The surgery had been scheduled before the insurance change, and he was told that the cost would be $1000 through that insurance provider. On the morning of the surgery, he informed the hospital that his insurance had changed and gave them the new provider information. He was shocked to then find out that the surgery would now cost $3000 through the new insurance provider. After asking some questions in the hospital’s billing office, he was taken aside and he was advised to go ahead with the surgery, but to do it as if he were uninsured, because the uninsured price was $2000.

So, old insurance, $1000. New insurance, $3000. No insurance, $2000.

This shows an angle of medical insurance that many might not fully realize. Under the current setup, hospitals can’t really offer a “menu” style pricing, because that sort of pricing doesn’t exactly exist. Insurance providers are deciding the price, and often some are ‘negotiating’ HIGHER prices than what a hosptial would normally charge for a procedure. Sure, that insurance company may be able to say that they cover a higher percentage of the patient’s costs, but that’s only because they’ve already artificially inflated the costs of services to begin with.

There has been some movement among insurers to publish pricing information through cost estimators. I know Anthem and Aetna offer that service and just yesterday UnitedHealthCare announced a similar online tool that will “estimate the cost of more than 100 common treatments and procedures.”