Tampa Families Skip Insurance to Save on Routine Care

Laura Kissak has gone without health insurance for seven years.

The South Tampa mother stopped paying premiums after her youngest child was born. She said the cost became her largest monthly expense, surpassing her mortgage. Her family’s premiums reached $2,000 a month with a $10,000 deductible. Kissak said the financial strain made the decision to drop coverage a logical step for their household.

Instead of insurance, Kissak pays a $200 monthly fee to a primary care provider that offers cash pricing. She noted that this arrangement costs less than her previous out-of-pocket expenses. For example, she previously received a $400 bill for a simple blood draw through a lab, even after insurance coverage. Her current doctor performs the same test in the office for about $20. Kissak created a Facebook group called Self Pay Tampa Bay to connect with others who have made similar choices.

Recent price comparisons confirm that cash rates can undercut insurance costs for specific procedures. A test using the Tampa General Hospital price estimator showed a discrepancy for a bilateral mammogram. The estimate with insurance was $529. The self-pay estimate was $185. This difference amounted to a $344 saving for the patient. Researchers at Johns Hopkins analyzed prices for 70 common shoppable services at 2,379 hospitals. They found that 47% of those hospitals charged cash prices that were lower than or equal to the rates negotiated by insurance companies.

Dr. Jay Wolfson, a professor at USF’s Morsani College of Medicine, attributes this trend to changes in the health care system. He said the growth in self-pay options reflects the Affordable Care Act’s failure to meet its intended goals. Wolfson noted that the market allows smaller providers to compete without the overhead of large insurance companies. He advised that if an employer offers insurance, individuals should take it. He also said people should choose a policy if the price is reasonable. However, he warned that an unexpected illness can quickly change the financial math for those paying cash.

Kissak and her family manage the financial risk by setting aside the money they would have spent on premiums. They also increased the bodily injury and liability coverage on her car insurance. She said this strategy allows them to self-fund some catastrophic costs. Kissak said the right choice depends on each family’s risk tolerance. Wolfson added that patients should always ask for lower prices, whether they are using insurance or paying cash.