&gt; Health insurance is somewhat the same too... Hospitals and Dentists have special rates for insured patients (much higher)... you can end up paying the same as an uninsured patient...<p>Health insurance is actually very different[0]. The flow of money with medical billing is really, really complicated, which is why we end up with a system that&#x27;s so confusing that even most physicians and clinicians don&#x27;t really understand it.<p>Hospitals are generally not legally allowed to have higher rates for insured patients; this is actually why the sticker price for uninsured patients is so high. Hospitals use those high prices as a starting point to negotiate lower prices with insurers. (As an uninsured patient, you can almost always get the hospital to knock off 90% of a large bill for this reason; they really don&#x27;t care what you pay,  and they&#x27;d rather negotiate a smaller bill with you than have you default).<p>I could go on a long rant about the indirection of the medical billing system and all the problems it leads to, but I&#x27;ll save that for another time.<p>&gt; Also, I have been told that it might be illegal to claim that you are uninsured, pay the bill and then get reimbursed by your insurance company to avoid surcharges... not sure if that is true.<p>Yes, this is fraud. (It also happens to be a pretty bad example of fraud, since it&#x27;s probably going to end up costing you <i>more</i> money, but it&#x27;s still fraud).<p>[0] Strictly speaking, health insurance isn&#x27;t really &#x27;insurance&#x27;, even though we talk about it and price it like it is, because one of the primary functions has nothing to do with smoothing risk.