Don't ask -- don't get

As many working Americans, I work for a firm that generously offers a choice of major medical plans to its employees. All of us have different needs and different family arrangements. Some of us have families with little ones, and others of us are empty nesters or single. In our case, a high-deductible health plan and a health savings account made the most sense, both in terms of coverage and cost.

Also similarly to many Americans, when open enrollment came around this year, we switched carriers. One of my key specialists is non-par with the new carrier. I have a great relationship with this doctor and his staff and wanted to try to find a way to continue seeing him without paying “retail.” The first few thousand dollars of care are my responsibility, so I called the doctor’s office and asked what kind of discount I could get for paying in cash.

The office staff said that they had never been asked about this before, but if I wanted to pay cash at the doctor’s billed charges rate, they would be happy to accommodate my needs. I suggested that since the doctor didn’t need to shoulder the cost of filing with an insurance company and didn’t need to carry a receivable, I should receive the benefit of those savings.