How Much is this going to Cost?

31 Jul How Much is this going to Cost?

Below is a video from the website that is one of the best visual representation of trying to determine the cost of a medical procedure before it is done….

Please click on the link to watch it, and read on for my thoughts. It is a little long, but really entertaining.


Well, what can I say, the family in the video has some great insurance- 90% coinsurance and no mention of a deductible (maybe they already paid it for the year?), sign me up!

But I think the big take away is the accurate depiction of our current claims system.  This is how it really works (seems like an inaccurate word, as it really doesn’t work).  Changes are being attempted to make the process less opaque, but until a facility has to charge everyone the same price for the same procedure regardless of their insurance or lack thereof, it is going to continue to be a confusing and frustrating mess.

There are certain things you can do to make navigating the medical complex easier. A good Employee Benefits consultant can be worth their weight in gold with situations like this.

One of the premium services we offer our clients, polestar, assists their employees prior to medical procedures.  polestar provides employees with a report that:

  1. provides the relative average costs for their procedure
  2. a ranking of the available facilities based on
    1. total claim cost
    2. employee’s out of pocket cost
    3. quality of care and outcome data for the facility
    4. the availability of their preferred doctor at the facility


Using these metrics, employees can choose the best facility in terms of care and outcomes while avoiding overpaying for high-cost facilities.  These reductions can save a plan sponsor thousands of dollars in claims over time.  And we all know that lower claims lead to lower premiums (at least if the consultant is doing their job!)

Please feel free to contact us if you are interested in rolling out polestar.

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