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The Fine Print of Health Insurance: Surprise Bills Are More Common Than You Think

Surprise medical bills can be a major headache for anyone, but they can be annoyingly common for those with high-deductible health insurance plans (HDHPs). In fact, half of patients with an HDHP state they have received a surprise medical bill, even though they have insurance coverage.

High-deductible plans typically feature lower monthly premiums but higher out-of-pocket expenses. And these plans can leave patients on the hook for unexpected medical costs that they may not be able to afford. In this blog, we'll explore why surprise medical bills are so common with HDHPs, and what you can do to protect yourself.

Why Are Surprise Bills So Common?

One of the main reasons surprise medical bills are common, even with an HDHP, is that the insurance plans often include a limited network of providers. To keep costs down, insurance companies may only cover certain hospitals, doctors, and other medical providers. If you receive care from a provider who is not in your plan's network, you may be responsible for a larger portion of the bill than you expected. This can lead to receiving surprise medical bills that you simply can't afford.

Another reason for surprise medical bills with HDHPs is that, with these plans, you usually have to pay a set amount–called a deductible–before your insurance starts paying for services.  However, the money paid toward your deductible may not apply to all of the services you receive. For example, your plan may only cover a certain number of doctor visits per year, or may not cover certain types of treatments. If you receive care that is not covered by your plan, you may be responsible for the entire bill, even if you've already paid your deductible.

Additionally, surprise medical bills can result from the way that insurance companies negotiate with medical providers. When you receive care from a hospital or doctor, they may bill your insurance company for a certain amount. However, the insurance company may only agree to pay a portion of that amount, leaving you responsible for the rest. This can result in surprise bills that are much higher than you expected, particularly if you receive care from an out-of-network provider.

How To Protect Yourself Against Surprise Medical Bills

So, what can you do to protect yourself from surprise medical bills with a high-deductible health insurance plan? One of the best things you can do is to carefully review your plan's network of providers and coverage limitations before you receive any medical care. Make sure that you understand what services are covered and what your out-of-pocket costs will be.

You may also want to consider using online resources that display transparent pricing for medical procedures. These resources can help reduce surprise bills by allowing you to compare prices and find the best value for the medical care you need.

One such resource is MDsave, a free online marketplace that allows you to compare prices for bundled medical procedures and services. By purchasing procedures through MDsave, you can pay upfront for the entire cost of the procedure. This means that you won't be hit with any surprise bills later. Plus, MDsave offers transparent pricing, so you know exactly what you're paying for

If you have an HDHP, using MDsave can be a smart choice. By purchasing procedures through MDsave, you can avoid going out-of-network and potentially facing higher costs. Plus, you can save money on procedures that may not be covered by your insurance plan.

Finally, if you do receive a surprise medical bill, don't panic. Many medical providers are willing to work with patients to create a payment plan or negotiate the bill. You can also reach out to your insurance company for assistance. By staying informed and taking proactive steps to protect yourself, you can navigate the world of high-deductible health insurance plans and avoid costly surprises.



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Mark G
Mark Gladden brings both personal and professional experience to his role as co-founder of Present Moments Recovery. Now in long-term recovery himself after struggling with addiction for years, Mark understands firsthand the challenges men face in achieving and maintaining sobriety. It was this insight, combined with a desire to help others, that led Mark to establish Present Moments Recovery.

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