If you work for a large corporation, organization, or employer, medical insurance probably doesn’t cross your mind very often. It’s a comforting constant, used without much thought. But for small businesses, there are other options than outsourcing to a big-named company. One that’s increasing in popularity is self-funded insurance.
With a fully-funded plan, the coordinating insurance company selects which doctors and services are covered. To self-funded plans, saving money is key so clinics like Longview’s Pacific Surgical Center (PSC) are a lifesaver. Their commitment to up-front, transparency pricing means every dollar goes further and more people can benefit.
Self-funded coverage is different than simply saving for a rainy day. It’s sometimes confused with official products aimed at supporting individuals with low-cost/high deductible corporate plans. HealthCare.gov explains that the most common of these, Health Savings Accounts (HSA’s), work by setting money aside to defray the upfront costs of “generally any health plan…with a deductible of at least $1,350 for an individual or $2,700 for a family.”
Individuals with high deductible plans can also create and access Flexible Spending Accounts (FSA’s). These un-taxed savings accounts are typically available through your employer and can cover “copayments, deductibles, some drugs, and some other health care costs,” says HealthCare.gov.
But unlike HSA’s and FSA’s, a self-funded insurance plan doesn’t usually involve an outside company at all. Industry experts explain the difference: “A fully insured plan means that you are passing all of the risks onto your insurance carrier who charges you a flat monthly fee based on how they gauge the risk of insuring your employees…A self-insured plan is one in which the business pays the actual claims and essentially assumes the role of the insurance carrier in terms of managing risk.”
When a company chooses the self-funded option, “the employer can pay for coverage, or have their employees pay a portion each month via payroll deductions. Rather than send payments to an insurance company, however, this money is placed in a designated bank account that’s used to cover potential bills.”
Although everyone pays into one account, individual health needs vary. This is where Pacific Surgical Center comes in. Why pay $69,000 for a knee replacement when PSC charges less than $30,000? Clearly posted prices include the facility fee, surgeon’s fee, and anesthesiologist’s fee, and outpatient treatment means you’re back on your feet sooner.
No matter what kind of coverage you have, PSC will work to find the best solution. They have financial counselors and billing staff on-hand to help you decide if it’s better to pay cash out of pocket or bill your insurance. Many patients are surprised when skipping insurance companies is actually the cheaper option.
Insurance can be stressful and confusing whether you’re an employer or employee. With its own language, limitations, and fluctuating dollar amounts, many people prefer to avoid the topic altogether. According to a 2018 survey, “two-thirds of Americans have avoided or delayed seeking medical care due to concern about cost, risking their health and likely leading to higher costs down the road.” But don’t put off care just to avoid red tape.
With outpatient surgery in orthopedics, urology, gastroenterology, general surgery, and podiatry, PSC specializes in minimally invasive, minimal downtime procedures. With an on-site laboratory and imaging center, you won’t have to make multiple trips or spend the night after surgery. This equates to fewer work days missed before and after your operation.
Postponing orthopedic surgery means living with pain and possible development of arthritis, joint stiffness, and change in lifestyle. “There is a particular risk to delaying surgery if a patient has become sedentary and can no longer carry out normal, everyday activities. Not being able to play tennis four days a week does not warrant hip replacement surgery, but not being able to comfortably leave your chair and go to the bathroom may,” say advocates from the BoneSmart Joint Replacement Patient Advocacy group.
We all like to save money. If you’re an employer looking for the best coverage, a self-funded plan may be exactly what the doctor ordered. Read about third-party administrators, stop-loss insurance, and federal laws on the subject through the Self-Insurance Institute of America.
Then learn more about PSC’s skilled doctors, patient resources, and billing and insurance practices. They’re willing to help whether you come with cash, traditional insurance, Medicare, or a combination of all three. Don’t live with physical pain or the pain of unanswered questions. Let Pacific Surgical Center help. Call 360-442-7900 to choose your specialist and get started today.
