Also I went in for a colonoscopy and an endoscopy. Insurance was billed for $14000. I got statements from 4 different doctors, and the facility where it was performed. None of the statements matched the explanation of benefits from the insurance company. And when I called each doctor, to pay them, they all told me that I didn't actually have to pay them what it said I owed. So I just ended up paying $2500 to the insurance company. It again, makes zero sense.
I’m reaching the point where I don’t really care if it’s private or public, but what we are doing today is the worst of both worlds. It either needs to be fully private, maybe with mandatory insurance purchase, or it needs to be fully public, though that has its own baggage.
I bet whatever cost these patients cause, the hospital will inflate this by an order of magnitude. It’s the same with charity care. Hey, my sticker price for an aspirin is $1000. I’ll give away 10 aspirin and I can get credit for $10000 charity.
OH YES THEY ABSOLUTELY DO!
When I was in-between jobs I had a medical emergency and I was on the ACA around the first year it was offered. I was billed above medicare rates so I was on the hook for ~40k after out of pocket max. They told me this limit is what insurance has to cover but hospitals can still bill above it. First they told me they could work on the prices and asked for my last 5 years tax returns. When they saw that I had dividend payments they said they couldn't help me and I owed them the $40k. I think that was the problem because even though I wasn't working in their mind if I had investments then technically I was not in need so they set up four-year payment plan and paid every penny with no cost reduction.
I probably did something wrong but to this day I didn't know what I would have done differently. The only people I could talk to were the hospital and they only cared about the hospital.
Maybe you just don't have any assets or make very little money. I have equity and cannot just toss it to a collection agency and hope they forget. I also play by the rules, silly, I know, but I don't want to risk getting fucked some other way later in life.
We had a baby 2 weeks ago, which included 4 nights in the hospital before and after the birth, a surprise c-section, various specialists, follow ups, consultants and blood tests.
Our total outlay so far is about €30 for the parking at the hospital every day.
We have insurance, but we did not use it for the baby. I need to see a dermatologist next week. Cost will be €300, which I can claim back from my insurance afterwards. I just punch the doctor's name into my insurance portal, and they list the procedures and the amounts I'm covered for each.
If I asked my GP to refer me to a public dermatologist, I would have waited longer for an appt, but I would have only had to worry about parking at the hospital, everything else would be free.
I've resorted to picking my plan based primarily on MOOP. (Maximum out of pocket expense.) It works out to be about $1000, maximum, per person per month for childless adults. I simply don't have time for price research.
That's the raw cost of the plan before subsidies or work benefits. It's a sort of "maximum that any American would pay" and is comparable to the $300 per month that countries with universal healthcare pay in taxes (rough number, it varies).
Obviously, if you go without healthcare and get cancer or a catestrophic injury, you can expect to go bankrupt.
They couldn’t answer if cholesterol test would count. How is that not automatically classified as preventative? It’s one of the most basic metrics.
So they want me to get the doctor to give me the ICD code and the diagnosis code. Or something. Two different codes. They’ve added so much bureaucracy and crap into the system because they can. Nobody’s stopping them and there’s too many fingers in the pie.
They're incentivized to classify whatever they can as not being their problem, so it makes sense for them to double-check everything - there is always a possibility that some edge case was found that lets them off the hook for some specific test or treatment. Moreover, obscuring information and spreading support staff as thinly as possible means that extra barriers heavily discourage people from fully knowing what they'll be on the hook for, which makes them more likely to just nod their heads and do/pay what is asked. These decisions aren't driven by medical concerns. It's a universal problem of nearly all kinds of privatized insurance - their core incentive is to ask for as much money as possible and provide as little in return as it's legally feasible.
The place where I live is often used by Americans as the first line of defense to justify their healthcare system. Among certain political circles, there is almost a reflex to point at us and say "see how terrible it is?!" by exaggerating all the drawbacks and minimizing all the upsides. Yet even in such a flawed, underfunded, mismanaged system, my government insurance plan covers all "medically necessary" lab testing, with a couple rare exceptions that are only covered if you're diagnosed with certain conditions. The process of getting a test consists of a doctor filling out a standardized sheet, then going to a lab and handing them that sheet and my regional insurance card. No money exchanged.
It took me two weeks, dozens of phone calls, and multiple "escalations" to learn what would be covered and what the price would be if it wasn't
Totally insane. The kicker is that after all that, the price I was billed wasn't even the price I was given (thankfully it was less though).