Getting an estimate before deciding on a major purchase, like putting a new roof on your house or getting your car repaired, is part of the American way of life.
Getting an estimate before deciding on a major purchase, like putting a new roof on your house or getting your car repaired, is part of the American way of life. When it comes to healthcare, however, most consumers and their doctors have no idea what a patient’s out-of-pocket costs will be until the patient’s health insurance plan crunches the numbers. As healthcare plans get more complex, it’s much harder to get a handle on out-of-pocket costs.
Come April, that will change for the almost 12 million members of large insurer Cigna, which is unveiling an online calculator that will let patients and in-network doctors and hospitals know what the patient’s share of the bill will be before any medical services are provided. The Cost of Care Estimator will factor in variables such as deductibles and copays and even identify other possible sources of payments, such as flexible spending accounts. As businesses shift more of the cost of healthcare to their employees, the estimator should prove a useful tool that will give patients and providers a chance to discuss paying for medical care.
A possible downside of the estimator, say some healthcare analysts, is that providers may pressure patients into paying out-of-pocket costs up front. According to Cigna, however, many doctors are already asking patients to pay deductibles and co-pays at the time of treatment. Of the hospitals that took part in the project’s 15-month pilot program, only a small fraction of physicians collected the patient’s out-of-pocket costs up front.