You’d think that having insurance would mean you pay less for your health care. It turns out, that isn’t entirely true.
This week, the New York Times shed light on something most Americans would never expect: the “discount” prices your health insurer negotiates for care — supposedly using their size and scale to drive a hard bargain — are often not such a good deal at all.
Their negotiated rates for services as common as physician office visits, MRIs and CT scans, and procedures like colonoscopies are actually higher than the prices available without insurance, to anyone who asks for a cash price. What Sarah Kliff, Josh Katz, and the team at the New York Times identified in data from thousands of hospitals is in fact the very premise Sesame (sesamecare.com) was founded on, but is often misunderstood.
For millions of Americans whose health insurance coverage (or lack thereof) makes them responsible for all or part of the costs of their care, the ability to compare transparent, competitive prices that are easily accessible and actionable — real prices, you can actually pay directly, to guarantee you care with no follow-up surprise bills — is missing from their decision-making process. At Sesame, this is the core of what we do, and — we’re happy to say — a problem we’ve solved.
Patients with any kind of health insurance (or no insurance at all) can use Sesame to find real, affordable prices — direct pay rates from the same providers and for the same services they would usually have billed through their insurance, but at prices that save them money compared to the surprise bills they’d receive after the fact, listing the supposed ‘discounted’ rate they pay via their insurer. Sesame helps any patient looking for non-emergency care (which is, of course, the vast majority of health care spending in America) compare local options to find the cash price that saves them money, and gives them the opportunity to pay up-front, lock in that discounted rate, and avoid a painful bill in the mail months later.
Since we launched in 2019, one of the challenges we’ve most often faced is disbelief — how can it be possible that the price you can get off the street from a busy medical practice or hospital is less than the price the supposed experts — the biggest health insurance companies in America — have negotiated for you? But thanks to this piece in the Times, the answer is finally clear: the little guy can win by paying directly. So, for anyone who doesn’t care how much their health care costs, feel free to rely on the price you see on that insurance bill in the mail. For anyone who cares about saving money on their health care — try Sesame.
