getting healthcare? It can mean you don’t have health insurance, or that you have insurance but choose not to use it for a particular service.
In this episode of Take Care, Melody Mulaik explains how both situations work and what to ask before agreeing to pay out of pocket. She discusses why a self-pay price may differ from an insurance-billed price, how one visit can include both insurance-billed and self-pay services, and why it’s useful to get the expected cost in writing.
In this episode, you’ll learn:
- What self-pay can mean if you’re uninsured or have insurance
- Why it’s important to ask for the self-pay price before receiving care
- How a visit can include services billed to insurance and services paid for directly
- What to ask about the total cost, including provider and facility fees
- How a Good Faith Estimate can help you understand expected costs before care
Questions to ask before you pay:
- Does my insurance cover this service?
- What is the self-pay price?
- Does that amount include all provider and facility fees?
- Can I get a written Good Faith Estimate?
Resources
- CMS: Know your rights when you don’t have or aren’t using insurance
- CMS: Dispute a medical bill
- Related episode: When to Choose the Self-Pay Option Instead of Insurance
Have a healthcare billing or insurance question for a future episode? Send it through Melody’s website.
This episode is for educational purposes. Coverage and costs depend on your plan, provider, and the service you receive.
