Mark Cuban Warns: Don't Let Insurance Overcharge You for Out-of-Network Care, Shares $2,000+ Savings Tip

Billionaire entrepreneur Mark Cuban is well known for his initiatives in contributing to more affordable health care, particularly when it comes to disrupting drug pricing with his company Cost Plus Drugs. But he recently took to X (formerly Twitter) to share some advice with his followers. 

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Cuban shared an X post from @RealDocSpeaks that said: 

"This morning, I used radiology assist in my town and found the following:

CT Abdomen Pelvis with Contrast CPT 74177

Hospital $2,541.38

Imaging Center $476.04

The imaging center uses board-certified radiologists, and the site is certified by the ACR. Always ask what the cash price is." 

This doctor shared the price difference between receiving a CT scan at a hospital versus an imaging center, where the savings were more than $2,000 at the imaging center. With that knowledge, he encourages people to always ask about the cash price before receiving a medical service. 

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Cuban stated in his X post: "This. And if you are self insured, NEVER allow your insurance company to bill you for out of network care. They negotiate the lower cash price with the out of network provider, but charge you the higher price. Always require that you pay the Out of network Provider directly If you have had many out of network claims, go back and look at them. Call the provider and ask for the cash rate for the care on the claim and compare it to what you were charged. It's insane"

According to Cuban, you'll likely pay much more for an out-of-network provider if you allow your health insurance to bill you for the care. Instead, he recommends paying the out-of-network provider directly because their cash rate is generally less than you'd pay through insurance. 

Cuban's insights shed light on an often-overlooked issue within the health care system in the United States: the discrepancy between the negotiated cash price and the insurance-billed amount for out-of-network services.

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Forbes recently published an article finding that half of U.S. hospitals set cash prices for their services lower than their median insurance-negotiated prices. About 20% of hospitals set their cash-pay prices to equal or lower than their minimum insurance prices. 

When the average health care spending per person for 2024 is estimated at $15,074, according to Reuters, any savings that Americans can get here helps. These savings that Cuban and @RealDocSpeaks have highlighted are not small numbers, and they can significantly impact an individual's or family's financial health – especially for those on fixed incomes or nearing retirement. 

Navigating the complexities of medical billing can be daunting. Being proactive, taking the time to understand the cash price options across various medical centers, and comparing them to insurance bills can help you avoid overpaying for necessary medical care. 

Consulting a financial advisor can be invaluable if you're uncertain about how to approach these situations or need personalized advice tailored to your specific financial situation. They can guide managing health care costs effectively and ensure your financial strategies align with your long-term goals.

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