Mark Cuban Says High Deductibles Are a Scam. Here Is What to Do About It.

Mark Cuban does not soften his take on American health insurance. In August 2025, the Cost Plus Drugs co-founder posted on X: "The real health insurance scam is that they know as their deductibles go up, fewer people can afford to use their insurance. Which means they don't have insurance. Despite having to pay premiums."

He followed that up by suggesting something that sounds radical but is grounded in math: if you cannot afford your deductible, you might be better off without traditional insurance at all.

He is not wrong about the underlying problem. And whether or not you agree with his proposed solutions, his critique points to real decisions patients face every day -- decisions that become significantly more manageable when you understand how the system actually works.

What Cuban is actually saying

Cuban is not telling people to cancel their insurance and gamble. He is pointing out a structural gap: the distance between what you pay in premiums and the point at which your insurance actually starts sharing costs.

Average deductibles for employer-sponsored plans now exceed $1,500 for individual coverage and $3,000 for families. For high-deductible health plans, those numbers are higher by design. The math Cuban is doing is simple: if you pay $500 per month in premiums and face a $3,000 deductible before your insurance pays anything, you are spending $6,000 per year before your plan does much for you. In that scenario, a provider's direct cash price -- which hospitals are now required to publish -- is sometimes lower than what you would pay using insurance.

Cuban went further in February 2026, arguing at the Slopes Summit in Salt Lake City that major insurers have grown too large and too removed from the patients they serve. He has also called for breaking up large insurance conglomerates and eliminating pharmacy benefit managers, which he describes as unnecessary intermediaries that inflate drug costs at patients' expense.

What this means for patients right now

Cuban's critique is most actionable for people in two situations: those with high-deductible plans who have not yet met their deductible, and those who receive a bill after care and do not know whether they were charged correctly.

Both situations have concrete steps.

If you have not met your deductible yet

Before any scheduled procedure or visit, request a cash price from the provider and compare it to what your insurance would require you to pay before your deductible is met. Hospitals are federally required to publish their prices. Many providers also have a self-pay or cash-pay rate that is lower than the standard chargemaster rate.

The comparison is not always straightforward. Your insurance's allowed amount (the contracted rate) may be lower than the cash price in some cases, particularly for expensive procedures. But for routine care, labs, and imaging, the cash price is often competitive or lower.

Use your insurer's price transparency tool or your state's all-payer claims database to get an estimate of what your insurance's allowed amount would be before you decide which route to take.

If you already have a bill

This is where Cuban's critique connects most directly to what patients can do. The bill you receive after care is not necessarily the amount you owe. Several things may be wrong with it, and you have the right to dispute each one.

Check for billing errors. Medical bills have a documented error rate that industry billing advocates put as high as 80%. Common errors include duplicate charges, upcoded procedures (billing a higher-complexity service than what was provided), charges for services not received, and incorrect diagnosis codes that affect how the claim was processed.

Request the itemized bill. The summary bill a hospital sends you tells you almost nothing useful. The itemized bill shows every charge by revenue code. You are legally entitled to it. Request it before paying anything.

Verify your cost-sharing. Your Explanation of Benefits from your insurer shows what the allowed amount was, what your insurer paid, and what your actual patient responsibility is. If the provider's bill shows a higher amount than the EOB patient responsibility, you may not owe the difference.

Ask about financial assistance. Nonprofit hospitals are required under IRS rules to have financial assistance programs and to charge patients who qualify no more than the amounts generally billed to insured patients. Apply before paying, even if you think you earn too much to qualify.

Negotiate. Cuban's point about cash prices and financing plans applies to your existing bill too. If you cannot pay in full, most hospitals will set up a payment plan. Many will accept a reduced lump sum for prompt payment. Reference the Medicare rate for your procedure -- which is publicly available -- as a negotiating anchor.

On prior authorization: Cuban's other target

Cuban has also been vocal about prior authorization, describing it as a system where physicians spend hours dealing with reviewers who are not qualified to second-guess clinical decisions. He said at HLTH 2025 that the process forces doctors into unnecessary bureaucratic friction that delays care and adds cost.

If your insurer has denied a prior authorization request, that denial is not final. You have the right to appeal at the internal level, and after exhausting internal appeals, you have access to independent external review. The standard for an expedited appeal when care is urgent is 72 hours.

The specific clinical criteria your insurer used to deny the request must be provided to you upon request. Your physician's appeal letter should address those criteria point-by-point rather than simply restating that the service is medically necessary.

The transparency argument

One of Cuban's consistent positions is that pricing opacity is itself a harm. Patients cannot make informed decisions when they do not know what things cost. His Cost Plus Drugs venture is built on the opposite premise: publish the acquisition cost, publish the markup, let people see the math.

The same logic applies to medical billing. The more you understand about how your bill was constructed -- what codes were used, what the allowed amounts are, what your actual cost-sharing should be -- the better positioned you are to catch errors, dispute incorrect charges, and negotiate from a position of knowledge rather than confusion.

Cuban's critique is fundamentally about information asymmetry. Patients are at a disadvantage because they do not know the rules of the system they are navigating. Understanding those rules does not fix the structural problems he is pointing to. But it changes your position within the system considerably.

What to do next

If you have a medical bill you have not paid yet, request the itemized version before doing anything else. Compare it against your Explanation of Benefits. Look for duplicate charges, services you do not recognize, and amounts that do not match your EOB patient responsibility.

If you have an upcoming procedure, get the cash price from your provider and compare it to your expected out-of-pocket cost under your insurance. For routine care while you have not met your deductible, the comparison may surprise you.

If your insurer has denied a claim or a prior authorization, request the specific clinical criteria used in the denial and file a formal appeal. Most first-level denials are never appealed. Most appeals that are filed include new information the original reviewer did not have.

Cuban is right that the system is broken in ways that individual action cannot fully fix. But individual action within the broken system -- understanding your bill, knowing your rights, appealing denials, asking for itemized charges -- can make a meaningful difference on the bills in front of you right now.

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Bill Advantage is a document literacy tool. Nothing in this article constitutes legal or medical advice.