Ask your Employer to Pay your Deductible

Yes, the title is correct. If you choose a Center of Excellence, or in this case a preferred provider or in-network facility, over an out of network provider for a surgery, hospitalization newborn delivery or procedure, while going out of network could cost you and extra $5,000 in out of pocket costs, the costs to your employer could be six times that. No joke! 

When given a choice of in-network or out (in network is sometimes referred to nowadays as a ‘Center of Excellence’), if you are paying a higher share of costs then tour employer is as well. So tip #7 is to ask your employer if they will pay your deductible for a procedure if you pick a specific in-network facility or Center of Excellence. Its worth a try and you would not be the first whose employer said yes! 

Download all of the Ten Free Tips to Spend Less on Healthcare, and start saving today. And don’t forget to take three minutes to complete the Personal Spending Reduction Tool online to see if you qualify for our $5,000 annual savings guarantee.

So let’s go into more detail here. You or a family member needs surgery. You have a high deductible plan requiring you to pay the first $5,000 of care for the year. When it comes time for your procedure, if you choose an in-network facility or Center of Excellence your out of pocket costs are $2,500, but if you choose the big, shiny hospital on the hill that your spouse wants you to go to because he or she believes (like most Americans that bigger and shinier) is better, then your out of pocket costs are $5,000.  

This is a great opportunity for you to approach your corporate Human Resources Director or benefits consultant and ask them if they would be willing to pay your $2,500 out of pocket cost if you chose the in-network facility or Center of Excellence for the procedure. Ask them to confirm and share with you both your personal costs and the cost to the company at each of the possible hospitals or healthcare facilities. Often times your benefit consultant will not understand your request or the benefit until they actually document the costs to both you and the company, at each of the potential facilities. They are often shocked and pleasantly surprised as to what they learn as well. 

Why would your company do that? Let me explain. 

Your cost double if you do not choose the in-network facility or Center of Excellence. Let’s assume your employer’s costs for the procedure double as well. The main difference is that are usually paying about 80% of the actual cost of the procedure. Thus, in this case if you choose the in-network facility or Center of Excellence their cost would be $10,000 but if you went elsewhere their costs could be as much as $20,000.

So if your company paid your $2,500 deductible, they would actually save themselves $7,500. 

Now imagine if this was a major procedure and their savings could be more than $40,000? It happens all the time. We call this becoming an EHC – an Engaged Healthcare Consumer. When you engage in the process and have this type of educated discussion with your employer, you are guaranteed to start saving significant dollars and eliminating wasteful healthcare spending for your family.  

There are exceptions to this rule as every company is different, and some contracts prohibit this type of steerage.  Things get particularly trick if you are covered by a PPO – but that does not change your task. Your task is to ask, inquire, check and hold your human resources or benefits consultant accountable to identify and provide these costs to both you and the company in advance. That’s it! 

Download all of the Ten Free Tips to Spend Less on Healthcare, and start saving today. And don’t forget to take three minutes to complete the Personal Spending Reduction Tool online to see if you qualify for our $5,000 annual savings guarantee.