Your Health Access Benefit is not traditional health insurance—and that’s a good thing for you! As a Health Access Member, you have more information about your own health care and are empowered to make the best decisions for you and your family.
Your primary care provider already has all the information they need in order to serve you. You can make an appointment with them at any time to manage most of your routine medical needs at no additional cost.
There may be occasions, however, that you find yourself in another medical office. This may happen if your primary care refers you to a specialist, sends orders for labs or imaging, or you are seeking certain preventive care services. In these situations, it’s important to tell them that you will be a cash pay patient.
What does it mean to be a cash pay patient?
Being a cash pay patient means that you are in control of your health care spending! There are no middlemen and no surprise charges. As a cash pay patient, you are telling the medical office that the services will be paid for directly—no insurance company will be involved—which allows you to get the lowest possible rates.
One question we often hear from our members is, "Will I be asked to pay up front for services?" While some providers may ask for payment at the time of service, most will simply provide a bill. For applicable preventive medical care such as dental cleanings, vision exams, flu shots, and much more, your preventive care service will reimburse you once you have a bill, which you can learn more about here.
In most cases, when you visit a new medical office, the first question someone at the front desk will ask is, “Can I see your insurance card?” As a cash pay patient, you won’t have an insurance card to give them, which can cause confusion or be stressful.
Here’s what you need to do: simply say, “I am cash pay.”
The person at the front desk should know what that means and provide you with out-of-pocket payment options. To make sure you are confident and clearly understood by the front-desk staff, here are some additional questions that you can ask.
Questions to ask as a cash pay patient.
What is the discount for cash payment? Almost all medical offices offer a discount for cash pay patients since their office won’t have to deal with the hassle of billing an insurance company. If they don’t voluntarily offer a cash pay discount, be sure to ask for one.
For example, Julie in Tennessee used to have traditional health insurance. When she would visit her chiropractor, her out-of-pocket copay was $65 per visit! When she asked what the discount would be for cash pay, her out-of-pocket cost per visit dropped to $40.
Do I need to pay today, or can you send me a bill? May I see an itemized statement? In most cases, you should be able to receive a bill with an itemized statement after your visit, rather than paying at the time of service. This makes it easier to file for reimbursement (if applicable) and for you to see exactly what you are paying for, in case you have any questions.
Jeremy in Maine has been using his Health Access Benefit for over a year to get reimbursed for his family’s preventive care. He told us that he has never once been asked to pay out-of-pocket at the time of service. While it will be different for each office, you can rest assured that asking to be billed after service is very common.
May I speak with the billing department? If you do have any questions, or the person at the front desk does not seem to understand how to best serve you as a cash pay patient, don’t hesitate to ask to speak to someone in the billing department. As the people who directly benefit from not having to file with insurance, they will be better equipped to assist you.
Being a cash pay patient is empowering!
The first time you explain to a medical office that you are a cash pay patient may feel awkward, but it is well worth it. Remember, you are not only saving money by not having expensive insurance premiums each month, but you are likely paying less money out-of-pocket than the patients with insurance!
That’s the kind of freedom and cost savings that your Health Access Benefit is all about.