While self-pay surgery is not ideal, it may be a more attractive option than life without surgery, which may mean living in pain or with an unhealthy condition. Also, even if you have insurance you may need to explore self-pay options, since most insurance pays only a portion of the bill, leaving you to pay the rest.
Be sure that the costs that you are financing include all of the expected expenses, including the surgeon’s bill, the cost of the surgical suite, anesthesia expenses, hospital care before and after surgery, labs, medications, X-rays and any testing ordered by your physician and visits required before and after the surgery.
In addition, be sure to establish what your payments will be after the surgery prior to having the procedure. You do not want to have a rude awakening when your first bill arrives and your interest rate or payment is substantially higher than you expected.
You will also need to plan for any contingencies, like complications, which may elevate the total cost of your care significantly.
Think of these people as your new best friend, who you will treat more nicely than you have ever treated anyone in your entire life. Really.
Seriously. If you are paying for surgery out of pocket, this is the person that you ask to allow you to pay the same rate that insurance companies have negotiated for the same procedure. This is a reasonable request and is often honored, especially if negotiated in advance. Get this agreement in writing.
If you need an extremely expensive surgery, such as an organ transplant, rather than a more standard surgery, it will be even more challenging.
That means everyone providing care, from anesthesia to the surgeon, the hospital, and pharmacy need to be in-network if you have insurance. You will have a better rate, even if your insurance company isn’t picking up the tab.
Next, negotiate a better rate. It is a bitter irony that cash payers pay a higher rate than people with insurance, even though insurance has negotiated a better rate with the provider.
Call the surgeon, surgery center, anesthesia provider, and anyone else providing your care and explain that you will be paying out of pocket so you would like to have the best rate they offer insurance companies. If you are pleasant, persistent, and explain your situation, you may be shocked at how much the potential bill can change.
Ask questions of everyone you talk to about reducing the fees. In some cases using a surgery center instead of a hospital can result in thousands of dollars saved. The people who work in billing will be the people most likely to know how to save you money, and they also will know about programs for people with financial difficulties.
How long will you have to repay the loan? What will the payments be on the debt? Will you be able to manage the payments or will you be struggling to pay your bills on time? Will you be paying your credit cards off forever because you will be unable to make a payment larger than the minimum? What will you do if the cost of surgery is higher than estimated by your surgeon? Will you be driven into bankruptcy if the cost, and therefore the payments, are underestimated? Will you be able to afford the prescription medication you require after surgery if you are paying your credit card bill? Will you be unable to save for your future needs if you are paying for your surgery?
The length of time allowed for repayment varies, but if you leave your place of employment before you repay the money there can be substantial tax penalties. You will lose the interest you would have earned on the money you withdraw, but you will not be paying interest on the loan as you would with traditional borrowing.
If you have a Roth IRA, you may be able to access the funds to pay for your surgery. Typically a Roth IRA is not managed by employers, but by individual investors, so you may have to do your own research. Start by calling the customer service number for your fund and inquire about taking money out of the IRA before retirement age.
Depending on your credit and income, you may want to borrow the money from an outside source and keep your savings easily accessible.
While a loan will result in interest being charged, it may be worth the extra money paid in interest to maintain the security of a nest egg or emergency fund, especially if you may need the money during your rehabilitation if you are unable to work.
The particulars of your situation will help determine whether you are better off taking money out of savings or making payments on a loan taken out for surgery.
It is typically easier to obtain this type of loan than an unsecured loan because the house is your collateral. This type of loan also provides a tax break as the interest is tax-deductible like a standard mortgage.
Keep in mind that if you are unable to make the payments on a home equity loan, the consequences can be dire. Failure to pay the loan back can result in foreclosure and eviction from your home.
The bank or loan company will determine how much you may borrow and at what rate, as well as the terms of repayment. This type of loan is harder to get than a home equity loan and typically has a higher interest rate.
Your surgeon may also be affiliated with a loan program, but be sure to compare interest rates with other sources if you qualify for this type of loan.
Pay close attention to the interest rate and compare it to your other options. If you have a credit card that offers a very low rate, the credit card may actually be a more attractive option.
A hysterectomy is almost universally covered by insurance, so surgeons who specialize in hysterectomy might not offer a payment plan; conversely, plastic surgery is almost never paid for by insurance, so the surgeon would be more likely to know about self-pay options.
In some cases, payment plans are a formal agreement that you will make monthly payments in order to pay for the expenses of your surgery. In other cases, the payment plan is a loan, but the hospital or surgeon is involved in the financial arrangements.
Some hospitals may offer a payment plan for their services, but the plan is a monthly pre-payment plan that is finished by the time surgery occurs.
In the case of an unplanned surgery or emergency surgery when the procedure is performed on an uninsured patient, hospitals are highly motivated to establish a payment plan with willing patients.
Monthly payments, even if they are not large, are more attractive to the billing department than no payments, and it may keep the debt from appearing on your credit report as a negative account.
Surgeons from outside the U.S. have begun to actively seek patients who are willing to travel for the surgery that they need, promoting themselves with websites and other advertising.
In some cases, the surgeons in question were trained in outstanding American facilities, and have the same, or better, training than surgeons practicing in the United States.
International surgery is not to be taken lightly and should be thoroughly investigated. In addition to the surgeon’s credentials, which should be verified, the facility in which you would recover needs to be researched as well.
It is imperative that the surgeon be highly skilled, but the person who cares for you during your recovery is equally important. They must be able to identify any warning signs or complications that may occur and notify your surgeon. Your surgeon is only as skilled as the staff members who care for you in his absence.
Some insurance companies are even paying for medical tourism for necessary procedures, as the cost to them is dramatically less than typical. You would need to discuss this with your insurance company representatives to get more information.
In some cases, the rate of interest is significantly lower than that, providing a much more attractive option for paying for surgery. Your credit card statement will clearly state your annual interest rate, but it may be possible to have the rate lowered, depending on the company.
If you have exhausted your options and must use credit cards, you should determine what your payments will be after you pay for the surgery. If you have multiple cards, be sure to use the card with the lowest interest rate and do not hesitate to transfer the balance if a different card offers a more attractive rate.
Many card companies will offer low-interest balance transfers to earn your business, and then raise the rates to normal levels after six months. If you have multiple cards, you may be able to keep your interest rate to a minimum by transferring the balance when the opportunity arises.
If you are married and your insurance won’t pay for the surgery, but your spouse’s will, you could potentially save thousands of dollars by switching to your spouse’s insurance.
Many companies wait until January to make alterations to their insurance policy, but others may make changes during a different part of the year. Be sure to inquire about any upcoming changes.
When the new policy begins, your coverage may have been changed or moved to a new insurance provider. In these situations, it pays to investigate what the new company or policy provides.
You may find that you need to schedule your surgery before the change in order to save money, or you may be wise to wait, depending on the changes in coverage and the copay amount.
A Word From Verywell
Surgery is expensive but there are ways to make surgery possible without insurance or with minimal help from your insurance. Some planning can make a huge difference in the size of your bill, and even small payments every month can prevent your medical bills from ruining your credit.
