Cash Pay Plans Make Sense


“Those who say Cash Pay Plans are pie-in-the-sky dreams are mistaken. If man can fly then so can Cash Pay Plans.”

By Bill Rusteberg

Cash Pay Health Plans Make Sense

More employers are beginning to realize paying cash for medical care reduces costs by 50%, 60%, 70% and more.  It’s been common knowledge for years that hospitals and other providers routinely offer deep discounts for cash.

How It Works

The employer issues a Cash Pay Health Card to be used at the point of sale much like a pharmacy card common to most health plans. The provider simply swipes the card at the point of service and enters in the CPT codes for services rendered. The funding request is instantly adjudicated and the cash pay price offer is indicated. If the provider accepts the cash offer, payment is sent electronically to the provider’s bank account within minutes.

Stop loss insurance indemnifies the Plan Sponsor against cash payments in excess of a pre-determined threshold. Patient cost sharing is processed through a credit card transaction linked to the cash pay transaction at the point of service. The entire funding transaction is bundled and seamless.

The Future of Cash Pay Plans

Cash Pay Plan options are already in the market and growing. Plan sponsors are adopting various pilots involving specific medical care encounters such a hip and knee replacement surgery. As this strategy matures, cash pay encounters will encompass a broad array of medical services.

Man Can’t Fly But Birds Can

Cash Pay Plans will revolutionize health care much as airplanes have revolutionized travel. Both continue to be a work in progress. Better things are yet to come.