Selling Copayment Vs Percentage for Advanced Imaging

[wehotex]

The local Humana Medicare PPO features a $255-325 range for radiology services such as CT, MRI, etc. Of course, the other competitors (AETNA PPO & Care Improvement) are smart enough to feature a 20% coinsurance and look alike on paper. The prospect asked me about the charge for CT scans. When I visited a local imaging center, I got nowhere by asking questions to the Billing Dept since there are so many possibilities. So, I don't know which charge is the lesser? I'd like to think that the HUMANA copayment works out to be cheaper, but I have my doubts. Anybody have any experience with this?

 

[agentjhc]

Recently someone posted a link for typical medical costs (Somarco or Sman?).

 

[goillini52]

The local Humana Medicare PPO features a $255-325 range for radiology services such as CT, MRI, etc. Of course, the other competitors (AETNA PPO & Care Improvement) are smart enough to feature a 20% coinsurance and look alike on paper. The prospect asked me about the charge for CT scans. When I visited a local imaging center, I got nowhere by asking questions to the Billing Dept since there are so many possibilities. So, I don't know which charge is the lesser? I'd like to think that the HUMANA copayment works out to be cheaper, but I have my doubts. Anybody have any experience with this?

I had a Cat Scan in May and it was $2,680. Looks like Humana's the better deal on that procedure.

 

[wehotex]

I had a Cat Scan in May and it was $2,680. Looks like Humana's the better deal on that procedure.

Yikes, with insurance?

 

[goillini52]

Yikes, with insurance?

Yes.................when they got done, I asked them what year it was. Felt like I was in a time machine.

 

[vic120]

Looks like there is a lot of, It depends on what type what for and where

https://www.newchoicehealth.com/places/tennessee/knoxville/mri

https://www.nerdwallet.com/blog/health/planning-paying-diagnostic-procedure/

I always feel better with fixed copay

 

[FLM2]

Yes.................when they got done, I asked them what year it was. Felt like I was in a time machine.

It sounds like it was done at a hospital outpatient facility rather than Imaging Center, the cost difference is substantial

 

[goillini52]

It sounds like it was done at a hospital outpatient facility rather than Imaging Center, the cost difference is substantial

Yes it was.................

 

[ICACharleston]

I make it clear that the percentages are based on the Medicare approved amount. I illustrate this to prospects with an old EOB for a scan my wife had some time ago. The billed amount was $656 or so, Medicare approved $150 and she paid thirty bucks. So what she actually paid was 20% of twenty percent. We all know these fees and medicare approved amounts aren't linear or consistent but people feel comfortable.
I have plans with flat rates as well as percentages but the illustration relieves people.

 

[yogooglethis]

The local Humana Medicare PPO features a $255-325 range for radiology services such as CT, MRI, etc. Of course, the other competitors (AETNA PPO & Care Improvement) are smart enough to feature a 20% coinsurance and look alike on paper. The prospect asked me about the charge for CT scans. When I visited a local imaging center, I got nowhere by asking questions to the Billing Dept since there are so many possibilities. So, I don't know which charge is the lesser? I'd like to think that the HUMANA copayment works out to be cheaper, but I have my doubts. Anybody have any experience with this?

In North Fl. complex imaging such as MRI,CT at the 20% co insurance of ma plans are around 50.00 -75.00 at freestanding imaging centers and about double that at a hospital imaging center