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Sunday, August 1, 2021

How to stop getting ripped off by American health care and save big money

When Kevin Vincent had to get two MRIs, he knew it would cost him. But he found an unexpected workaround that saved him big money — while exposing a lot of what’s wrong with American health care. 

Like tens of millions of working Americans, the 51-year-old from Amarillo, Texas, had a high-deductible health plan. His insurance policy required him to pay the first $10,000 before the health benefits kicked in. 

Vincent’s nurse practitioner referred him to a nearby hospital-affiliated imaging center for the two MRIs. 

“How much is this going to cost?” he asked when he called the imaging center. 

The customer-service representative told him they would charge his insurance plan $11,000 for the two tests. Vincent asked if he could get a discount by paying cash. They told him the cash price would be $9,000. 

The sticker shock caused Vincent to gasp. The helpful rep told him not to worry and offered to put him on a payment plan. Thanks, but no thanks. Medical debt is not the solution for the problem of high prices! 

Fortunately, Vincent, who sells property and casualty insurance, had a friend who sold health benefits. He ran the prices by his buddy and learned about a better way to get the tests he needed — at a much lower price. 

MRIs can range in price from $300 to $3,000 in the same geographic area, with no demonstrated difference in quality — and hospitals tend to charge more.
MRIs can range in price from $300 to $3,000 in the same geographic area, with no demonstrated difference in quality — and hospitals tend to charge more.
Getty Images

Vincent’s friend referred him to Green Imaging, which contracts with independent imaging centers around the country to offer cash prices for CT scans, mammograms, MRIs, X-rays and other imaging tests. The company is capitalizing on what industry insiders and researchers have known for a long time: Hospital-based imaging centers have much higher prices than independent imaging centers. One study found that the price of an MRI can vary from $300 to $3,000 in the same geographic area, with no demonstrated difference in quality. Hospitals simply impose a markup on the same MRI or CT scans you could get elsewhere. 

Kevin Vincent
Kevin Vincent
Courtesy of Kevin Vincent

Vincent didn’t realize hospitals were marking up MRIs, but he gave Green Imaging a call. What he learned astonished him. The new price: $950. For both MRIs. 

Vincent would not be able to apply the cash payment to his deductible, but the process was easy. He sent his order for the MRIs to Green Imaging and got the MRIs at an imaging center about half a mile from the site that had quoted him the inflated price. Just like that he saved more than $8,000! That’s more than the combined value of my two cars! (I realize that says something about my trusty Honda and Toyota, but you get my point.) Vincent even got the MRIs read by a radiologist and received copies of his images. He shakes his head in astonishment that he saved the equivalent of multiple mortgage payments by shopping around. 

Vincent relished his own victory. But it upset him to think of people who didn’t know they could get a better deal. About 1 in 6 Americans has medical debt in collections. People like him were likely to go into debt because a hospital required them to pay more than they should. 

Never Pay the First Bill

“The fact that so many people are financing this debt, and they could save so much money — I didn’t like it, frankly,” Vincent said. 

Now here’s where we all need to be on guard. This unjustified price variation isn’t just related to MRIs. Health care prices vary greatly for all types of drugs and tests and treatment. This isn’t a rare thing. It’s everywhere! The business model of the American health care system is based on making working Americans pay more than they should for the care they need. 

Fortunately, we have more tools than ever to see if we’re getting fair prices, including the federal government rule that now requires hospitals to post their prices — including the previously secret rates they have negotiated with each insurance plan. See if you can save yourself big money next time you undergo some type of medical treatment. 

Marshall Allen’s new book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” featuring health care hacks to equip and empower consumers and employers, is out Tuesday. For more information, go to marshallallen.com. 

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