The insurance market can feel like too much of a good thing. There are options galore but choosing the right one for your budget, family, and specific needs is often confusing. More than 100 years ago, writer and wit Ambrose Bierce called insurance “an ingenious modern game of chance,” and that’s still true today.
In Washington State, census data shows that 49% of residents receive insurance through their employer, echoing the American national average. The next 44% fall into Medicaid, Medicare, other (military or Veterans Administration), and uninsured categories. That leaves 7%, approximately 500,000 people, who purchase coverage outside of work, whether individually or with fellow employees or associates.
Counter-intuitive as it may seem, sometimes it’s cheaper to keep the policy ID card in your pocket and pay cash for needed medical procedures. At Longview’s Pacific Surgical Center (PSC), all costs are listed up-front so there won’t be any surprises down the road.
PSC provides comprehensive outpatient surgical care in matters of orthopedics, urology, general surgery, podiatry, and gastroenterology. With clearly posted transparency pricing, you won’t fall victim to unnecessary delays, sticker shock, or prohibitive fees that force you to postpone treatment.
An Explanation of Insurance Options
Even with more traditional employer-funded programs, the patient’s portion of surgery can be expensive. You pay deductibles, coinsurance, and unexpected costs are not unheard of. A recent knee replacement surgery was quoted as costing $69,000 in a hospital and only $27,000 at PSC.
If you work for a business or company, fully-insured and self-insured plans are options. These are good for groups wishing to pool resources. Fully-insured is defined as one where “The company pays a premium to the insurance carrier. The premium rates are fixed for a year, based on the number of employees enrolled in the plan each month…The insurance carrier collects the premiums and pays the health care claims based on the coverage benefits outlined in the policy purchased.”
This is as opposed to “a self-insured (self-funded) health plan, employers (usually larger) operate their own health plan as opposed to purchasing a fully-insured plan from an insurance carrier.”
These self-funded plans benefit tremendously from options like Pacific Surgical Center. Since all monies are held in a shared community account, they must stretch as far as possible when surgery is needed. With PSC’s one-stop-shop approach, lab work can be done on site and costs include the facility, surgeon, and anesthesiologist’s fees. The facility charge covers pre-operative evaluation, equipment, personnel, most supplies and medications, and use of the operating and recovery rooms.
If you’re self-employed or part of the growing ‘gig economy,’ finding insurance at all can be difficult. Reports show that “in 2015, 1 in 3 workers were choosing to earn income from non-traditional work, that works out to 53 million Americans. The estimates are that by 2020, that’s just 2 years away, 50 percent of the workforce in the United States will have some form of freelance work. A major challenge facing independent, self-employed or freelance works is in finding affordable and reliable health insurance coverage.”
This uncertainty often leads people to postpone needed operations. But if your income relies on accepting spur-of-the-moment jobs, deliveries, or shifts, living with daily pain could mean missed work and less money.
Pacific Surgical Center Will Help You Through the Process
At PSC, skilled financial counselors will walk you through all the steps beforehand. If you choose to bill your insurance, we’ll obtain the necessary details and do it for you. Either way, we’ll provide a detailed estimate of charges that is honored even if surgery requires additional time or materials.
Outpatient surgery at PSC does more than just save money. We strive to provide “a very attractive alternative to hospital-based surgery, eliminating common concerns most people have. Your experience will involve exceptional care with easier access, more privacy, less paperwork, greater comfort and less stress than if your procedure were performed at a hospital. Our physicians use the most advanced surgical equipment and technology available. This ensures that your procedure will be fast, comfortable and minimally invasive; and it also will require less recovery time than a surgical procedure performed using older methods and instruments.”
Insurance is tricky. It has a language of its own and many of us live in fear of making the wrong choice and paying pricey consequences. But don’t put off surgery that could relieve pain or improve your quality of life. Let us explain how we can help and you’ll be back on your feet in no time.
Schedule an appointment online or by calling 360-442-7900.