Question:
I am trying to find out if a health insurance company decides not to cover a medical procedure that would significantly improve a patient's life and the patient is willing to consider bearing the costs in order to obtain better health, can the patient still go ahead with the procedure and be entitled to all of the health insurance company's negotiated discount rates for purposes of charges by doctors, hospitals, surgery room, and supplies, etc?

Thank you very much with your assistance.

Answer:
I am not aware of any laws or regulations requiring doctors or hospitals to offer negotiated discount rates to individuals paying out of pocket. Many will do so, but they are not required. I would encourage you to discuss this with your doctors and hospital prior to any procedure.

Allison Waxler, Senior Manager of Health Policy & Practice
Reviewed by NASS Patient Education Committee