Patients are the new payers

Welcome to the Self-Pay Patient a free resource to help people who choose to pay for their healthcare directly at a fair transparent price and find quality care near them.

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Patients want transparency

80% of patients want to be able to shop for healthcare the same way they shop for other goods and services online with transparent pricing.

Change is coming

Self-pay healthcare spend is more than 10% of the U.S. healthcare market and yet 90% of doctors turn self-pay patients away. We are here to change that.

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We are a free resource to help patients find quality care at a fair price. The site is powered by HealthMe, a platform that helps doctors treat self-pay patients.

Self-Pay Healthcare Market

For patients who are looking to pay directly for their healthcare, the options to do so are growing and becoming increasingly popular. The self-pay options for patients now touch every aspect of the patient care cycle from preventive care to clinical visits to prescription medication.

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Self-Pay Market Map

Use our self-pay healthcare market map to find doctors who accept self-pay patients near you. Are you a doctor who accepts self-pay or do you have a recommendation of a doctor who should be on the map. Learn more and submit their information to be added.

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Research, Resources, and First-Hand Experiences

Our blog authors include healthcare experts, business leaders, and thought leaders from both the provider and patient perspectives.

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“The Self-Pay Patient is a very user-friendly and practical guide to paying for healthcare without insurance or with high deductibles. I was a self-pay patient for a couple of years and I wish I had known about some of these ideas back then… I appreciated the fact that Parnell doesn’t bicker about politics and policies, he just gives advice on what you can do in the circumstances at hand…”

The Self-Pay Patient is a tool for all Americans who want to be in charge of their own health care, without the government or an insurance company acting as an intermediary or provider of reimbursement payments to physicians and other health professionals.

“…If you are interested in saving money on your healthcare costs—and who isn’t these days—then this is the site for you!

Read Our BlogAn Overview of Health Savings AccountsAn Overview of Health Savings AccountsGuest Post byWiley Long, HSA for AmericaAs a licensed insurance professional, I have been asked countless times to recommend a health insurance policy that will cover catastrophic events yet allow the consumer to have some control over how they spend their health care dollars. My most recommended product is a high-deductible health plan (HDHP) combined with health savings accounts (HSA).An HSA allows you to deposit funds to be used for health-related expenses into a specially created savings account. You can then use these funds to help pay the cost of your health care. The funds can be used to help meet your deductible and pay for medical services that may not be covered by your insurance plan. Some of these may include dental care or alternative health care like chiropractic care. Alternately, you can keep the funds in your account and pay your medical expenses out of your pocket. In this way, the funds can stay in the account and accrue interest over the years. You can then reimburse yourself in the future, after you have benefited from the tax-deferred growth. Money you put into your HSA is tax-deductible, it grows tax-deferred, and withdrawals to cover medical expenses are tax-free. If you fully fund your HSA account, you can take a deduction of that amount on your 1040 when preparing your taxes, regardless of how much other income you might have.So, if you are a single person who funds your HSA with the maximum contribution limit of $3,250, your taxable income is reduced by $3,250. For families, the maximum amount is $6,450, and in either scenario, people over the age of 55 are allowed an additional deposit of $1,000 per year.Additionally, if you are in good health and do not spend large amounts of money on medical expenses yearly, your HSA acts like an interest-bearing savings account that grows tax-deferred, similar to an IRA. You can invest the money in stocks or mutual funds, just like you may with an IRA, and you can use the money for medical expenses at any time without having to pay a penalty or taxes. However, you need to be aware that if you use the funds for non-medical reasons, you will be assessed a 20 percent penalty. And also bear in mind that there is always risk of losing money when investing in stocks and mutual funds.If you choose to leave the funds in the account, you can withdraw them for any reason after you turn 65. You will not pay a penalty even if you use the funds for non-medical reasons, although you will have to pay taxes on the amount you withdraw at that time.If you own an HSA account and contribute the maximum amount yearly, it is possible for you to accrue as much as $500,000 or more over a 30-year period. Of course, the accrued amount will vary depending on how much you contribute, the return you get, and how much of your funds you use for medical expenses.Another benefit to combining an HSA with an HDHP is that, because you are shouldering more of your medical costs yourself, the premiums are typically lower than a more traditional health insurance policy. This can save several thousands of dollars a year in premiums alone.Also, since you are paying most of your health costs yourself and are using cash to do so, you are in the position to shop around for the best prices on most medical services.Doctors will often offer a cash-up-front discountto save them the hassle of billing to an insurance company. This also has the potential to be a huge money-saver.Also, the tax deduction you get from having an HSA account actually lowers your modified adjusted gross income (MAGI) by the same amount. For example, if you contribute the maximum amount allowed of $3,250 for a single person, your MAGI is lowered by that amount. Since premium subsidies or tax credits for purchasing an HSA plan are based on your MAGI, this means that your HSA contribution may help you qualify for additional help paying health care costs.There are many ways that people can save money on their health care and medical expenses. As this post highlights, an HSA combined with an HDHP is among the best options for most people to maximize their contributions every year in order to get tax benefits and be a smart consumer when spending on health care. You’ll lower your monthly premium, reduce your taxes and hopefully end up with a nice nest egg one day.Wiley Long is President at HSA for America, an insurance brokerage specializing in high deductible health plans and health savings accounts...Medical Cost Sharing – What You Need to KnowHealth sharing ministries have become a popular alternative to traditional health insurance. As a member of a medical cost sharing group myself, I would like to share my experiences with you.  If you’re considering joining a sharing ministry, this post is for you.First, a basic review. Most healthcare sharing programs are organized under religious organizations. These programs are separate from traditional insurance and are typically less expensive than traditional insurance. Readers should thoroughly review the programs they’re considering joining before doing so as the programs can vary widely.Many health sharing organizations offer various levels of membership, with “personal responsibility” monthly amounts. The range of these amounts can be substantial, but typically fall within the $300 $500 a month range. . The “personal responsibility” for a health sharing ministry is akin to the “deductible” for your typical health insurance plan. Health-sharing ministries also often include additional levels such as a level for children (aged 2 months to 18 years) and a level for young adults age 18 – 26.One of the crucial questions when it comes to sharing ministries is whether members are exempt from having to pay a tax/penalty for being uninsured. Please note – The Self-Pay Patient are not authorized tax professionals, and you should consult a CPA for any specific tax advice.  Policies and regulations can often change, and we encourage readers to always reference most recent legislation. It is not a given that every health-sharing ministry is exempt, and consumers need to read the small print to verify if the sharing ministry you’re choosing does in fact give you the benefits you’re seeking.For example, some sharing ministries who may not qualify for tax exemption offer to pay the tax/penalty for members (up to a maximum amount). This is of course different from being fully exempt.  Language often used is “No Penalties for Members.”According to the laws passed by congress, all Christian Medical Cost Sharing organizations formed prior to Dec 3, 1999 that have been in continuous service are exempt from penalties. What happens for those medical cost sharing groups formed after 1999? If you join a cost sharing ministry that was formed after 1999, does this mean you are responsible for any penalties? This is not always a straightforward answer. It often depends on your specific tax filings, and we recommend consulting a tax professional before enrolling in a medical cost sharing ministry.In summary, it makes sense that as health care insurance costs continue to balloon, the popularity of insurance alternatives such as healthcare sharing ministries also continue rise. There are many options on the market – many of which are detailed elsewhere in this blog – but readers should always do their homework before making decisions around their healthcare....A new Catholic sharing ministryReaders of the “Self Pay Patient” blog will know that I am a big fan of health care sharing ministries as an alternative to conventional health insurance. If you aren’t familiar with sharing ministries, the concept is fairly straightforward. They are voluntary associations of people, typically Christian in nature, who agree to share one another’s medical bills. Members pay a set amount each month, and those funds are used to pay the medical bills of members (typically referred to as “needs”). Weve recently discovered a new Catholic sharing ministry and breakdown their program here for readers.Health Sharing BackgroundThere are a few variations on the theme – at Samaritan Ministries, for example, members send the funds directly to their fellow members, while at others the money may be sent to the ministry’s central office for distribution – but the general concept is the same.The ministries typically have what they call a “personal responsibility” amount, which is similar to a deductible in that members are expected to take care of that portion of medical bills before turning to the ministry.  A number of ministries also offer services such as nurse hotlines and bill negotiation.Despite looking somewhat like health insurance, they are not insurers. The biggest distinction, at least from a legal standpoint, is that there are no guarantees that any particular member’s medical bills will be paid. As I like to say, they are faith-based in two critical ways – first, they are based on Christian faith and the Biblical injunction to “bear one another’s burdens,” and second, members are placing their faith in the goodwill and generosity of their fellow members to cover their medical bills.This sounds dicey to some, and if you’re of the cynical variety you may not think this sounds like a very good deal.  Such ministries have existed and generally done well at fulfilling their mission for decades, and at this point, millions of Americans (myself included) have opted for this alternative to conventional health insurance.Solidarity HealthShareOne *new catholic sharing ministry came to my attention recently, Solidarity HealthShare so I thought I’d provide a little information on them for your consideration.Solidarity HealthShare is specifically a catholic sharing ministry. While to the best of my knowledge all of the ministries welcome Catholics, by and large, they are rooted in Protestant traditions and understandings. This isn’t a theology blog so I’ll just note that in the past I have heard of some Catholics expressing reservations about certain language often used by the ministries that were, at least to them, problematic.Here is how Solidarity HealthShare describes its mission:Pope John XXIII addressed in his encyclical Mater et Magistra the vast field for personal charity which would absolutely include health cost sharing. He wrote: “Tragic situations and urgent problems of an intimate and personal nature are continually arising which the State with all its machinery is unable to remedy or assist. There will always remain, therefore, a vast field for the exercise of human sympathy and the Christian charity of individuals. We would observe, finally, that the efforts of individuals, or of groups of private citizens, are definitely more effective in promoting spiritual values than is the activity of public authority.” (Mater et Magistra, 120)Solidarity HealthShare seeks to restore and rebuild an authentic Catholic health care system that will, in every way, respect and promote the Church’s teachings and traditions with regard to love, responsibility and the sanctity of all human life while endeavoring to share the eligible medical expenses of our members.The requirements for membership in the ministry are consistent with those of other ministries, for example, no drug or alcohol abuse. Regular church attendance is also expected. Not surprisingly for a Catholic entity, there are also prohibitions on contraceptive use (Protestants tend not to have objections to married couples using contraception) and an expectation that members “eceive the Sacraments regularly” and “onsult with our priests over matters of moral conscience.”Solidarity HealthShare offers three different membership levels. The “annual unshared amount” (personal responsibility amount) is the same for all three levels, $500 for an individual, $1,000 for a couple, and $1,500 for a family. The most generous level, Solidarity Whole, will share 100 percent of medical expenses up to $1 million per incident after the annual unshared amount has been met.Costs for Sharing MinistriesCosts are generally much less than individuals, couples, and families would pay for conventional health coverage. And, just like the other ministries I have written about in the past, members of Solidarity HealthShare are exempt from having to pay the tax/fine for being uninsured, even though technically it isn’t insurance.One interesting feature of Solidarity HealthShare is something called HealthTrac, which is aimed at members with pre-existing conditions. Here’s how it’s described on their site:HealthTrac is for Sharing Members of Solidarity HealthShare who qualify for our medical cost sharing program but have certain pre-existing health conditions that can be improved through lifestyle changes. HealthTrac is in place for Sharing Members to improve their health while reducing the risk of developing or exacerbating serious diseases.HealthTrac is designed to help individuals with diagnoses such as diabetes, hypertension, cancer, heart disease, high cholesterol and obesity, as well as tobacco users who are willing to work towards a healthier life. Each HealthTrac participant is assigned a Health Coach to develop a personal plan for achieving goals related to their condition or diagnosis. Regular communication with the coach and tracking of progress is part of the program.It’s an additional $80 per month to join the program, but I can see where it would be a real value for people struggling with specific conditions.There is one additional thing that should be pointed out about Solidarity – it is part of a longtime sharing ministry operated by Gospel Light Mennonite Church of Canton, Ohio. No surprise there, since restrictions included in the Affordable Care Act limited the ability to avoid paying a penalty for being uninsured to members of ministries that existed prior to 1999. By partnering with one such pre-existing ministry, Solidarity HealthShare is able to provide this important benefit to its members.What is a little unusual is that Gospel Light Mennonite Church is also the partner of Liberty Healthshare, and the two ministries seem to have roughly identical programs, including the monthly membership contributions and the HealthTrac option. The website layouts are pretty similar as well. There’s nothing wrong with this in my view – having separate entities that rely on the same infrastructure is a pretty common business model – but it does raise the question of what the difference is in the two ministries beyond membership requirements.Solidarity HealthShare is the second ministry aimed at Catholics. CMF Curo, which is part of Samaritan Ministries, has been operating for about two years now. So if you’re Catholic and are looking for a health care sharing ministry that more closely reflects your faith than the generally Protestant-oriented ones, you now have two choices to compare and see which best suits you....The Wedge a new tool for finding cash-only doctorsThe number-one question consumers submit to The Self-Pay Patient is “Where can I find a cash-only or cash-friendly doctors?” There are more and more resources that can help readers answer this question. In the past, we’ve often pointed patients to the Association of American Physicians and Surgeons, which provides a directory of practices that are aimed at self-pay patients. While this directory is helpful, it’s not the most user-friendly or shoppable.For a few years now, “The Wedge of Health Freedom” has been geared towards helping patients find cash-friendly doctors. Per their website, “The Wedge of Health Freedom will put patients and doctors back together — and set them free…around the country, pockets of doctors and patients are breaking free. The Wedge of Health Freedom will point the way to this exciting escape route. With high deductible insurance policies and health sharing organizations on the risepatients want doctor’s offices that are affordable, patient-centered, and confidential—and doctors want to start them”The Wedge PrinciplesTransparent, Affordable PricingFreedom to ChooseTrue Patient PrivacyNo Government ReportingNo Outside InterferenceCash-Based PricingProtected Patient-Doctor RelationshipAll Patients WelcomeThe Wedge takes a political and policy stance that is more than some self-pay patients prefer, but everyone who has to pay directly for some or all of their health care could benefit from the map of practices that cater to self-pay patientsLike our Self-Pay Patient map, the map on the Wedge website is by no means exhaustive, but it is being continuously added to and maintained, and I’d guess there are currently close to hundred practices listed of cash-only doctors a number that will hopefully continue to grow.As the Self-Pay Patient is powered by HealthMe, patients will find that our map is largely geared towards self-pay options for the orthopedics specialty. Finding a doctor willing to offer fair, simple, and transparent prices for health care is crucial for those of us who pay directly for our health care. As more options are becoming available to self-pay patients, it is becoming easier to keep the control of our healthcare spend in our pockets.We’re constantly searching for additional options for patients. Get in touch if you have additional recommendations not listed here....Cash-Only Pharmacy Offers Savings on MedicinesWere pleased to introduce another member of the Self-Pay Patient team, Yana Krinker! Yana is a DC-area resident who works at the U.S. Patent d love to hear from you about your experiences. Get in touch!...Insured but not letting the doctor know?Insured patients have often written in to the Self Pay Patient blog asking if they can save money by pretending to be uninsured.  The gist of these inquiries is that negotiated rates paid by insurers to doctors are sometimes more than the cash price the same doctor might charge someone who is uninsured. This can be especially true with the rise of high deductible health plans and catastrophic insurance.  In those circumstances, people who suspect they will have to be paying the full bill because it’s under their deductible, they ask whether it’s better to hide the fact that they have insurance and just pay the cash price.The question weve received has to do with the legality of not telling your doctor that youre insured, and what might happen if the doctor finds out you are in fact insured.In short, it is completely legal to not use the insurance you have. As to the question of whether you should hide from your doctor that you are insured, wed recommend being forthcoming from the start and asking them to provide you a waiver to opt out of your insurance for the given treatment or procedure.The process to opt out of insurance is simple and almost all doctors have the proper forms to accommodate patients who wish to do so. Weve heard from some readers that they’ve tried to get the cash price after they have given their insurance information, only to be told they have to charge them the negotiated rate. Rather than being discrete, being forthcoming from the start about your desire to pay cash would likely prevent this scenario.Another reader recently described the following scenario: they’ve been getting the cash price by not telling the doctor they are insured, what happens if their doctor finds out now after the fact that they are insured? Will the doctor go back and have to re-price all the past bills?Again, its certainly to your benefit as the patient to be forthcoming and request to opt out of insurance before your treatment, but in the case of this reader, the answer about the likelihood of their doctor re-pricing all past bills is that it unlikely especially if your bill has been paid, which it should be since you paid cash.In summary, patients can be insured and can opt-out of insurance for certain procedures and treatments. Often times patients with catastrophic insurance or high deductible health plans may see savings in doing so. Its always advisable to be forthcoming and transparent with your doctor about your intentions and desires to opt-out of your insurance ahead of time rather than being discrete.Have you opted out of insurance before? Wed love to hear your story. Get in touch....Read MoreGet In touch

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