How much does the average doctor visit cost?

I live in a fairly rural area--although we're becoming a bedroom county for NYC.

Doctor's visits run anywhere from $60 to $240--but they are discounted because Medicare will pay 80% of agreed limits. Thanks to our private insurance, our co-pay for each visit is $10.

Of course, if you have no private insurance or you're under 65, you pay the full amount.

Kicky...don't take that catastrophic care plan.

Expecially once you're past a certain age. ahem....like 40.

Saving a few dollars on the premium is not worth it if you develope a chronic condition. Not to mention the cost of drugs, regular checkups are needed to check everything.

To be very blunt, it would be quite foolish of you.

ER visits are not the only thing that's big money.

Make sure your insurance has a negotiated a discount rate for visits.

My last visit was $112 but I think the undiscounted rate was about $250. I would guess the rates vary depending on tests and reason for the visit.

One thing to consider is the HSA program. If you buy a high deductable insurance you can put money tax free into an HSA account and then use that money for medical expenses. The money stays in the account, earning interest and you can use it now or in 20 years. I think the definition of "high deductable" is $1,000 for a single person. Put $1000 in the account, get the tax write off, and if you don't use it you roll it over to the next year.

I got a crappy plan a couple of years ago and had to pay a deductible and a co-pay for each doctors visit, so I got to see the detailed doctors bills.

An hours visit with my doc (not including any tests) was two hundred bucks. Other, shorter visits, anywhere from $100 to $150, nothing less than $100.

I had an E.R. visit (unexpectedly) and it cost $8,000 - however, I only paid a co-pay, I was insured for most, but not all of the ER bill.

When I figured out what my co-pays and deductibles were and calculated what the difference would have been had I picked the much better medical plan, I had paid more than a few grand above what I would have paid in the better medical plan.

I didn't make that same mistake this year. I picked the better plan. The peace of mind alone is worth it.

However, if you are not planning on having the sex-change operation for another 12 months, then by all means go with the crappy plan, save a few shilling for frocks and open-toe shoes, and save money on haircuts - let it grow out. You will need all your pennies for make-up and styling products next year. We will pay YOU if you post pictures of your progress!

$50 for an office visit by me. But that's just to be seen. No tests or anything.


Those are what get mega expensive. If you need blood work, strep test, xrays...that will run you couple hundred.

My last round of blood tests was $300. Regular panel with maybe 1 or 2 extras (thyroid stuff).

Costs vary, depends on what doctor for what problem. In general, they rise.

I had, eventually, a $5000. deductible on my Blue Cross (after going through, if I remember, $1500. and 2500. By the time I stopped with the Blue Cross and got medicare, my bills were up to $350. a month for the insurance, and I hear from others that's not so bad. For me, with my work ability, and thus income, related to the hours I am safe driving in daylight, that affected who I could work for or with over several decades, thus markedly diminished income to pay this chunk of money.

So, in 2001, not a good year, a year I had the 2500. deductible, I had this little calcification on my negative for years on end mammogram. That turned out to be breast cancer, and by the time the episode was over I had paid a huge amount of money for what blue cross wouldn't pay - the deductible and stuff they said was too high - and my insurance payments to keep the largesse up. In memory (I confuse two years and don't have data at hand), it all came to about eleven thousand out of my low earning pocket.

A few years later I had an eye whoop de doo, and a by then $5,000 deductible. Four surgeries later and insurance payments up higher, the total out of pocket was again something like 12,000.

I was lucky, I didn't need chemo, having an early stage thing.


Lessons -

1) they'll still get you for what they deem too high charges from whatever m.d. Since I went to blue cross accepting m.d.s on their prudent buyer plan in the first place, where they got me was on the surgery anaesthesiologist (who did better, far better, than the surgeon in the bc situation), and whom one doesn't just pick (in those two separate years in total I had six surgeries, six anaesthesiologists, watch money fly) and the radiologist (only serious place for hundreds of miles).
POINT BEING - things will cost more no matter what.

2) I was lucky, I've been a relatively healthy person up to my now beginning to be wizened age. Luckily I didn't get rheumatoid arthritis or any other long term costly sucky problem between being 40 and 65. A lot of us in my age group winged it in our thirties. Gets wingier as time passes. (Some people handle this with selfinsured maneuvers, that I know nothing about, but I bet they depend on the well being of the economy).

3) You are coming to grips with something getting harder now - insurance to the Self Employed - like me - has always been higher than that group insurance at least partially paid for by employer. This has heretofore been handled for some self employed with Group Insurance, various self employed work related people banding together. I never benefitted from that. In any case, that whole s.e. group system seems to be shutting down. Recent article on it on google esplainin' it all. As in, from them an attitude of "go fish". However, the article (not sure I saved it) justified it for the group insurance folks bowing out, since cheapo insurance to the young is syphoning off the 'well' population, leaving the group ins. businesses having trouble surviving.

That might be a reason to get whatever you can.

Wow, what an interesting variety of very good information.

Osso, I'm doing this through a brooklyn-based organization called the Freelancers Union. It is a Group Plan-type of deal, like you mentioned. They do have a few different plan options, and this one is the cheapest. I'm just looking into it. It doesn't sound so good, from what you guys are all saying. Gotta look into that HSA thing that parados mentioned though, just to be sure that might not be a way to go...anyway, I have some thinking to do, but I've got a few days to decide. Thanks everyone.

Dude, check out your options at Esurance.com.

Kick, that article I saw said much of those group things (I remember 97%) were shutting down. Research, research, research, before you just sign.
Back if I find a link. Iffy long term, in my non insurance knowledgeable opinion.

kicky, I joined the writers' union so I could get the group insurance. The costs and the options when I joined were reasonable. They got less reasonable with each passing year until I could no longer afford the premiums. Is there any way that you can check on the stability of the plan? If the premiums have been relatively stable for some time, it's probably safe to join. In fact, I'd consider joining.

BTW, I agree with everyone else. The catastrophic care plan is questionable. Second BTW, my doctor charges me a discount rate of $75 per visit. He knows I have no insurance and little money. When I go to a city facility, I'm charged $60 per visit plus whatever special treatment or tests I receive. This is based on my income.

Now I will admit I just happened to work two doors down from a couple who owned an art gallery. I'd heard for years that the husband had some eye thing. Eventually, something like four years into working near next door, I found out he had my exact eye thing. This is rare. Far as I can tell, he sees better than moi. Yes, he's been on disability for decades.


Ooof, with me putzing along making do.
Back in the late eighties, a friend had both breast cancer, in remission, and lupus, and had disability payments from the state. We didn't know each other for this reason, more having to do with neighborhood politics. One day I mentioned that I was interested in the question of disability, after she'd mentioned it, I was thinking ahead, and she said, Oh, No, You would never Qualify. I listened to that.

Snaps at self.

I'm not sure what I feel, glad I semi survived, stronger, braver? Futz.
It makes a big difference, people ought at least inquire, and as I hear it now, more than once.



Osso

I'm thinking of a couple of years ago, I fell just walking down my driveway. No idea why, all of a sudden realized I was on my way down, and had just enough time to think "oh ****"

At that moment, it was definately not an ER thing, more of a "wow, that was stupid", brush yourself off, limp back into the house type of thing.

Over the next month and a half, it took about 5 doctors visits, about 4 or 5 days missed from work, and 2 or 3 perscriptions to set me right.

You just never know.

Kicky, your work is cut out for you. Medical costs will vary (as has already been made clear to you), In New York City you have a few options (some good, some not so good). Other than private doctors where the visit may be reasonable; but, the after costs (blood/x-ray/e.k.g./urine-analysis etc.) can run into the thousands, you can also consider local hospitals and clinics and even the public health clinics.

While you're at it take another look at getting an insurance plan of your own. Start out at the State of New York...they can be accessed at: State of New York Department of Insurance and then there is also this location within that site NY State HMO guide
Neither of these sites will answer all your questions...such as what will happen in the future...but, if you look into these, you can find out past pros and cons of the various insurance companies. Some are good at paying claims others will fight you on most claims. Some have premiums which are stable (do not change every year) others increase by several dollars annually.

The idea of having Major Medical, is clearly a step in the right direction for many (including perhaps yourself); however, it does not help if you end up with some hard to diagnose condition or a condition which needs a great deal of treatment and doctor visits. Those treatments and visits could bankrupt you before you close your checkbook. Strongly consider a full comprehensive plan if there is any way at all for you to get one.


Regarding the State sites I listed; from past experience (including a short work stint there) I can tell you they are well informed and will help you figure all of this out.

Everyone has already said basically what you need to know. I'll just add that from experience, if you know you have to lay out a couple hundred bucks to see the doctor, you aren't as likely to go... even when you should.

Go with the co-pay.

Osso, I have a question about this. How can they just decide that something is too high, if it's all in writing? I don't understand how that's legal.

Price tag for service needs to fit their guidelines for "reasonable and customary" or the overage is on you.

Here's that article about insurance ...



http://www.chicagotribune.com/business/chi-0704130549apr15,1,6162380.story


Insurance options dwindle for many

By Lisa Girion
Published April 15, 2007

A major source of health insurance for people who work for themselves has all but disappeared, casting thousands of contractors, freelancers and solo practitioners into the ranks of the uninsured with little hope of obtaining new coverage.

Health plans offered by professional associations were once safe havens for millions of people who couldn't obtain coverage anywhere else. But, as medical costs have soared, groups representing professions as varied as law and golf have been forced to stop offering the benefit or have been dropped by insurers.

While no one tracks association coverage to know how many plans have disappeared, the experience of Marsh Affinity Group Services is telling. A decade ago, Marsh, which brokers and administers such plans, had 142 such clients. Today, all but three have closed.

During the same period, the uninsured U.S. population, now estimated at 45 million, rose dramatically, fueled in part by the dearth of affordable options for the self-employed, experts said. Among uninsured workers, nearly 63 percent are self-employed or work in small companies, Todd Stottlemyer, president of the National Federation of Independent Business, told Congress recently.

Fewer than a quarter of the 1,020 professional and small-business associations surveyed in February offer medical coverage, even though a majority of the groups said they would like to. The American Society of Association Executives, which commissioned the survey, views the issue as a crisis.

In its heyday, association health coverage was so popular it was touted as a membership recruiting tool for professional organizations.

"The association business used to be a huge part of the group health insurance business," said Robert Laszewski, a Washington-based health-policy consultant and former insurance executive. "Now it's like the buggy and whip business, almost entirely gone."

Insurance carriers began pulling out of association markets about 10 years ago amid mandates requiring the groups -- like employers -- to offer coverage to all members who wanted to buy it, regardless of pre-existing conditions. Unlike employers, however, who typically pick up the lion's share of premiums for employees, most associations do not share in the costs. Instead, they arrange for their members to buy coverage at group, rather than individual, rates.

In today's marketplace, that's almost always a better deal for older members and often the only option for people with pre-existing conditions. But insurers are eager to sell individual policies to the young and healthy for as little as $100 a month, scooping the cream off the risk pool. That leaves higher-risk older and sicker people to the group market, a phenomenon known as adverse selection.

As healthy members leave an association health plan, the concentration of members with higher-than-average medical costs increases. That forces the underwriter -- usually the insurer but sometimes the association -- to raise premiums. A "death spiral" sets in, when medical costs exceed the plan's ability to raise premiums to cover them.

"The problem with associations is they go into a death spiral because they get the worst risk," said Alan Fox, vice president of plan design for the American Psychological Association Insurance Trust, which covered thousands of psychologists and their families for 35 years before closing its health plan in 1999.

The list of casualties also includes health plans once sponsored by the American Bar Association, which still hopes to resurrect the benefit it dropped last year, and the California Bar Association, which lost its coverage when its insurer pulled out in the early 1990s.

Before the Professional Golfers' Association's health plan ran into the rough, the group had extended coverage to about 1,000 golfers. But the plan was discontinued in 1996, as medical costs rose and younger, healthier members bought coverage on their own at lower rates.

"If you can get cheaper coverage through the individual market, that's what you do," said Mila Kofman, an associate research professor at Georgetown University's Health Policy Institute.

In many states, insurers are allowed to reject applicants for individual policies for any medical reason, including common conditions such as asthma and varicose veins. As a result, many people who lose association coverage are effectively uninsurable.

Insurance options of last resort -- Cobra-conversion coverage and publicly subsidized high-risk pools -- are not an option for everybody because the coverage is insufficient or unaffordable, or both.

"If they don't have an opportunity to go to another group and have to go into the individual market, it's a real problem," said Kansas Insurance Commissioner Sandy Praeger, president-elect of the National Association of Insurance Commissioners.
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Lisa Girion is a staff reporter for the Los Angeles Times, a Tribune Co. newspaper.

I guess I can see them doing that. It's a scumbag move, but it is insurance companies we're talking about here after all, so I guess it shouldn't surprise me.

Thanks for the article Osso. I haven't read it yet, but I will.

Not really. This provision prevents patients from seeking treatment at inordinately expensive facilities and driving up the price of everyone's policies. Most well run facilities will lower their stated prices to fit this requirement as a matter of policy, anyway... though the best of the best will charge according what the market will bear. A practice in a crazy high-rent building can't be expected to match the price of one in the hood, and your fellow policy holders shouldn't be expected to foot the bill for another's expensive tastes. Nothing scumbagish at all from my perspective.