Stacy Beller is still trying to pay off her student loans and she has some other debt, so the last thing she needs right now is a huge medical bill.
But that became a possibility recently when she experienced severe abdominal pain. Her doctor recommended a CT scan, a test that was going to cost more than $4,000 at the hospital in Nebraska City, nearly all of which would have come out of her pocket thanks to a high-deductible health plan.
That caused Beller to pause and consider not getting the scan.
"It was a tough decision," she said, "but I knew I needed it."
She said she would have just sucked it up, added to her debt and worked out some kind of payment plan.
But thanks to a new option at CHI Health hospitals, she didn't have to.
Beller used MDSave, a program CHI Health has been offering for a few months, to get a discounted rate.
Her CT scan at CHI St. Mary's wound up costing about $450, for which she paid cash up-front. It turned out she had appendicitis, and she wound up having surgery the same day.
CHI Health began offering the MDSave program at some of its facilities in November and recently expanded it to CHI St. Elizabeth and CHI Nebraska Heart in Lincoln.
It allows people without insurance or with a high-deductible plan to get deep discounts on certain medical procedures and lab tests by paying in full up-front.
Trent Booher, division vice president of payer strategy for CHI Health, said the organization's parent company, CommonSpirit, had been using MDSave at a hospital it owns in Texas for several years.
It decided to expand the program and chose the CHI Health facilities in Nebraska, largely because the state has a higher percentage of people with high-deductible health plans than the rest of the U.S., he said.
The program is aimed at people without insurance, those who have very high deductibles or those who need a test or procedure that their insurance company won't pay for.
Booher said the program offers discounts of up to 60% off the hospitals' self-pay prices — the prices that typically are charged to people without insurance.
For example, according to the MDSave website, someone using the program at St. Elizabeth could get an MRI scan done for a little less than $800, compared with the normal self-pay price of more than $2,200.
Those using the program actually buy a voucher on the MDSave website, which guarantees them that price at a participating health provider. If for some reason the voucher does not get used, a refund is available.
Eligible expenses can be paid for with money from a health savings account or a flexible spending account, but one drawback to the program for those with insurance is that the amount they pay is not submitted to their insurer to be applied toward their deductible. They can attempt to submit the charge themselves, but there is no guarantee it will be accepted.
However, for those without insurance, which numbered about 180,000 in Nebraska as of 2016, the program can be a lifesaver.
A recent study by the American Journal of Public Health found that medical bills play a role in about two-thirds of all bankruptcies.
And people without insurance often forgo needed care because they can't afford it, which means they can wind up needing even pricier emergency care later.
That means programs such as MDSave actually help to reduce health care costs for everyone, Booher said.
The program has been slowly catching on as word gets out about it, he said.
Initially, about 150 MDSave vouchers were being used per month at CHI Health facilities in Nebraska. Booher said that number grew to around 250 in May.
Right now, the program is fairly narrow in what is eligible at the Lincoln facilities, covering imaging, lab tests and births.
"Most of the use so far has been for imaging, but we'd like to add more (services)," said Dan Schonlau, vice president of operational finance for St. Elizabeth and Nebraska Heart.
That could include surgical procedures such as colonoscopies and endoscopies, he said, which are offered through MDSave in the Omaha area.