Does Insurance Provide Significant Benefits to Patients?

Every day patients are asking whether or not having insurance provides any significant benefit. Two recent USA Today articles describe the great discrepancy in the pricing of various medical procedures and tests such as MRIs. In today’s paper, it notes that in some states the variation between getting an MRI in a hospital versus at an outpatient center can be as high as $3,200. Within the article, it notes that some patients save money by actually not using their insurance for these services.

Many patients have no idea what the cost of various procedures are and therefore they are surprised when they receive services that are allegedly “covered by my insurance” that they have large co-pays and deductibles. For example, meniscal surgery in the state of New Jersey has an average cost of $7,225 which is somewhat below the national average of $8,023. Therefore, the surgery and associated physical therapy following the procedure will likely cost a patient WITH insurance coverage multiple thousands of dollars. Fortunately, there are now various websites where patients can learn about the actual cost of their procedures and try to plan ahead. I encourage all patients to explore these sites for information that can help them negotiate the costs of various tests and procedures.

At New Jersey Regenerative Institute, we are commonly asked why our various innovative procedures are not covered by insurance. I have recently blogged on this topic (Why Aren’t Regenerative Treatments (Stem Cell Therapy) Covered by My Insurance Company?) but in the end, many patients can get treatment from our center at costs that are no more than what they would get for various procedures that are often associated with significant downtime and potential complications. Don’t let your insurance coverage dictate what is in your best interest regarding your health.

Gerard Malanga, MD