It's totally legal to pay the cash price if it's lower. It's not against the law to have insurance and not use it.
But if you try to make a claim later, I've never heard of that working. They'd either require that you pay the difference towards the price with insurance first, reject it entirely for not following in-network procedures (most likely), or else reimburse you according to out-of-network rates, which will be far lower. I can't imagine any scenario where you'd save money in the end.
If you haven't reached your deductible and don't think you'll reach it, then it can make sense to pay in cash and just not report it to your insurance company at all. That's fine (though it doesn't count toward your deductible of course).
But also note it's not a universal that insurance prices are higher than cash. At every doctor and dentist I've ever seen in New York City, insurance prices have always been lower than not having insurance. I ask every time, since I have a HDHP. One of the benefits of health insurance is often precisely that they negotiate lower rates with doctors, because (in theory) they bring in more patients to make up for it.
Of course, if you're paying cash the doctor can give you a discount if they choose to, if you tell a sob story... which I've never heard of happening with insurance.
> But if you try to make a claim later, I've never heard of that working. They'd either require that you pay the difference towards the price with insurance first, reject it entirely for not following in-network procedures, or else reimburse you according to out-of-network rates, which will be far lower. I can't imagine any scenario where you'd save money in the end.
Unless you're the provider, in which case there are many cases of providers billing insurance after taking a cash patient. Effectively "reverse balance billing", aka fraud.
If you see instances where providers "accidentally" process your care through your insurer after paying cash, tell your insurer. While it may seem like a non-issue, and that the provider will claim accident, I assure you that for all their (many, many) faults, insurance companies dislike provider fraud too, and similar to credit card chargebacks, too many "accidental" billings will become problematic to the provider.
But if you try to make a claim later, I've never heard of that working. They'd either require that you pay the difference towards the price with insurance first, reject it entirely for not following in-network procedures (most likely), or else reimburse you according to out-of-network rates, which will be far lower. I can't imagine any scenario where you'd save money in the end.
If you haven't reached your deductible and don't think you'll reach it, then it can make sense to pay in cash and just not report it to your insurance company at all. That's fine (though it doesn't count toward your deductible of course).
But also note it's not a universal that insurance prices are higher than cash. At every doctor and dentist I've ever seen in New York City, insurance prices have always been lower than not having insurance. I ask every time, since I have a HDHP. One of the benefits of health insurance is often precisely that they negotiate lower rates with doctors, because (in theory) they bring in more patients to make up for it.
Of course, if you're paying cash the doctor can give you a discount if they choose to, if you tell a sob story... which I've never heard of happening with insurance.