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When Doctors Stop Taking Insurance

October 1, 2012, 5:10

Private health insurance used to be the ticket to a doctor’s appointment. But that’s no longer the case in some affluent metropolitan enclaves, where many physicians no longer accept insurance and require upfront payment from patients — cash, checks and credit cards accepted.

On Manhattan’s Upper East Side, it’s not unusual for a pregnant woman to pay $13,000 out of pocket in advance for childbirth and prenatal care to a physician who does not participate in any health plan. Some gynecologists are charging $650 for an annual checkup. And for pediatricians who shun insurance, parents on the Upper East Side are shelling out $150 to $250 whenever a child falls or runs a high fever.

Efforts by insurers to rein in health care costs by holding down physician fees — especially for primary care doctors, who play a critical role in health care though they are among the lowest paid doctors — appear to be accelerating the trend, and some patients say it’s getting harder to find an in-network physician.

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SteveMT's picture

The way of the future for both patients and physicians .....

to break out of the system of middlemen. The more physicians that breakout, the more the prices decrease. It's called competition, out of government control.

Thanks for this story.

I am in school, but for

I am in school, but for chiropractic. There is not much incentive to be in-network and the profession is anticipating a move to cash-only. The profession is still hoping for the affordable care act including chiropractic services, because right now chiropractic does not have the money and research to lobby the government for inclusion. If we had a free market chiropractic would do better as chiropractors have consistently had better patient satisfaction than medical counterparts.