Your Health Access Benefit is not traditional health insurance—and that’s a good thing! Health Access Solutions is designed to help you save money on medical bills so that you can have more financial freedom. We also want to empower you to make the best decisions for you and your family.
One of the ways you are in charge of your healthcare is through your primary care provider. They already have all the information they need to serve you. You can make an appointment with them at any time for no additional cost in order to manage most of your routine medical needs.
However, there may be occasions when you need to visit another medical office. Perhaps your primary care provider referred you to a specialist or ordered more testing. Or maybe you are seeking specific preventive care services. In these situations, it’s important to tell them that you are a self-pay patient.
What does it mean to be a self-pay patient?
Being a self-pay patient means that you are in control of your health care spending. It’s different from any health benefit you’ve had before—and that’s a good thing! Here’s what makes it so special:
- You will know exactly how much everything costs upfront.
- There are no middlemen like insurance companies.
- There are no surprise charges.
- You will often pay lower rates compared to insurance prices.
As a self-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.
Will I be asked to pay upfront for services?
One question we often hear from our members is, "Will I be asked to pay upfront for services?" While some providers may ask for payment at the time of service, most will simply provide a bill that’s due in approximately 30 days. Here’s where your Health Access Benefit comes in. HAS keeps things as simple as 1-2-3 with Preventive Reimbursement Requests.
- First, determine if your visit is eligible for preventive reimbursement. For example, this includes medical services such as dental cleanings, vision exams, flu shots, mental health care, and much more.
- After your health care visit, fill out the Preventive Reimbursement Form and include a copy of your medical bill.
- Your reimbursement will be processed within 10 business days, and then you can use the reimbursement to pay for your medical bill.
Tip: If you file the Preventive Reimbursement Form right after your medical visit, you can have the funds in your account before you have to pay the medical office!
How to communicate that you are a self-pay patient.
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 self-pay patient, you won’t have an insurance card to give them, which can be confusing or stressful.
Here’s what you need to do: simply say, “I am self-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 self-pay patient:
What is the discount for being a self-pay patient? Almost all medical offices offer a discount for self-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 self-pay discount, be sure to ask for one.
For example, Julie in Tennessee used to have traditional health insurance. Her out-of-pocket copay at her chiropractor was $65 per visit! When she asked what the discount would be for self-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 will 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 to see exactly what you are paying for, in case you have any questions.
Jeremy in Maine has been a Health Access member for more than a year, using his Health Access Benefit to get reimbursed for his family’s preventive care. In his experience, he has never 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 have any questions or the person at the front desk does not understand how to best serve you as a self-pay patient, don’t hesitate to ask to speak to someone in the billing department. Since they are the people who directly benefit from not having to file with insurance, they will be better equipped to assist you.
Being a self-pay patient is empowering!
The first time you explain to a medical office that you are a self-pay patient may feel awkward, but it will get easier. Remember, you are not only saving money by not avoiding expensive monthly insurance premiums, but you are also paying less money out-of-pocket than the patients with traditional insurance!
That’s the kind of freedom and cost savings that your Health Access Benefit is all about.