When to Choose the Self-Pay Option Instead of Insurance
When does it make sense to pay out of pocket for healthcare instead of using insurance?
In this episode of the Take Care podcast, Melody Mulaik answers David’s question about the pros and cons of self-pay (cash pay) versus using health insurance for medical services.
She walks through real-life situations where paying out of pocket may cost less, when insurance is clearly the better choice, and the key tradeoffs to think through before making a decision.
What You’ll Learn:
- [00:02:40] Why self-pay can sometimes be cheaper than using insurance, including a $75 self-pay vs $100 copay urgent care example.
- [00:02:40] How copays, deductibles, and negotiated rates can change what you actually pay out of pocket.
- [00:03:52] Why does self-pay not count toward your deductible because the claim is not submitted through insurance?
- [00:04:18] When prompt-pay discounts may be available if you pay upfront as a self-pay patient.
- [00:05:07] How privacy concerns can factor into your decision if you prefer not to submit a service to insurance.
- [00:05:39] Why prior authorization requirements can push some people toward self-pay for faster, simpler access.
- [00:06:43] When insurance is usually the smarter option, especially for hospitalizations, surgery, and ongoing treatment.
This episode is educational and helps you think through your options. Your costs and coverage depend on your specific insurance plan and provider.
Have a Question for Take Care?
Send your question through the form on Melody’s website or post it on social media for a future episode.
