2 Answers

The only way a doctor can work with an insurance company is if he submits his normal charges to the insurance company and they negotiate how much they will actually reimburse the doctor for his charges. If he wants to work with this insurance company he has to accept what they are willing to pay. The same with hospitals and their charges and how much of the charge will be paid by the insurance companies. The rest is to be paid by secondary insurance companies (if there are any) and finally out of the patient's pocket. When Medicare or Medicade is involved they get paid first and the rest comes out of the person's personal insurance provider (Blue Cross Blue Sheild, Anthem etc.) and then the individual.

People who don't have insurance can always make arrangements with the hospital to apply for grants they have for uninsured persons in hardship situations. I don't know if doctors offices do this. Then the entire bill wouldn't necessarily have to be paid, but a fraction of it.

Insurance companies have set rates on what they will pay on each procedure, medication, treatment etc. This rate is not necessarily the same as what the provider charges. The difference is owed by the patient. Additionally, insurance usually only covers a percentage, i.e. 80%. As for the patient with no insurance, many providers will reduce their rates in the hope that they will at least get something for the service provided.