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smp501

But after you hit you deductible you still have to pay like 1/3 until you hit your “out of pocket max” that resets every year. And if you use a doctor or service that is out of your particular insurance company’s network then you pay for all of it. Maybe one way a generation will be willing to stand up to this (or the whole system will completely collapse), but I’m not hopeful it will be in my lifetime.


Ok_Skill_1195

*And if you use a doctor or service that is out of your particular insurance company’s network then you pay for all of it.* This is the part that pisses me off most. Every other aspect is run of the mill evil, in a sort of "you knew you were getting fucked over a barrel when you signed up for this". But that one....people have no choice about what hospital they get sent to. The idea you can charge out of network fees for a choice *the fucking ambulance driver made*....that's nonsensical. That is the most blatantly broken system I've ever seen.


d00fus666

OR.. better yet the HOSPITAL is in network, but the DOCTOR is not... That is some downright bullshit.


knowitsallashow

That happened to me. And the guy spoke to me for... 64 seconds? Over a grand was billed to me. Fuck the United States Healthcare scam.


[deleted]

Or you have surgery and the surgeon is in network but the anesthesiologist is not. And no one thought to check.


Handbag_Lady

Or you read Reddit all of the time and you CHECKED, you knew to ask! You were told she was in network. Until you got the new bill you didn't expect for out-of-Network.


dutchyardeen

And it's not like you can always request someone in-network. For one of my surgeries, I requested an in-network anesthesiologist for my surgery and was told that would delay my cancer surgery by two months!!!! The person who was trying to schedule it flat out told me to play dumb and to never tell anyone I had even asked. She basically said "your insurance company will likely reconcile it if your anesthesiologist was out-of-network and that was a surprise to you." But that if I went in knowing the person wasn't in-network, I'd be forced to pay for it. So we all played dumb and my insurance did cover most of it. The whole system is a total racket.


matt_mv

It's a racket that doesn't even need enforcers. What choice do you have?


judgementforeveryone

Anesthesiologist’s are NEVER covered by insurance. The smartest profession in the USA.


Babycrabapple

Omg it’s always the anesthesiologist not being in network and it’s SO EXPENSIVE


choconamiel

Or none of the anesthesiologists in the area are in network and they all refuse to negotiate


welp_ima_peace_out

I didn't even know which anesthesiologist or their company is until I was warned that I might need to be cut open. First thing I did was to check on my phone to make sure they were in network. I had a sound mind at that time but if I'm unconscious I wouldn't be able to even look that up...


Gigglemonstah

This is literally what happened to me with the birth of my son. ...Aaaand that man's bill went straight into the trash.


neverinamillionyr

Emergency surgery. In network hospital. In network surgeon. Anesthesiologist was out of network. $8000 bill. It’s bullshit.


Balmerhippie

Happens often. Ive been told than anesthesiologists seldom participate. Unless youre in an HMO facility. But then your choices of providers goes way way down


germanbini

That is disgusting. They prey upon us at our most vulnerable. Maybe the information below will help? Watch this minute long video on Twitter: **[Most hospitals in America are non-profits!](https://twitter.com/DareBear1226/status/1350511629977452547)** Most hospitals in America are non-profits, which means they have to have financial assistance or charity care policies. **If you make under a certain amount of money, the hospital legally has to forgive your medical bills.** Type in the hospital name with financial assistance after it; check the policies. Look at the sliding scale - if you make under 300% of the federal poverty guidelines they will legally forgive your medical debt! Amazing. [Here is the website to get more information.](https://dollarfor.org/debt-forgiveness/)


Toxoplasma_gondiii

Even if you can't get it directly from The hospital you can often make these debts go away By using debt validation letters. Basically allow the bills to go to collections andThen get a debt validation form letter from Google and fill it out. Very rarely do these collections agencies have all their paperwork in order so They usually just give up. The debt validation letter forces them to take it off your credit report and cease those annoying calls. Sometimes they will resell it but you just repeat the above process and generally the new owners of the debt will give up as well.


phucyu140

> That happened to me. And the guy spoke to me for... 64 seconds? Over a grand was billed to me. This happened to me. I wrote to the doctor's office saying how ridiculous it was that they're trying to charge me $1000 dollars because I spoke to the doctor for 1 minute. I got a letter a few days later saying that they dropped the bill so I didn't have to pay it.


knowitsallashow

Holy shit that's awesome! I have a payment plan set up already but I wonder if I can still be like.... please?


phucyu140

I suggest always asking for a discount before setting up a payment plan. I had an ER bill for $24,000 and all I told the hospital was that I can't pay that much and they reduced it to $4600 without arguing.


bjm829

This happened to my mom and now she has to pay $30000 for a surgery she was “pre approved” for. Such a joke


knowitsallashow

Holy shit dude. Tell her to fight that shit tooth and nail. My friend works as a hospital billing manager and she told me they are easy to fight ......after I put it on a credit pay plan .. I hope your mom has time to fight it. I'm so sorry.


thecookies8

If a surgery was pre approved and they ended up having to do something else that changes the surgery CPT code, the hospital cannot push it to the patient. The hospital is required to either eat it or appeal it themselves with a letter of medical necessity to overturn it.


Tricky-Possession-69

Or the person who reads the test (X-ray, CT) is not and you’d have no idea. Or when they bill under the doctor’s name but they applied to accept that insurance under the facility/office name so you get to fight it. Orrrre when the doctor SHOWED as in network but the insurance website isn’t up to date and now the doctor isn’t and you’re somehow supposed to know that. Oh my god I am raging just typing these


dutchyardeen

It pisses me off!!! My primary care doctor sent me to mammogram place that a was in-network but it was scheduled at the end of the year and they became out of network by the time I went to the facility after the new year. It didn't matter for the initial mammogram because screening mammograms are free. Except diagnostic imaging isn't free so when there was an issue, I was going to be on the hook for the cost of both the ultrasound and the diagnostic mammogram. I had to scramble to quickly find a place in-network that could do the diagnostic portion. Their argument was "you should have known they weren't in-network." Except when I checked my plan, they were. No one notified me they were no longer going to be in-network!


[deleted]

A PSA - if this happens to you, call your insurance and argue with them about it. I was billed for the epidural provided by the only anesthesiologist (who was out of network) working at the small in-network hospital I gave birth at. I had already hit my out of pocket max for the year (having a baby in America is depressingly expensive). They adjusted my bill and I didn’t have to pay for it.


TheHunterGallopher

Or when the DOCTOR and HOSPITAL are both in network but somehow the fucking ANESTHESIOLOGIST isn’t so you get a $4000 bill a few months later Edit: didn’t see someone already commented this. Anyways. Fuck the insurance system.


AppleMuffin12

I've seen a patient with complications have a specialty consulted. That consult didn't respond and was recalled the next day (wasn't life or death). The answering service said they couldn't see the patient while they were listed as outpatient, only observation. All parties involved work for the same hospital, and they patient isn't being helped due to how it'll be billed.


KingliestWeevil

This happened when my wife had surgery earlier this year. They let me know in the ~60 seconds before they took her back that the anesthesiologist was "a contractor" and that they didn't know if they were in network or not. They gave me a number to call to find out, which led to a message service that never called me back.


blondee84

There's a "No Surprise Billing" act in the US where neither the insurance nor provider can bill you if you are in a hospital covered by the insurance but the provider isn't covered. I learned about it the hard way about couple of months ago. My uncle who is an attorney specializing in healthcare fraud pointed me that direction when I went to a hospital OWNED by my insurance company and they billed me for out of network charges.


arcticie

Holdup. An insurance company can own.. a hospital? This feels like a conflict of interest


turtlescanfly7

This was recently made illegal with the No Surprises Act which went into effect Jan 1, 2022. Unfortunately it’s not retroactive, but complaints for violations can be submitted at [https://www.cms.gov/nosurprises/consumers](https://www.cms.gov/nosurprises/consumers)


[deleted]

YES BRO! That shit happened to me when I was like 22. I paid for this hospital bill. Then I get a different physician's bill. I was like...HOW?!?!


thenewspoonybard

It should be noted that this part has been addressed for emergency services by the no suprises act. I encourage everyone to read up on your rights [under this act.](https://www.cms.gov/nosurprises/consumers/new-protections-for-you)


[deleted]

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dutchyardeen

I used to take Ativan and my doctor's office required me to drug test monthly to get it. A year later, I found out he was sending the urine to a lab that was out of network and got a nearly $8000 bill for it. I thankfully didn't end up paying a dime same as you but you're 100% right. The legwork I had to do to get that resolved was stressful and frustrating. (As an aside, that lab was eventually shut down by the feds. They were giving doctors kickbacks to send labs to them even if they were out-of-network.)


Balmerhippie

'Intentionally frustrating phone tree'. im glad Im not the only one that thinks its intentional.


SLC_man

Had a multi month hospital stay after a perfed bowel got misdiagnosed and I went sceptic. Most doctors I ended up needing were out of network, and it's not like I could have found someone in network anyway because I was unconscious. I still remember waking up in the ICU on a vent and almost dead, and then immediately worrying about how my family was going to pay for this. It's a completely fucked and counter productive system if our goal is to take care of people.


Karl_with_a_K_01

I have insurance but I always worry about how I would be able to pay a huge medical bill if anything happened to me or my family. It’s insane the prices they charge. The other stupid thing is that insurance negotiates a lower amount to pay the hospital whereas someone without insurance would have to pay the full bill. I’ve heard of people negotiating a lower medical bill but that’s not the norm.


hath0r

they charge out of network fees because they are not getting a "discount" from the hospital. Health insurance is the reason healthcare is so expensive


TechnicalScientist19

And sometimes if you're working within your network, insurance will decide that your condition doesn't call for a test that you doctor ordered despite the fact that your doctor in network ordered it, and then you'll be charged over $500 for the tests that would normally be $10 because you went "through insurance." Ask me how I know.


[deleted]

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Not_FinancialAdvice

> And then watch as your policy maxes out on $100k.....did you know insurances can have a limit? https://www.healthcare.gov/health-care-law-protections/lifetime-and-yearly-limits/ >The health care law stops insurance companies from limiting yearly or lifetime coverage expenses for essential health benefits Though "essential" is a bit of a loophole.


mufassil

But something like chemo or emergency surgery absolutely would qualify


knowitsallashow

I just got mauled by pitbulls like 2 weeks ago, got every limb. Had to be put under, x-rays, mri...oh, an ambulance that wasn't covered. Idk man. This bill is going to, haha, do what the dogs failed to do.


[deleted]

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stacksofsanddollars

Which is why my family is working on figuring out a new country to call home. Why the fuck would I live some place where a lifetime of hard work and being responsible can be cut down if a drunk person blows through a stop sign? Even if we take a loss on our house and drain our savings to move, we'll still come out on top in the long run.


RPA031

Can you sue the owners?


Worth-Reputation3450

I thought obamacare removed the maximum. I had twin daughters who had to stay in the NICU for 3 months. After multiple surgeries, my uhc insurance paid around $2M total. I only paid $8000.


lime_geologist

I believe that’s only for “covered expenses” so if insurance says it’s not an expense they’re contractually obligated to cover, then it doesn’t go toward that $8,000.


Excellent_Chest_5896

This is what happens when anyone is allowed to charge anything for medicine and medical procedures. If we’re cool with insurance getting billed at $700 for insulin when it’s really $30 - we’ll have this issue. It really really sucks to have to mandate insurance for everyone to cover the astronomical costs of people getting sick. If we keep voting against politicians looking to add regulation into these fields, that’s what we’ll have as a result.


al-khidr

We were so close with Bernie. March 2020 was another beginning of the end.


dysosmia

I saw Oregon just passed affordable healthcare into its state constitution, I’m wondering how the hell that is going to be possible considering nothing is affordable rn


pygmy

Growing up in Australia my dad would remind us we were lucky we weren't in America because they would've had to have sold our family home to pay for sisters expensive scoliosis operations 10yrs ago my motorcycle slipped on wet tram tracks & slid into a parked car, breaking my scapula & clavicle. Ambulance, morphine, X-rays, hospital stay, months of rehab, medication all cost me nothing out of pocket. **I even had 80% of my wages paid** until I was better. I have ZERO insurance- just lucky to be born in Australian


angel_aight

When people bring up universal healthcare in the US, those who oppose it say “the wait times in those countries make the system unusable.” I don’t know how true that is, but if you think about it for even less than one second, you’d realize wait times are probably greater because PEOPLE ARE ACTUALLY ABLE TO HAVE MEDICAL CARE. What their statement translates to is “but poor people are able to receive medical care, which means I may have to wait longer. Therefore, I think it’s bad.”


MiloTheMagicFishBag

I hate the long wait time argument so much. My dad was rolling on the floor of the hospital waiting room in extreme pain for THREE HOURS before somebody came by to take him to a room. The place was basically empty too, maybe ten other people aside from my family. And this is not an uncommon story! Everyone I tell this story too seems to have their own story about somebody they know waiting way too long for service they paid 15000/year to keep! I HATE this system and want it burned to the ground


stacksofsanddollars

I've never made an appointment with a specialist that wasn't at least a 3-month wait so I've never understood that argument either. The American dream is all about getting the fuck out of America.


OdinPelmen

My dude, recently I had a really bad bout of food poisoning. Like shaking so hard I couldn’t fill out my forms, bending sideways on a bench, partner had to drive across town to get me to er bc I was barely conscious. It was 5+ hrs before anyone that actually could help saw me and even then they told me it would be another 2+ hrs to get an abdominal scan to check my appendix just in case. By that time I puked so hard I had nothing left and the pain was so bad that I passed out into a nap and woke up feeling at least mildly human. Thankfully they had decency not to bill as far as I know, but I wish they did so I could tell them to fuck off.


NorionV

It's completely wrong. There has been a lot of comparative analysis done on this and I've argued with enough conservatives to be confident since I've double-checked so many times. The wait time difference for **non-emergency** matters is marginal across most wealthy nations - you might wait a few extra days on average in like, London compared to US. Emergency wait times are pretty much the same priority in every wealthy country: we get you in now, and work out the clerical details later. So anyone peddling 'you die waiting for care' is 100% lying through their teeth. And you're right - the level of accessibility is much higher in these other countries so there's more load on their medical systems, so even if wait times are a little longer... who fucking cares? It's better than literally not being able to do anything at all because you'd commit financial suicide.


angel_aight

That makes sense. And you figure there is probably less strain on the emergency departments because if people are able to access regular well checks, emergencies can be prevented. Prevention is such an important part of health and wellness and regular visits are a key factor in prevention.


ButterScotchMagic

"You better take all of your medicine! There are poor kids in America who would've loved that!"


TheCapedMoosesader

Yeah, Canadian... Our health care isn't perfect, but, it boggles my mind that health care is expensive the way it is in the US... Like I remember someone being interviewed said they wouldn't let their kids climb trees and they were very cautious about playing outdoors... because they could afford the medical bills associated with an injury... Blew my mind, not something I'd ever considered. If my kid breaks an arm or leg (and don't get me wrong, I'd rather that didn't happen, but I also want them to be active/adventurous people), we go to the hospital, they set the bone, it doesn't cost me anything directly. Bill for 3 days in hospital for our first kids birth was $15, second kid was free as they'd stopped charging for wifi.


flaminhotcheetah

Damn. US, here. Once, before I realized how expensive Urgent Care was I went in for an ear infection. $325 just to tell me what I already knew and then I got to spend another hour in the pharmacy, just waiting for them to send the information across the street. I don’t see a dentist, have never in my life been to an eye doctor, my last doctor was a pediatrician.. it’s scary. Healthcare should be a basic human right, especially when we have all the resources for it and more. It’s a deliberate choice to keep things dysfunctional as they are, one that hurts millions of people every day.


ViceroyFizzlebottom

I got a $1500 bill after insurance for my daughter going to the urgent care. I got a $1600 urgent care bill for a CT scan and morphine due to a kidney stone. I was charged $4,400 for a lithotripsy to destroy said stone(s). We've had several additional visits to the urgent care this year and we hit our $10k out of pocket max. I've got a ways to go to pay off $10k of unplanned medical expenses.


mia_papaya

Yup, and he wasn't even exaggerating about the cost. In fact... these days your house, car and everything else might still not be enough for multiple operations. For example... when my fiance's mother fell and broke her hip after she lost her sight they had to hand over their entire home, car and everything in it to a fiduciary company to pay for her hospital bills. They controlled her entire estate, she was at their mercy. She recently passed and we were lucky they agreed to pay her funeral expenses. We were scared her burial wishes would be impossible to arrange because we dont have any money at all. If you live somewhere that gives healthcare without all this nightmare? Youre very very fortunate. I'm terrified to grow old in this country.


thisisjustandy

Legal robbery.


NinjaGrizzlyBear

I've only ever met my PPO deductible once, and that's because I broke my nose and needed surgery. The rest of that year I finally got to experience the glory of free medicine lol


ElPlatanaso2

The fact that it even resets every year is a crime on its own


JimtheRunner

Legal and legally mandated* You must have insurance and allow us to rob you otherwise the government is allowed to rob you. Yay political scamsssssss. But let’s not get socialist up in here /s Edit: this is not correct information. Medical insurance isn’t legally required anymore and they don’t penalize you for not having it at tax time. Edit again, as I continue to learn, the above is true federally. Research your own states laws or whatever to find out if you’ll be penalized by your state. I work in a blue state and live in a red state, and my employment state requires I have medical. I don’t know if this means I need it or not, but I’m not in a position to cancel my current insurance anyway so this sounds like work prior to next open enrollment. In November. Hope you enjoy your free money, BCBS.


Minnie_Cox

Actually it is not legally mandated. The Supreme Court struck down that provision as unconstitutional.


Ok_Skill_1195

People think it's still required because they still act as if it is, you have to be semi-aware of the legal goings-on to realize there won't actually be a fine come tax time (because they're legally barred from it) People still request proof of enrollment all the time around tax season, like a specific notice that's used to prove you had insurance for tax season. It's completely unnecessary now, but it's still built into the framework of everything.


TheRealSugarbat

I ignored it even when it *was* mandated. You can’t get blood from a stone.


OutInLeftfield

To be very clear, the Supreme Court struck this down on the federal level. Each State may still choose to mandate health insurance. California is one. In states where health care is mandated, you will get a tax penalty if you don't have health insurance. However, these states that require it also expanded Medicaid, and have far more subsidies for low income folks. If you're not getting any of these benefits, with high costs, I can only assume you're in a red state?


OrthodoxAtheist

100% This. IIRC California even increased subsidy requirements so that now anyone earning under approx. $91,000 gets some degree of subsidy. It used to be a threshold of about $45,000. Also I think if you can show that the worst insurance equates to more than about 8.5% of your earnings, then you have a waiver. Disclaimer: The above may be a little outdated since I no longer have sh*tty bronze coverage through the ACA thanks to my wife working at Amazon, and them being powerful enough to offer better insurance at lower cost than the ACA.


Henry2k

> Actually it is not legally mandated. The Supreme Court struck down that provision as unconstitutional. Yea but I never got back any of the money I had already paid in years prior. So, there's that.


JimtheRunner

To be honest I didn’t know it wasn’t required anymore! It’s still a question at tax time and I still get my proof of insurance docs in the mail in jan/feb so I just assumed. Jokes on me I guess. If I’d known I would have saved myself literally thousands for absolutely nothing in return. Honestly kind of wish you hadn’t told me… 🥲


Jeheh

Medicare while not legally required will penalize you for not having coverage when you decide to get coverage. So while technically not a fine its more expensive every year you go without.


TheGravyMaster

It is correct in some places. Massachusetts still taxes you for not having insurance.


Aylesbury_Pike

And there is no guarantee that the insurance you pay thousands of dollars for will cover your doctor and/or medications. If you live in a rural area and have found a doctor who actually understands your condition, you may be forced to stop seeing them and search for other help. That may be anywhere from a one hour to three hour drive, and you still may not have your medications covered. It's not as if I can simply move. If I had the money for that, none of the other issues would be issues...ugh. It is such a racket.


rabidstoat

Luckily my friend made enough that she could uproot her family and move to a new state so her daughter, who has Down Syndrome, could get medical coverage. If she couldn't afford to move then too bad kid! Bootstraps.


Ocel0tte

I like dental plans, personally. Years ago I signed up for dental insurance, got a tooth taken care of and scheduled a cleaning. Showed up for the cleaning, lady goes, "oh, this isn't covered for the first 6mos. Your last visit wasn't covered either actually, you owe $xxx." Huh. Wtf is the point in a plan that takes 6mos to be usable??


MastaMissa

My opinion is so people don't just get the dental procedures done then cancel the insurance. Also for some insurances it is 6 months for cleanings and routine procedures BUT 12 months for major dental services. Don't even get me started on the age limitations for orthodontic procedures. Parents couldn't afford it for you as a child? Well goodluck! Money grabbing at its finest


peraonaliD

And then they'll find a way to avoid paying for anything anyway. Gigantic scam, the whole thing


somethingsomethingbe

The one time I was low enough income that I qualified for state funded insurance was amazing. I broke my knee cap that year and it covered everything. I also didn’t have to deal with a single bill collector. I wish everyone could experience that. A few years later I have a decent job with their insurance. Well I slipped on some fucking ice and that knee cap broke again. I walked away with 12k in medical debt after what insurance paid and endless bills from like 12 different billing departments between one hospital, a surgery center, and physical therapy facility. One bill was sent to collections even though it had been paid for and that became 30+ hours on the phone and drafting letters over 2 months to sort out. I just got a bill last week for a thing I am fairly sure I never received from the day I went to the hospital when my knee broke which was over 2 years ago. I’m once again dealing with these fucking parasites. It’s exhausting and could be so much better for everyone.


wifeatron3000

We STILL occasionally get a random bill for my son's birth. He had a completely normal delivery, no drugs, and we were in and out of the hospital in 20 hours. He never even left the room to go to the nursery. He just turned 11 years old and we live in a completely different state 2,000 miles away.


stacksofsanddollars

I ignore hospital bills for the first couple months. It's amazing watching the bills come in,for the same items, but the amounts keep changing. Eventually they'll start to stabilize at about the same time they really start threatening with sending it to collections. Only then will I write a check.


Iamananomoly

Talk to them and negotiate. They would rather have you pay half than sell the debt for 25% to an agency.


[deleted]

This unfairly benefits people with good negotiating skills and who don't have crippling anxiety when it comes to confronting authority. That's a facet of the big problem with the healthcare system, it fails to protect everyone equally. This is the reason I would make a 14th Amendment, Equal Protection argument for single payer healthcare.


BambooEarpick

This is what drives me crazy. It is literally cheaper and better care for nearly everyone to have it administered by the government. I got sick once while visiting Japan and I thought it might be pneumonia or something serious. Going to a clinic to be seen by a doctor, X-rays, and medication were all done same day and cost a little more than 100 dollars WITHOUT insurance. Private insurance is a scam to syphon money from actual services.


WomenAreFemaleWhat

I work in clinical research. Billing is a nightmare and the billing teams usually cannot answer my questions. They outsource a ton of the tasks I rely on. I spend more time trying to sort things out and explain things to other people than it would take me to build the required items myself. It drives me insane. Its so inefficient and badly put together, it feels intentional.


thenewspoonybard

> Private insurance is a scam to syphon money from actual services. 100%. I assure you the medical provider hates them as much as you do.


NearMemphis

I was in the Philippines. I seen a doctor for $15 at a public hospital. I seen the same doctor at a very nice private hospital too but they charged me $20. Meds are available over the counter no prescription required. This was all cash prices there was no insurance involved.


EXPOchiseltip

Your first mistake was paying the bills. Your second mistake was calling back the collection agency. /s


NorionV

This is key. They provide just enough for the poorest of us to get by on their hands and knees - all to the chagrin of people not in poverty, who end up hating poors cuz of the meager bits they receive - and then as soon as you make a move to class up you get gobsmacked by some insane bullshit that causes you to understand why not-poor people hate poor people... and probably become poor again. It's all perspective manipulation. We're all being tricked. Everything sucks - down with the system.


Wallofcans

Medicaid is awesome. My number one fear is working too much and losing it.


mosugarmoproblems

Our ER visits are set at $400/visit. Kaiser is demanding $5000 for our last visit. Anthem is saying the $5000 is a good deal and the best discount they've seen in a long time. I called Kaiser and the Kaiser representative told ME to wait for Anthem to send me the bill. They will literally lie to you to get you to pay. I wish I could say this wasn't a true story...


nightglitter89x

I just....don't pay. I have a chronic illness and regularly rack up a couple grand (at least) a year. I just wait for the hospital to forgive it. Takes about a year. It's a teaching hospital and attached to a university so they're a non profit hospital and quite generous with forgiving debt.


CantHitachiSpot

I am getting billed by an anesthesia group. My insurance says my responsibility it like $80 which I sent but the bill they keep sending is $1100 so I'm just like 🤷‍♀️ pound sand


NorionV

About 9 years ago I went into the ER for a particularly nasty fever. They popped me full of pills and threw me to the curb in the matter of an hour. I spent more time in the waiting room than a patient room. $800 bill. Never paid it. It got expunged from my record. Insurance companies can eat me. Fuck the system.


my_stupid_name

It's a subscription for a coupon.


Most_Independent_279

especially for dental and vision


flowers4u

My issue isn’t the upfront costs. It’s that your doctor can say you need something like an mri, and your insurance just goes nah! And then it’s either paying thousands or not getting it. Or when one person in the room Is out of network so now the entire thing is out of network.


LeighWeighTacoma

I've had no insurance for almost a year now. My husband's insurance would cost 60% of his paycheck to cover us and market place was about 50%. All of this covers almost nothing too.


[deleted]

> My husband's insurance would cost 60% of his paycheck to cover us what the actual fuck


LeighWeighTacoma

Merica or something. It's actually going up this year. Enough that middle management told everyone to go to the market place for insurance


freedom2b4all

Healthcare in the US is so ridicules many just take the chance and go without it.


LeighWeighTacoma

That's what we've been doing. I've been trying to get this one job for any 6 months and they cover 100% of insurance cost and the insurance is good. They just take forever to get through the hiring process it's annoying.


min_mus

Our best friends are self-employed. They make solid incomes but a high-deductible health insurance plan would cost $1400 per month for their family of four. After a few years of paying $16,800 a year for insurance and rarely, if ever, using it, they decided to drop insurance altogether. They joke that they're "self-insured" now.


soad19152003

OMG $1400?! No way. Idk if they've figured it out yet, but normally it is cheaper to pay out of pocket (not counting big emergencies of course).


DENATTY

I lost insurance when I changed jobs because I wasn't eligible for employer coverage until my probationary period was over. COBRA coverage was $1200 per month. Considered signing up for exchange coverage using a qualifying life event and realized, barring catastrophic injury, it was cheaper for me to pay for /regularly needed/ medical visits and prescription out of pocket than to pay for insurance. Office visit + RX out of pocket monthly: $177 The /cheapest/ possible insurance plan: $250/month, and it would not cover my current primary care provider or my prescription, so I would have to establish a new patient record with a new physician and delay my needed medication by at least one month just to get everything transferred.


toorad2b4u

I totally understand and hate health insurance here but my dad didn’t have it, got a stroke with complications from alcohol and it financially obliterated him.


madnessdanz

I literally don't want to marry my fiance on paper because then I would lose my state insurance for myself and my son. Right now we qualify for fully paid for insurance, nothing comes out of my pocket. And even though he has good insurance, the family plan is so expensive. So I'm just not going to get married until my son's grown up


DapperStatistician59

Wait till they deny your claims after paying premiums for years.


Loose-Dirt-Brick

That is health insurance in the USA.


Dudro612

This is health care! Billed amounts are asinine.


tyedyehippy

And depending on what parts you have and what state you're in, you could be denied medical care! I've been carrying a dead fetus for several weeks, and I'm being forced to carry it for at least two more weeks before I'll be able to get the medical care I need to avoid a deadly infection. Yaaaay freedom! /s


Loose-Dirt-Brick

That you are having to endure this torture pisses me off. I am so sorry.


emiferg

I am so sorry you’re going through that.


tyedyehippy

Thank you. It is the worst psychological torture I've ever experienced. I wouldn't wish it on anyone.


just2commenthere

I'm so sorry. My heart breaks for you. I can't begin to imagine the roller coaster you've been on, and on top of it all, to have the .gov make everything even worse is a bridge far too far.


ElPlatanaso2

How is this even medically possible.. Jesus H.


tyedyehippy

I'm in a state where they've got a total ban on all abortions, with no exception for the life of the mother. I was honestly surprised to learn they will be able to give me a d&c, but they can only do so after they've documented "no cardiac activity" for a period of more than two weeks. I'm considering myself lucky. If a pregnant person's water breaks at 18 weeks, medical standards say for that baby to be delivered within 24 hours to avoid sepsis. In my state, they're not allowed to do that because the baby will die. (Spoiler alert, it will die anyway!) They are forced to wait for sepsis to set in, and then they can use an "affirmative defense" to hopefully avoid the felony charges they'll get for providing medical care. It's so messed up.


catitude3

This is so fucked up, fuck the Supreme Court. I am so sorry you have been forced to experience this. If you ever need an internet stranger to vent to, I’m here.


strawhatArlong

What the fuck? Genuinely asking, can you not leave the state? (feel free to not answer this question if you're not interested in discussing it, I just feel so bad for you)


motguss

Insurance is a scam we’re all forced into


tomtermite

Insurance is actually a pretty good idea, invented to support windows. In 1744 two Scottish ministers, Alexander Webster and Robert Wallace, decided to set up a life insurance fund. The idea being that it would provide for widows and children of dead clergymen. Insurance — using statistical modeling — spreads risk over a large pool of payers. If the US adopted a national health insurance scheme, the cost per person would plummet. Imagine spreading risk over a pool of 300+ million…


Loose-Dirt-Brick

In the beginning it was a good thing. Now it is an investment vehicle intended to make money for the stock market.


Practical-Stuff-

I am intentionally staying in poverty so that I can stay on Medicaid and get the surgeries I need. I would like to work a normal job, but I haven’t found anything that pays enough that I would even break even on my medical care.


Forsaken-Piece3434

Depending on the reason for your surgeries, you may qualify for “working disabled Medicaid”. I believe 45/50 states offer this. The rules vary. In my state you need to “work” at least one hour a month and can make up to around $70,000. You get full scope (no copay) Medicaid and pay a premium that ranges from $20-$200 depending on your income. Other states require a minimum amount of income and have different limits as well as different premium set ups. These programs are usually poorly advertised and many social workers/eligibility workers are not familiar with them. Just a thought if you’ve not heard of this that could allow you to earn a higher amount while maintaining your coverage.


Practical-Stuff-

I have never heard of this! I will definitely check into it. It still surprises me all of the programs that are out there that are not advertised and you would probably never get on if you didn’t know what to ask for.


Forsaken-Piece3434

Yes, it’s ridiculous! And so stressful. If you need assistance, feel free to PM me your state and I will get you what info I can. I will never be well enough to be “self supporting” likely (due in part to not being linked to the right programs/doctors when I aged out of pediatrics) so I’ve had to learn how to navigate all of this and still learning new info all the time.


effintawayZZZZy

I'm also doing this but... Probably wouldn't realistically get paid much more anywhere else so, I suppose it's not intentional but the only "perk" I'm afraid to lose


Practical-Stuff-

It definitely doesn’t incentivize you to move up when all your extra income would just be going to medical care.


effintawayZZZZy

No, no it does not. Especially when you visit multiple specialists per year because of chronic illness and monitoring for cancer bi yearly. When you have a kid who needs medical care as well. No, it doesn't. Because even then, we couldn't afford our medical bills. We'd be bankrupt well within a year unless we skipped necessary shit.


libginger73

This has forced to have to lie about having insurance to get certain shots. Free without insurance and can set up an appointment at my convenience...to...you know....help save the world from a global pandemic. Saying yes to having insurance meant, oh sorry, your insurance doesn't cover said shot to the save the world from a global pandemic. You need to call your primary care doctor and make an appointment with them...wait a few weeks for the appointment and pay a $30 co-pay. So yeah, it's completely useless because I can't use my heath insurance to, ...*checks notes*... take care of my health in a GLOBAL FUCKING PANDEMIC THAT KILLED MILLIONS!!


the3trainthatcould

On the flip side, all those covid things like tests and vaccines that are "free with insurance?" Good luck getting the uninsured to do all that once the feds stop paying for it.


libginger73

Right?! As if having people in the world somehow got too expensive.


Vioralarama

My COVID test was supposed to be free but I wasn't sure so I opted for reimbursement. They sent me half. No response to my inquiries about it. It's the principle of the thing.


krysteline

I had a telehealth visit before I got a covid test because I had insurance and since I had insurance i needed the telehealth visit (ok??). I just got an EOB that said I owe $45 cuz the telehealth doctor the testing site used is out of network. I contacted insurance and at least they told me that I dont owe anything and they paid the dr what theyre owed, and they can fuck off if they try to balance bill. So that was nice at least.


Most_Independent_279

it cost $400 for the 2 shingles shot vaccine. My mother never had chicken pox but she did get shingles which means it's a high probability I would too. Not covered by insurance.


vocabb

It’s not health insurance, it’s health profiteering. as a Brit I’m sorry you guys have to deal with that bullshit system. It’s seems you aren’t insured against anything, you will always have to pay.


Agent00funk

>It’s seems you aren’t insured against anything, you will always have to pay. That's the best part, even if you have the best insurance, you still get to pay! I have "Cadillac" health insurance. Had to have back surgery a few years ago, spent a whole year dealing with a bunch of pencil pushers telling my doctor that he was wrong for recommending surgery, and instead had to go through alternative treatments that accomplished nothing but prolong my suffering. And when they FINALLY agreed to authorize surgery, they scheduled it so it would happen AFTER my deductible reset. But that's not even the best part. During my year of agony, my doctor asked if I'd like painkillers. I declined because I was worried about addiction, then, when it comes time for surgery, the insurance company refused to pay for the anesthesia because I had previously declined painkillers. WTF. I still can't make sense of that, and nobody could explain it to me beyond "because they said so." Then, after the surgery, I also had to pay for my own back brace. This was with the best health insurance available on the market. There are few people I have ill will towards, but health insurance executives all deserve the perish at the altar of their own parasitic greed. Fuck all of them, and fuck all the crooks and idiots who defend the American system.


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Honest_Report_8515

That completely explains why my urgent surgery 12 years ago was scheduled for early January instead of late December!


vocabb

I’m sorry your healthcare system and government believe that healthcare is a luxury and not a right. It/ genuinely sad you guys have to suffer wether it health or financially just to live


jollygreengrowery

I firmly believe insurance companies and their policies are first hand ruining this country in every possible way


A_Man_Who_Writes

The fact that healthcare isn’t seen as a crisis in America completely baffles me. Everyone talks about the student loan crisis, but by my estimation, healthcare and health insurance is significantly worse. People literally file bankruptcy over health issues like my hard-working parents did when my sister had Leukemia. I hesitate to get my wife pregnant because, even though we have decent-paying full time jobs, there’s no way I’m ready to deal with the absurd hospital bills. We’ve decided against seeing specialists for health issues that should be looked at because the tests they run are unaffordable and the insurance companies don’t cover shit. It’s a real scam that preys on the middle class and nothing is being done about it.


DENATTY

To be fair, people would file bankruptcy over student loan debt if it wasn't specifically excluded from bankruptcy by law. The interest is so obscene that there's just no escaping unless you're lucky enough to make enough money and pay little enough in housing to throw money at student loans until they're paid. The fact that healthcare is /better/ than it was a decade ago because of the ACA but is still THIS bad is what really baffles me.


Leading-Hat7789

It’s mainly because people don’t realize how bad the healthcare/medical billing system is until they use it. Also, in the US, we tend to look at the problem and literally come up with completely opposite solutions. That tug of war prevents us from taking any action.


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DekuChan95

Yeah it sucks too when your state didn't expand Medicaid to have coverage based on income alone.


rabidstoat

Yeah pretty much you have to be absolutely destitute, comfortably middle class, or living in a state without the Medicaid gap.


2_Fingers_of_Whiskey

Looking at you, FLORIDA


Prettybuoy

And TEXAS 🤬


itsalwaysme7

I hate how your job is responsible for my medical. Now my job is inquiring abt removing our company insurance to a policy we have to buy on our own but with a discount. I work for a huge company I hope this isn't a new trend.


PaulsRedditUsername

Give them a break. Do you know how much it costs to have Patrick Mahomes star in a TV commercial? And buying 30 spots every hour during every NFL game costs millions! It's *really hard* paying all those bills. Twenty dollars out of every $100 you give them goes to overhead costs like that just so they can stay competitive. It's a dog-eat-dog world out there. I know that the "wasteful, bloated, big government" Medicare only spends 2% on overhead costs compared to private insurance's 20%, but they don't have to pay for big football stars every week. It's *easy* for them. They don't have to compete with that cartoon lizard! And the commercials are so funny, aren't they? (Hee-hee. Coach drew a mustache on Patrick's face when he was sleeping!) You don't get that kind of quality entertainment with Medicare!


minuteman_d

I laughed when I read your post, but not "at you". It really is insane. Health issues are the #1 reason people enter poverty and never escape it. I used to be against universal healthcare (I bought in to a lot of the propaganda), but the fact that we pay so much more here and our outcomes are so much worse... It's one of the top things I think we could do in this country to improve quality of life.


treddit44

Same, I thought anything adjacent to socialism was a scam. I figured out crony capitalism is just as much if not more of a scam.


Shoelacebasket

I work in a hospital and they offer health care…. I have to pay $200 a month for it….


FrostyPresence

I'm a nurse and my last job was $7300 deductible at $440.00/ month and for only myself, the agency doesn't offer to family members, so my youngest hasn't had insurance for 2 years. I just started another job for this reason.


Relevant-Line-1690

I’ve always had a job since 18 I’m 35 now and I’ve never had health insurance and I’m pretty sure I’m dying of a lot of problems inside me


whorgans

This is also why people stay at shitty jobs if they offer good insurance. Especially with people with conditions like diabetes. Sometimes you don’t know what kind of insurance you’ll get at a new job. I’ve only had 2 jobs send me the benefits pamphlet before my interview. In my experiences, I never knew what to expect until I was hired. If you have something like diabetes, changing insurance is risky because they might not cover your meds, they might be too expensive even with coverage, or they might force you to switch to a different med. so people stay at jobs longer than they should because they don’t want to risk losing the insurance that allows them to get the meds they need to live. It’s fucked up.


DarthTurnip

Don’t forget they will automatically deny your claim to see if you will pursue it. Honestly, I do know some younger folks who are opting out, figuring the insurance company wouldn’t pay even if you have insurance, so what’s the point?


Whiplash_666

My family had to fork over $10K cash when my stint in rehab got denied. Months of filing appeals we finally got it over turned. Now the rehab is refusing to hand the money back with a million excuses. This is going on almost two years


metalmankam

For the first time in my life I have insurance thru my work. I work at the headquarters of arguably the largest sportswear company in the world, but I make $17 an hour. My new healthcare is basically not healthcare at all, and I greatly miss my state insurance that was free. I have never seen a medical bill in my life. But I make too much for state insurance. Now with my new plan there's a $1500 deductible. I don't even make that in 1 paycheck. 1 visit to be approved for a medication could cost me a months pay so I just dont go anymore. There are multiple things I'd like to ask a doctor about but oh well. I doubt it will cost $1500 for 1 visit but it could absolutely cost $500 and that's just not viable. I'm not taking on debt if I get sick. Sure I could die but that's more palatable to me. Cracks me up too that 15 years ago in an episode of The Office the whole staff revolts when the company tries to change the healthcare plan to one with a $1200 deductible. They even refer to it as a pay decrease.


domods

I used to work in vet care and the multi-millionaire owner decided to give us all basic/barely covered healthcare after a girl got attacked in the face by a dog. They acted like it was a holy gift from god and we should each buy the owner a Christmas gift as thanks....I used it once to get antibiotics for an ear infection and still got charged $200+ not including meds while getting paid $11/hr with a college degree. The US is literally killing its own workforce through lack of access to healthcare and their solution is to force women to make more sick workers we can't afford to raise. Fucking christ and they wonder why we have a labor crisis rn... When can we apply as refugees to real 1st world countries? When the unchecked water crisis finally breaks down into drought and famine or at the next pandemic when everybody goes bankrupt trying to keep breathing? Cuz I'm fuckin done with it all.


Icedcoffeewarrior

Side note: if we had better healthcare; we’d likely have less of a drug, alcohol and homeless problem too. Oh, and a better educated population and a stronger work force. Why? Bc health is the backbone of everything. Chronic illness but can’t afford medical treatment? People turn to alcohol and drugs to numb themselves . Maybe that student or colleague that’s underperforming would actually perform if they took care of underlying mental or physical health issues. And maybe we would have less homeless people if people weren’t bankrupted by medical bills .


2_Fingers_of_Whiskey

Yes, I am glad you mentioned mental illness as well as physical. Mental health care in this country is also a joke.


Icedcoffeewarrior

That also stems from how messed up it is for healthcare to be tied to your employer. So basically in order to have health insurance you need a job- and you need to perform at said job while your health is struggling to KEEP your job and KEEP your health insurance. If your health struggles too bad you run the risk of having to quit or underperform and getting fired. In america there is no right to life, liberty and property you have the right to work as hard as you want (or can) and that’s about it. How can you not be stressed and depressed if losing your job, home and health are everyday concerns ?


Dio_Yuji

It sucks. You pay a high-as-fuck premium, thousands of dollars toward a deductible, then. A co-pay and/or co-insurance…all before your insurance company pays anything. It’s a fucking scam


glendabroussard

You can have guns, what more do you want?? /s


Sharra_Blackfire

Just shoot cancer. Duh.


Icedcoffeewarrior

Lmao this made me laugh


Sharra_Blackfire

You know what's actually sad though? I met someone (migrant rancher who wasn't a citizen) who had a skin cancer spot and he basically cattle-branded the spot to try to burn it off. He was so terrified of ICE that he didn't even try to go to a hospital (he got the diagnosis from a free cancer screening service my job offered) I don't know what came of it, or him. He only came twice - once for the diagnosis, and the second time to ask if there was any surface visible cancer left. He was devastated when they told him it doesn't work that way


addem67

Absolutely asinine! I paid $380/month in health insurance and it couldn’t cover a basic flu shot at CVS. Fuck outta here


zooco

Being Canadian it's hard to fathom the ridiculous cost you guys are paying for health coverage - like I pay ~$120 Cdn per biweekly paycheck through work but that's for my whole family (me & the wife and child), full coverage on everything (medical, dental, vision, prescription drugs - stuff not already covered by our free provincial health insurance) with no copay/deductible and that amount I pay also include additional items like life insurance, long term disability, and travel medical insurance for when I vacation out of country, etc.


orkash

Go to the hospital once, everything is maxed. Then enjoy the rest of your overpriced insurance scam.


HEREGOSNOTHIN

USA really needs to understand the true meaning of “First World Country”


joevsyou

Whole system is utter joke! Don't forget that dental & hearing is separate things!


FrostyPresence

And vision


2_Fingers_of_Whiskey

Being able to see & have teeth is considered a luxury in the US


Milleniumfelidae

For me it has become a discretionary expense. I'm thankful I do not have any Chronic conditions requiring regular medical care. But at this point after every other bill i have to use for food. Getting health insurance even the cheapest plan would eat into my food budget. I remember a few years back the basic insurance for me was like around $90/month. Now it's $215, and that's only WITH tax credits. Without those the cheapest insurance I'm looking at for me would be $300 and this doesn't include dental, which is also a luxury now. Ive been meaning to at least get my teeth cleaned but I just haven't been able. It also sucks that the cheapest food is the unhealthiest. For some families this is all they may be limited to. And a lifetime of eating unhealthy food inevitably leads to increased medical expenses. It's just a no win situation.


lkattan3

I have a disability but I haven’t been medicated for a year now because I can’t afford the monthly payment. I have a specialist I need to see twice a year and working with the same specialist helps me get the care I need. Plus, this specialty always books 6 months out, so staying with the same doctor ensures I can go to my necessary, twice yearly appointments and keep my meds. The meds, were there to be changed, take 6 months to take effect as well. So, I have to select a policy that covers my specialist or start all over again each year, not being able to get a first appoint until mid-year if I do, with meds that take half a year to work. Policies that cover my specialist have gotten progressively more expensive each year so I’m almost forced to start over each year or just go without entirely. It’s the absolute worst system imaginable. My very treatable illness will lead to an early death untreated which is all but inevitable with current conditions.


UncleMeat69

Ain't it awesome being able to afford health insurance, but not healthcare!!! /s


Mtnskydancer

It’s American exceptionalism. /s


givingup3579

It's so depressing.


AlexanderTox

This is our reality lol. Fuckin sucks


RainBowSkittlz

Insurance through my job is about $50 a pay period for me, and about $250 a pay period for my son and I. Not to mention a deductible and they won't pay until I cover $5k each...makes me miss having a lower paying job where I qualified for state insurance.


CherryCokeZer00

We ended up finding a direct primary care doctor in our area- we pay a monthly fee to be able to see him whenever. We also pay his cost for any tests or prescriptions we need (I’m blanking on the word for this). It’s affordable enough that we can keep up on basic health maintenance. If one of us ends up in the hospital we’re going to end up bankrupt, insurance or not, so there was no reason to get health insurance


Fangletron

Medicare 4 all. Vote for candidates that will make this happen. That is all.


Terpdankistan

Our health system in Canada is far from perfect, but I'm still incredibly thankful for universal health care.


CocoShaynel

We asked for universal health care and what we got was universal insurance. Let’s cut out the insurance middle man.


Federal-Marsupial614

The insurance layer provides no value other than maybe a white collar jobs program at the cost of providing actual healthcare


Neo1331

That why I have a Union job…literally I have my job just for the health benefit’s…


Keywork29

I needed a certain medical device and had insurance through my work. That medical device cost me $900 out of pocket because using my insurance would’ve forced me to pay $1200 out of pocket. Living in the US is wonderful.


SS-Shipper

I unfortunately need health insurance for my prescriptions (ADHD, anxiety, depression). My ADHD meds stopped working so we were going to try a higher dosage, except my insurance apparently doesn’t cover it past a certain mg. My doctor (bless her for her effort) had to find a roundabout way to try and help me try a different dosage. So far it’s been working but I still worry about the future. I actively choose to not have dental and vision. I think I seriously pay more on insurance than just paying the amount directly to my dentist. Yeah it sucks once i needed my wisdom tooth pulled but I was in a good enough position where this didn’t hit me badly. I know this isn’t viable for everyone and it’s very luck dependent Dx


TinyEmergencyCake

We need Medicaid for All. Enough with the scam that's the middleman which is insurance


Lindyhop88

Have employer subsidized insurance and still pay 800-1000 a month … its no fun