Discounted Labs and Imaging: What Home Care Caregivers Get
Twenty-two percent of adults could not pay a medical bill in the last twelve months, and KFF counts bills for tests and labs in that figure. A caregiver whose doctor orders a blood panel is deciding whether to spend money she had other plans for. The plan's own benefit summary puts diagnostics at 40 to 60 percent off the cash price, labs and imaging included. It does not pay the bill. It changes what the bill is.
Call the lab your doctor sends bloodwork to
Ask what a lipid panel costs a patient paying cash, because labs and hospitals publish those prices now, then hold the figure against what a three-day-a-week caregiver clears in a week. Write it down. Most owners never have.
Here is why the number never comes up. Your own coverage swallowed that number years ago, so a test was a copay and a Tuesday morning, not a decision. For a caregiver on Medicaid or on nothing, the office visit is the cheap part and the orders written at the end of it are the expensive part. Eleven percent of home care workers carry no health insurance and 48 percent sit on public coverage, mostly Medicaid, per PHI's 2025 key facts report. Across all adults, 28 percent say they skipped or postponed needed care in the past year over cost, per KFF.
What does the plan actually do about labs and imaging?
It cuts the cash price. That discount covers labs, imaging, procedures and in-person office visits. The virtual side sits in front of all of it at no cost, so a caregiver can talk to a clinician before anybody orders anything, and the yearly wellness physical and ACA preventive care carry no cost under the plan's minimum essential coverage piece.
| What the doctor orders | What usually happens | What the plan changes |
|---|---|---|
| Routine lab panel | Put off until the next visit, or past it | 40 to 60 percent off the cash price |
| An X-ray or a scan | Facility price, or skipped | Same discount band as labs |
| In-person office visit | Walk-in clinic, often a missed shift | Discounted, with free virtual visits first |
| Yearly wellness physical | Rarely happens at all | No cost under the MEC piece |
Coverage does not settle it. The average deductible for a worker with single coverage is $1,955, and $2,624 at smaller firms, per KFF's 2026 employer survey. Under a deductible, a lab bill is a cash bill. The pharmacy side works the same way.
What that looks like in one household
Darnell works three days a week and drives his mother to her appointments on Fridays. At a physical in the spring his doctor ordered a lipid panel and a repeat in three months. He got the first one done. The second one sat. Under the plan that panel runs 40 to 60 percent below the cash price he was quoted, and the virtual visit that reads it back to him costs nothing. What stays in his pocket is not dramatic.
Composite example, not an actual member.
My caregivers are part-time. Does this reach them?
Hours are not the gate. The thirty-hour line is a group health carrier's eligibility rule and has nothing to do with the tax code, so a Section 125 election is open to W-2 employees whatever their schedule. Forty-six percent of home care workers work fewer than 35 hours a week, which is why a group plan never fit this roster.
Wages decide it instead. What a caregiver nets depends on pay rate and what already comes out of the check, so the lightest schedules can net nothing. The part-time options sit side by side here.
The plan carries a CPA opinion from CBIZ and a legal assurance letter from HitesmanLaw. Our compliance page lists both, and the legitimacy question is the one to read before any vendor call.
We priced this already and it did not work
You priced a raise and a group plan. Both of those need money the business does not have, and on a 7 to 10 percent net margin the spreadsheet closes itself before you finish typing. Here is the raise.
A Section 125 wellness plan asks for none of that. It redirects employer payroll tax the agency already sends to the Treasury, which puts net employer cost near zero.
Where this stops
This is not insurance. A discount on a lipid panel is nothing like protection against a scan ordered after a hospital admission, and a caregiver who needs surgery is as exposed afterwards as before. A percentage off a cash price is still a cash price. Somebody has to have the money on the day.
What would this look like at your agency?
Two inputs answer it: how many caregivers, and what they earn. That is the whole ask, and it stays small on purpose. The estimator takes those two numbers and shows what you pay in employer payroll tax now, what turnover at the industry median costs you, and what could be redirected into caregiver benefits instead. Thirty seconds, no signup.
Across Home Care Benefits' own proposals the employer figure has landed between $300 and $900 per participating employee per year. That is a range and not a quote. Which of your caregivers qualify, and what shows up on their checks, only your own numbers answer. Have your CPA read the plan documents. Nothing to send us, nothing to upload.
Home Care Benefits is not a law firm, an accounting firm, or an insurance company, and provides marketing and enrollment support rather than legal, tax, accounting or health advice. The Unify Wellness Plan is administered by UnifyWell and ACA Solutions. The plan is not health insurance. Savings figures in any proposal are estimates based on the information provided and are not guaranteed. Federal and state tax laws change. Consult your own CPA or attorney before enrolling.
