About The Self-Pay Patient

Welcome to The Self-Pay Patient!

I created The Self-Pay Patient site along with my book The Self-Pay Patient: Affordable Healthcare Choices in the Age of Obamacare to be a resource for the tens of millions of Americans who are either uninsured, have high-deductible health insurance, or just want to escape from bureaucratic medicine and get their healthcare without either an insurance company or the government being involved in their medical treatment.

These Americans are often referred to as ‘self-pay patients,’ and this site and my book are intended to help them find affordable health care options in a health care system that is not generally friendly to self-pay patients.

On this site and in my book you will learn how to find doctors, hospitals, pharmacies, imaging centers, and other medical providers that cater to people who pay directly for their care, as well as alternative forms of insurance and insurance-like coverage that may be a better fit for many people than conventional health insurance.

The Self-Pay Patient web site was launched in August 2013 and The Self-Pay Patient book was first published in December 2013. In the months since then, I’ve heard from countless Americans, some uninsured, some with high-deductible insurance, even some with ‘comprehensive’ coverage, telling me how they’ve saved hundreds, thousands, even tens of thousands of dollars by using some of the information contained on this web site and included in The Self-Pay Patient book.

If you are one of the tens of millions of Americans who is looking for affordable medical care and expect that you’ll need to (or just prefer to) pay out of your own pocket for some or all of your healthcare, I hope you’ll consider buying your own copy of  The Self-Pay Patient: Affordable Healthcare Choices in the Age of Obamacare and checking in regularly at The Self-Pay Patient web site!

 What Others Are Saying

 “Sean Parnell… has become a guide for the opt-out crowd with his blog and book called “The Self-Pay Patient.”

                Washington Post article, June 5 2014

 “…Parnell has done a great job researching alternative funding and cash payment options, and has put that wealth of information into a concise, clearly-written reference book.”

                Frugal Nurse book review, February 7 2014

 “The Self-Pay Patient: Affordable Healthcare Choices in the Age of Obamacare by Sean Parnell is a great resource for those who want/need to pay directly for their own healthcare…

The book is full of practical advice—for example, where can a self-pay patient find medical providers at a discounted price? How can they avoid the higher costs that self-pay patients are often charged? How can they get treatment that is not addressed by their insurance?

…If you are interested in saving money on your healthcare costs—and who isn’t these days—then this is a book well worth investing in!”

                Dr. Felicity Dale book review, April 29 2014

 “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 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…”

                Sharis, Amazon reviewer, March 6 2014

 “Sean Parnell’s blog, 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.

Parnell… has designed both his blog and his book to be a “users’ guide” to self-pay medicine. In the regularly updated blog, which started in August, readers are able to find doctors, hospitals, pharmacies, and other health care providers whom they can pay directly for services.”

                Breitbart.com article, November 14 2013             

 “Although focused on those without health insurance who have to pay for any healthcare services out of their own pocket (the “self-pay patient”), there are a lot of ideas that can be applied to minimize healthcare costs for those who do have health insurance… [The author’s] expertise on where things stand right now and how people can work within the current framework to find what works best for them is excellent…”

                Big Al’s Books & Pals book review April 12 2014

 About Sean Parnell

Currently I own and operate a public policy consulting firm in Alexandria, Virginia, with a focus on healthcare policy. I serve as Adjunct Scholar in Health Care for the Rhode Island Center for Freedom & Prosperity and a Policy Adviser to The Heartland Institute. Other health care experience includes writing for Health Care News and authoring healthcare policy studies for the Texas Public Policy Foundation and National Center for Public Policy Research. I also worked for several years for former Congressman Greg Ganske MD, a primary author of the Patient’s Bill of Rights in the late 1990′s, and I learned a great deal about many of the problems with third-party payment in medicine from him.

I graduated from Drake University in 1996 with a degree in Economics, and presently live in Alexandria, Virginia with my wife Anne and son Ryan.

22 Responses to About The Self-Pay Patient

  1. Hey Sean,
    I know that Steve Bassett just mentioned a few items for you to consider in your postings, and in particular I have used two online services for years with great success. For years prior to my arrival on Medicare, I had a high deductible health plan and HSA. My personal physician is cash only and I have regular need of prescriptions and lab work.

    For prescriptions I have used BidRx. They provide an online “reverse eBay” solution – one provide the prescription parameters and then open a 72 hour bid among pharmacies throughout the country. The real savings in on generics of course, since that is where the highest markups are. Once you select the winning bid, you provide the pharmacy with a fax copy of the Rx and they mail the meds to you (shipping costs included in the bid). The bidders tend to be privately owned pharmacies since the big chains are in bed with the Gambino Crime Family…….er I meant to say PBMs and insurance companies. This is one very slick and easy solution.

    For labs, I am aware of two services. The one I use is Direct Labs and again this is an online solution. You go online and choose the labs you need to have done and one of the Direct Lab physicians writes the order. You take the order to a Lab Corp facility and YOU receive the results – NOT your physician. Typically it takes 24 to 48 hours for you to receive the results. Of course it makes sense to be certain that your physician sees the results (especially if they requested that you have labs done), but the key is that YOU get the results before they do and you don’t have to wait for them to call you a week or two later with same.

    Both of these services can be accessed by your physician. Most if not all cash based docs will be happy to do this for you as part of their service.

    Good Luck with this blog and your book Sean – I don’t think there is any question that self pay will be a significant part of the future of healthcare.

    Dick Matthews

  2. Jay Berman says:

    I am self-pay in New Hampshire. I am so glad I found your web site. I never knew there were so many people in my situation. I have Aflac for accident insurance. I will contact my Aflac agent for critical care insurance. I am finding these alternatives to health insurance to be much less expensive. Also, my doctor is affiliated with a hospital that gives 40% to 45% off services, such as doctor visits and lab tests. When I need a test, I call the hospital with the five digit medical billing code. As long as I pay the bill within 30 days, I get the discount. If my primary doctor is too expensive, I go to my local Urgent Care Clinic. My daughter and I had a respiratory infection last winter. The clinic doctor treated us for $108 plus $4.00 for antibiotics and a few bucks for cough medicine. For flu shots, I can afford the $20 per shot. I don’t need expensive health insurance to pay for these minor out of pocket medical expenses. I hope you start a revolution in health care economics. I would like to help you start a self-pay movement, so people like me can exchange their health care saving ideas with other people in their local communities.

    • seandparnell says:

      Jay – thank you for your kind words! There are a lot of people in your exact situation, unfortunately too many of them just assume they can’t get care without insurance, or if they do they have to pay outrageous prices and face serious financial catastrophe. As for a revolution in healthcare economics – well, that’s on the list of things to do! Please stay in touch, I’d love to share any advice or stories you think might help others in a similar situation.

  3. John Thornton says:


    I’m not sure if the book covers the self-pay provider but wondering if I can publish cash prices less than the Medicare/insurance price? Of course if someone calls, we have no problem with cash discount. What I’m wondering about is setting a published price less than what Medicare allows. Could I get in trouble?

    Can you do it based on “hardship”. I’d like to give patients more options.

    • sean@impactpolicymanagement.com says:

      There’s no problem with publishing prices that are less than Medicare, as for any insurers you’d want to check your agreement with them to make sure there’s no guarantee that they receive the best price or similar language, but otherwise I don’t think there’s an problem with it.

      • Providers who are contracted with Medicare or federally funded insurance programs DO have to be careful about publishing fees that are lower than the medicare allowed fee for their locality. The Social Security Act prohibits providers from enticing a federally funded patient (such as a medicare patient) by offering free or discounted services that are less than what Medicare would pay. By publishing a rate less than Medicare’s allowed fee, you would be enticing medicare patients to see you over another medicare provider in your area. You should proceed with caution in this matter. Regards, Lisa M, President Gold Star Medical Business Services.

        • sean@impactpolicymanagement.com says:

          I don’t believe this is correct, simply having prices that are less than Medicare allowable does not qualify as enticement. But I’d be interested in any legal opinions/rulings to the contrary.

  4. John Thornton says:

    Thanks for your response. My understanding now is that you cannot price healthcare less than Medicare prices if you accept Medicare. However you can discount prices for special advantage for example prepaid healthcare. If the patient pays for the service before receiving it, (when he walks in) that price can be less.
    Anyone heard of that?

    • sean@impactpolicymanagement.com says:

      It may be the case you can’t charge a Medicare patient less if you accept Medicare (in fact, I’m pretty sure it is), but if you’re charging (and posting prices) for non-Medicare patients, you can charge whatever you want.

  5. Steve Paul says:

    Hi Sean, do you have a recommendation of one Healthshare company over another? My wife and I are generally healthy, with one dependent, and can afford the premiums. My biggest concern is in the event of a catastrophic illness – that’s why we stayed with conventional insurance last year. Medical expenses can easily exceed $1M. Thanks for your advice.

  6. Bob says:

    I’m a Christian, I believe in God, I do not want to support Obamacare because I don’t believe it is right to force me to buy something and because the premiums are expensive (I can’t afford them and I don’t want the subsidies which are welfare), the deductibles are high, and the coverage is marginal at best. BUT I do NOT attend church. I am 58, good health except for some back trouble (compressed disk) but I have that under control, exercise regularly, no tobacco, light alcohol use.

    Will any of the sharing ministries allow me to join considering that I do not attend church?

    Thanks for any information. I need it quickly because right now I have no insurance and my wife is afraid we’ll lose the house if I have big bills – a legitimate concern!

    • sean@impactpolicymanagement.com says:

      Both Liberty and Altrua will accept you, and I think Christian Healthcare Ministries may as well. The other two do require a note from your pastor, I think.

  7. Michael Collins says:

    I wonder about the financial stability of these self pay organizations. Where are the share payments invested when in excess of the share amount? How does the share organization get audited, etc. At the end of the day this will be a lot of money and who provides oversight of the funds and operations? Insurance is a regulated industry and there is ?some? value to the regulatory bodies.
    On a separate subject, the pensions and insurance industries are being damaged by NIRP and zero interest rates. They are not generating enough income in the investment alternatives to sustain their long term commitments. Any words on this in the medical insurance side?

    • Sean Parnell says:

      Several of these organizations have been around for decades, so the stability seems to be there. My understanding is that the monthly revenue usually roughly matches the monthly expenses, I’m sure there are modest surpluses some months but I’d guess those are kept in cash or money-market funds. Unlike insurers, there isn’t much in the way of investment income (and regarding health insurance, I don’t think there’s much investment income in the model either, that’s more for life, liability, and property insurance, I think).

  8. Anna says:

    I am considering Liberty Direct in response to the contraction of network providers and expansion of costs in traditional insurance. While $1MM per incident coverage is substantial, it is potentially not enough for a catastrophic event.

    Liberty’s premiums are affordable, but do not cover in the event of an expensive catastrophic event.

    Have you heard of any supplemental policies which might cover me with an open network and low cost?

    • Sean Parnell says:

      So, hitting $1 million is theoretically possible for a single incident, but the odds of happening it are far less than the odds of successfully navigating an asteroid field (sorry, couldn’t help it). If you’re concerned that $1 million isn’t enough, you might want to look at a critical illness policy, tho depending on your age those can be pretty pricey.

  9. I have Steven Johnson Syndrome and can not take any medication, EVER. I treat myself through vitamins, minerals and other natural remedies. I also do not go to a physician for any services. If need arises, I might go to a Chiropractor, Acupuncturist or other homeopathic doctors and pay out of pocket for my treatments. I have been paying a penalty for not enrolling in the ACA. Is there a way that I can opt out and not pay a penalty, since I will never use any of the services?

    • Sean Parnell says:

      I would suggest a health sharing ministry, but it sounds like you might not see much value in that either. The good news is that it looks like the Trump administration will not be enforcing the mandate tax/penalty going forward.

  10. Jonathan says:

    BOYCOTT AMERICAN WOMEN! http://www.BoycottBitches.com I am an American man, and I have decided to boycott American women. In a nutshell, American women are the most likely to cheat on you, to divorce you, to get fat, to steal half of your money in the divorce courts, don’t know how to cook or clean, don’t want to have children, etc. Therefore, what intelligent man would want to get involved with American women? American women are generally immature, selfish, extremely arrogant and self-centered, mentally unstable, irresponsible, and highly unchaste. The behavior of most American women is utterly disgusting, to say the least. This blog is my attempt to explain why I feel American women are inferior to foreign women (non-American women), and why American men should boycott American women, and date/marry only foreign (non-American) women.

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