Out-of-network health care costs more. A lot more

Out-of-network health care costs more. A lot more
September 30 01:00 2015

Out-of-network health care costs more. A lot more

If you go “out of network” to get health care, your bank book might go into the red.

A new analysis finds that people who get common treatments from doctors and facilities that aren’t covered by their insurance plans routinely receive bills that are anywhere from 118 percent to a whopping 1,382 percent higher than what the federal Medicare system is billed for the same services.

The findings come on the heels of a spate of reports detailing cases of patients being surprised by high bills from out-of-network doctors who became involved in treating them when patients thought their care was being provided by doctors and hospitals covered by their health plans.

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The study was based on 18 billion health claims for 97 types of the most common services in 50 states, and released Thursday by America’s Health Insurance Plans, the industry trade group.

Nationally, the study found that the average out-of-network charge for neck/spin disk surgery was $10,459, or nearly 640 percent higher than the $1,414 paid by Medicare. And a 40-minute office outpatient visit would cost a patient an average of $260 from an out-of-network doctor, whereas that same doctor would receive $147 if Medicare was paying for the visit…

Read full story at CNBC
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