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by elif
1454 days ago
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Unfortunately not in the USA. I assume lot of it comes down to the doctor's discretion because if the insurance company finds that the doctor is performing excessive treatment/tests, they will deny coverage, renegotiate rates with the provider, or even refuse to cover the provider outright. I've been trying to get certain blood screenings through 3 doctors, and they were all more than happy to repeat the same basic blood panel 3 times, since it is incontrovertible, even though it would have cost less overall to get the specific blood screen I asked for. And if I want to pay "out of pocket" it is impossible because the tests often require a doctor's prescription, and even if not, the non-insurance rate for the tests are 2-10x what providers negotiate with insurance companies. |
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For much of my 30s, 40s, and 50s I was strictly a fee for service patient in Southern California. This, of course, is no solution for someone with significant health problems. I've been blessed with good health, undeservedly so. I had cataract surgery on my left eye in 2011 for $2600 cash, up front, at the area's biggest hospital. No further charges materialized. I had no regular primary care physician at the time. To me, $2600 for a surgery, the result of which was so magically wonderful that I burst into happy laughter in the ophthalmologist's office when he removed the eye bandage, was worth far more than the $2600.
Don't overlook businesses like Everlywell or Private Labs MD that enable one to get tests performed outside your own network. I've used such a service to "nudge" my health care provider (with whom I am generally satisfied) to investigate some subject further. Admittedly, this is not much help for exotic tests.
If, like me, you are lucky enough to live reasonably near our southern border, labs in Mexico don't even require a doctor's order to perform tests. There may be exceptions to this -- I don't want to imply that I know more than I do.
I don't want to "wave away" the very real problems that exist for those who cannot afford any service outside their network, nor do I mean to ignore the very real problem of arrogant medical professionals who ignore a patient who tells them, "Listen, Doc, I've had this same test three times in the last three months." I only mean to suggest that sometimes, when it is possible, it helps to work around a stubborn physician, rather than attempting to bend said physician to your view.