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Why is the cost of Health Insurance so expensive? Inquiring Minds Want to Know!

broken piggy bank with prescription meds

A person goes to a restaurant, and the prices for each item are clearly listed.

You purchase a car, and again, you know exactly what the price is from the start.

There is never a question about how much a gallon of milk or a dozen of eggs will cost. (Sorry! With everyone talking about the skyrocketing price of eggs, I couldn’t resist using it as an example. 😊)

Does anyone know how much the cost of a normal, doctor’s office visit is?


Most people assume the cost is the same as their copay. Little do they know that their copay is just a fraction of the total cost.

How about the cost of one of those drugs that are regularly shown on television?

Again, no one (and I mean no one) knows these medications can cost $5,000 a month or more. Most people only think these medications cost a little more than their copay.

The examples of the complete lack of cost transparency are literally endless.

In an effort to “pull back the curtain” on prices charged by hospitals, Congress passed legislation requiring them to post pricing information about the items and services they provide. Last year, a federal rule went into effect, requiring health plans to disclose the negotiated prices they pay to doctors and hospitals for each item and service they provide.

I’d like to say that forcing hospitals to post their prices has been a smashing success, but unfortunately, it hasn’t been. One year after these transparency rules have gone into effect, 85% of hospitals are still not in compliance.

As we know, “Actions speak louder than words,” and with the large number of hospitals not complying, this “speaks volumes.” Hospitals have hated this idea since it was first proposed, and so they are dragging their feet, because the penalty for non-compliance is so small.

And so, the big question we must ask ourselves is – How can we expect the members of our Health Insurance plans to be good consumers, if they have no idea what the true cost of a procedure or medication is?

Since hospitals, doctors, and drug manufacturers aren’t going to help, it’s up to us, your broker/agent, to provide tools and education to you, the employer, and the members of your plan to close this gap.

For instance, we have tools that tell us who the “high quality, low cost” providers are. We create Health Insurance plans to incentivize members to access these doctors and hospitals.

We work with companies that help members get their expensive, maintenance medications for a fraction of the cost of getting at a retail pharmacy, and they pay nothing.

There are several, out-patient clinics that show the “all in” cost for various procedures. A member goes to the clinic’s website and the prices for every procedure they perform are clearly listed. Again, in an effort to create informed and educated members/consumers, we provide incentives for them to have their procedure performed at these clinics.

We have a lot of work to do “to turn this ship around,” but it can be done!

In my next blog post, I’d like to dig a little deeper into how hospitals and doctors charge for their services.

At MAGIC, it is our passion to help show you how to take back control of this out-of-control cost, so, that you can keep your hard-earned revenue, so you can grow your business, improve your bottom line, and offer awesome benefits to your incredible employees!

Give us a call at (844) 800-MAGIC for a free consultation and learn how we always do “MAGIC” and sometimes even miracles – all without “smoke and mirrors!” 😊


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