8/21/2025
Why This Happens
- Insurance Billing Rates – Providers may charge higher rates when billing insurance due to negotiated contracts and administrative costs.
- Cash Discounts – Many offices offer a lower, upfront payment for patients who bypass insurance.
- Less Red Tape – Cash transactions can be quicker and simpler for providers.
What Providers May Not Tell You
Some will insist they “have to bill your insurance” if they know you have it. While that may be their office policy, it’s not a legal requirement.
Important: It is not insurance fraud to pay cash instead of using your insurance—as long as you’re not:
- Filing a false claim
- Asking both your insurance and the provider to pay for the same service
Your Legal Right
Federal law supports your right to choose how you want to pay. You can legally decline to use your insurance and pay out-of-pocket for a service.
When Paying Cash Makes Sense
- You haven’t met your deductible and the cash rate is lower
- The procedure or test isn’t covered by your plan
- You want to avoid potential premium increases from high claim amounts
Final Thought: Sometimes skipping your insurance card can save you a significant amount of money. Always ask for the cash pay price before assuming your insurance is the best deal.
Want more insider tips for saving on healthcare? Call (716) 503-1113 for a free consultation.