Item — HN Reader

Agreed, it's so opaque. I feel like I've called a specialist asking what they think my copay will be given my insurance plan and they said they don't know, talk with my insurance firm. I call my insurance firm and they say they don't know, I have to submit the claim first.

Any marketplace where the buyer isn't informed of the price until after the transaction is ripe for disruption.

2 comments

It is complicated ( don't want to excuse it), but I am not sure I would expect the doctor to know your insurance arrangement (or even how much you would expect to pay because you would need to know how much of your deductible you have already gone through.)

And how would the Insurance company know until they are billed for the procedure?

This is what's so strange about the system. There is no "price sheet" because it's all funny money until the consumer gets billed. Perhaps the doctor would not know, but the hospital should have a price sheet for every routine service rendered.

Those edge cases that are not routine procedures should have estimates provided in advance.

For those edge cases that are so time sensitive that an estimate cannot be provided to the consumer in advance... well, that's what insurance is for.

Frankly, I don't see how it should be possible to buy something you're not entitled to know the price of; or rather, I don't think it should be possible to bill more for something than the quote.