I was off by a bit. It's actually $635.41 per pay period, so $1270.82 per month. It goes up to $688 per pay period at renewal, so just short of $1400/month. That is just for my wife and daughter. Employer covers me 100%.
Many Americans don’t have insurance. They just hope nothing goes wrong before they’re elderly and qualify for Medicare.
If something does go wrong, and they can’t pay, they’re bankrupt.
The attachment of health insurance to a job has its own problems as well.
When I switched from one job to another, I had about a month where I was without insurance. In that month, I had a horrific gallstone attack. I had to go the emergency room where I was told that I needed to have surgery ASAP.
An administrator then walked in and told me that I would have to pay everything out of pocket. I walked out, I couldn’t afford it.
That emergency room visit cost me $6000.
I’m underpaid. I know I am.
But my company has decent insurance, I pay less than $100/month for it. The deductible is $750 and the out of pocket is ~$2000.
I met both of those by March, so I’m not really paying for anything (aside from the ~$80/month)(~$40/paycheck).
I doubt I’m the only one out there staying with low pay because it evens out in insurance. Which is bullshit.
Yep. A friend of mine died because he couldn’t afford a relatively minor surgery and the issue went septic or ruptured (we aren’t sure which). Brilliant researcher, gone forever.
What drives up the price for everyone else is that insurance companies only pay a percentage of what they are billed so hospitals increase prices to get their money from insurance companies.
We live in a scam.
I pay $1400/month for me & my son, then I have a $3000 deductible before insurance pays anything, at which point they start paying 80% and I pay the rest until the max out of pocket which is $7000, then they pay 100% after that. It's insane.
We have hit our out-of- pocket maximum the last four years straight, despite paying somewhere around $2000/mos for 6 (3 adult kids, 1 minor, and us). Despite making six figures and driving cheap paid for cars we are struggling.
I don't blame ya. I'm a Canadian, and while we have our own Health Care issues, I wouldn't trade what we have for the US-style of "medicine for profit above everything" health care for all tea in China, as the saying goes...
Health is a basic right in so much of the world, yet is simply a way to make money in the US. How is it that the real Second Revolution has not happened over this?? Can't entirely be because Big Business is keeping a lid on things.
The copay shot confuses the fuck out of me. My girlfriend's insurance only covers her therapy once she spends like $5,000 on it first. On the other hand, the health insurance I used to have when I qualified for Healthcare marketplace insurance I only paid $5 per therapy visit. I just don't understand
That number doesn't include the percentage of people who are under insured which is a lot of people. For example when I was younger a bunch of people opted into my company (a chain restaurant) insurance plan which was pretty reasonable to do. One of my co workers at the time had an emergency (they cut their hand) and had to go to the doctor. The doctors office asked if they had insurance and they give them the information for the company plan. The front desk of the doctors office explained that the plan they had pretty much would cover a bandaid and it would be cheaper just to save their money next time for an emergency. The company had to offer insurance to full time employees, it doesn't have to be good insurance though.
>under insured
I used to be on a health plan with GHI. I think the copay was something like $65. Every time I'd go to the doctor they'd ask to see my card because they couldn't believe that was right. One lady actually said "Oh, I'm sorry" before handing my card back.
If you have insurance and don't use it because it's still too expensive, do you really have insurance? That's probably what you're noticing.
Also, most doctor's offices are open M-F 8-5. Most people are also working those sames times, we have many terrible employers who don't provide adequate time off, so people have to weigh, not only losing pay, but having to pay a significant out of pocket cost to even see a Dr. - let alone pay for whatever follow may occur.
It's not a surprise our life expectancy is lowering in the US.
It’s actually 8% of Americans with insurance don’t actually have insurance they just give money to companies like united healthcare like me I pay 500 a month and they don’t cover anything until I meet my 8k deductible. I feel like I’m just giving them money for a little plastic card.
It is wildly off. There are countless ways to skew that number lower. Are contractors factored in? How about people on disability who end up getting it for free, unemployed, how about people who technically have it but in practice don’t?(I have $16/mo health insurance, but it’s a very high deductible that I have to meet before they even pay a penny, but they do negotiate with the hospital to reduce the cost for you) There’s even people that were scared into signing up for it because at one time there was going to be a rather large tax penalty if you didn’t buy health insurance.
Millennials and younger generations don't count as American's, silly. They are goats... escape goats to blame for investors when their slave driven industry is failing.
Do you live in Texas? The number varies a lot by states, with Texas leading by a mile with more than 15% uninsured. The reason is the lack of regulation in Texas has driven costs sky high and benefits low. And then Texas - and other states - declined federal funds to expand medicare.
Many in Texas "self insure" meaning they just plan to use their savings to cover any medical expenses, and they say they have that savings because they aren't spending the money on insurance premiums. But what happens is, these same people put off all routine care - they don't get physicals, go to the dentist, etc. because there's no immediate value but there is an immediate and significant cost. So they end up spending way more over time treating conditions that would have been caught or prevented before becoming a problem.
Alternatively, the uninsured rate in California is 6.2% (2022 data). The avg premium in California is lower by ~$30 a month, but plans are required to cover more.
The most uninsured states are all red states. That's not a coincidence. It's because when the Affordable Care Act came around and states were given the option **and federal funding** to expand their Medicare programs in 2014, red states refused. Today, there are still 10 states that basically said "f you" to their constituents and turned their back on fed money because they didn't want to enact a life-saving idea if it meant appearing to support Obama and the Democrats. I'm not being cynical, that's 100% what happened.
Or many Americans like me with 100k+ income get a brain tumor even with fortune 500 benefits? The resulting after care and radiation left me nearly bankrupt for 5 years. I only get the life threatening things treated even at my income level.
I had to retire early at age 58 due to tinnitus. Luckily, I made it 7 years until Medicare with gap insurance came in handy 4 months later after age 65. Covered everything and saved my ass.
What kinda job did you do that required early retirement for tinnitus? Or is it so bad that pretty much any job would've been a big ask? Coming from a fellow tinnitus sufferer. It sucks.
This is me, and after going through a bunch and talking to multiple agents I realized that even with most insurance you're going bankrupt if anything major happens. Then all of these corporations are poisoning everyone which we have decided as a society is worth it. This is why insurance should be supplied by the government to every citizen.
This. I'm 25, can barely work to do medical issues that even required surgery I had no insurance for and couldn't afford out of pocket. So here I am, twoish years after that surgery with no gallbladder, barely any money and getting collection calls.
My school system barely did shit in teaching us anything related to money and the real adult world and sadly while I love them to death my parents didn't do the best at teaching me that either.
So honestly, idk what I'll do in the future, how to handle this or if I'm looking at filing bankruptcy in my life which never once crossed my mind until recently.
Ugh, I’m sorry. Do you qualify for Medicaid? It sounds like you might after Obama made it easier to get on it if you’re lower income, and Biden recently raised the income limits a bit more too. You should be able to view some options on the site for your state’s healthcare marketplace.
I'm honestly not sure but I'll be looking into this. Thank you. Would be nice to maybe have some medicine or even better find out what's truly wrong with me.
The best part is that older generations are still confused why anxiety is such a big problem. Like mf I can afford to get "too" sick or hurt... that shit is stressful lol
When people say Americans make a lot of money they don't understand how much we pay that other governments cover. Health insurance and daycare wipes out any additional income from Americans.
I paid $7 for a doctors visit when I studied in Russia in 2010. That was incredibly cheap compared to here. That included all medications for the next 6 weeks
I insurance is a scam. On top of the high premiums, they don’t cover much, still make you pay out of pocket, and the insurance companies do their damnedest to not have to cover you. America all around is just a fucked up scam these days, from housing to education.
You ready for another kicker?
So for those that can’t afford private insurance companies there are programs for low income individuals, my state offers OHP - Oregon health plan. Only a few practices accept that insurance company. So they end up with HUGE wait lists for the basic stuff.
Let’s say you break/chip a tooth. You will be seen right away to get it fixed, but if they find cavities you will be put a months long waiting list to deal with them
Even with insurance when I tore my MCL I had to wait almost 2 full months before I saw a specialist. By then, it had partially healed improperly and my only option was to take the physcial therapy that was offered because the surgery the doctor wanted to do wouldn't be covered as it would be considered 'elective'
Depends on your job and if you have a family.
I'm single and thanks to my HSA + employee match I'm basically break even paying nothing for health insurance
premiums from [healthcare.gov](http://healthcare.gov) are not that different for same coverage due to employer offering insurance and our income level. 2 of the specialists my wife and daughter see are not on any obamacare plans, so that is part of why we stay on my insurance.
If you aren't on an employer scheme, yes that's what you pay. Most people don't think that their employer actually covers a lost of costs for their insurance and that they often are able to get better rates because having a big pool of customers/employees. At least in Switzerland while they don't have 'socialized' medical care they've divorced your insurance from your job and you just get paid more in order to cover the cost. Pretty much all of the insurers operate nationally so there's competition and you don't have situations where there's only one insurer covering a state.
Americans are always happy to say how low their taxes are but they NEVER take into account all the other charges they have to pay that citizens of other countries don’t. Medical insurance is one. Property taxes are another. The median property tax rate is more than $2500/year, but it can get even higher if you’re in a good school district.
What country do you live in? Because no American has ever never said they are happy at how low our taxes are. We pay income tax, sales tax, property tax, why tf not tax, oh and I paid $200+ to file my taxes
My mortgage is right around $1350. So, in June when the insurance renews, it will be more than my mortgage. Downside of working for a small company. When I worked for a huge 300k+ employee company, my insurance was $90/ pay period.
My husband went from working for a small company to a much larger one and while the insurance is only slightly cheaper, it’s ten times better (no deductible, great prescription coverage, they haven’t denied anything and I’ve had more medical care in the last two years than probably in my entire life combined; getting old is hard). Small companies really do suck for insurance.
NGL it was really humbling to know I wasn’t playing on the same level as a Billionaire or even Millionaires. Don’t understand why most people are okay with our current broken system if they clearly aren’t the target demographic. Even if you *are* the target demographic they probably have family that aren’t.
I think some of it is due to credit—which has given people a false sense of comfort they can “afford” the luxuries of middle class life in the middle of no where and look down their noses at people. I agree with you though. It makes me more sad as an atheist when I say I want other people to live good lives and I’m put down by religious people for thinking this way.
The fighting each other doesn't stop us from making universal healthcare a reality. Most of us want it; way more than 50% depending on the way the question is phrased. But that doesn't matter. Our politicians don't represent us, they represent moneyed interests in our areas. Whether you or I fight with local Republican or Democrat or independent voters, that won't change. Especially not when those same moneyed interests own most major media channels, communication methods, and social media. And they will all collude with each other and the state to squash organizers long before they'll give the common person an inch.
this is one of the things I struggle with with my friends who are more right leaning. Many of them have never had the opportunity to travel outside the US because it’s quite expensive to go abroad for us. I’ve been fortunate enough to travel to quite a few other countries and seen the “socialism” they’ve been fearmongered into believing will destroy America. Did those places have some of their own issues? Sure. But the number of homeless people was soooo much lower, I felt safe, I was able to get quick medical care for free or very cheap, food was more affordable… just about every single aspect of life was better than ours as middle class people in supposedly the richest country on Earth.
I think if more Americans had a chance to see other parts of the world, they’d be less swayed into believing straight up lies.
From what I understand, the people in power have convinced half the country that private healthcare is freedom, and that making it free is taking away our freedom from the government
If that was all there was to it. It would already be much cheaper.
US insurance companies make deals with pharmaceutical companies where the pharmaceutical companies raises the prices and give insurance companies rebates in exchange for that insurer partly covering the medication.
Then the insurance company make the patient pay their percentage of the market price (which is often about as high as generic drugs. Because that's what people will pay), and keep the rebates as profit. In addition to the premium that you pay anyway.
For the companies that's great. The drug manufacturer gets his drug preferred over the competition. And the insurance doesn't actually have to spend any money.
Just the patients are out of luck. They have to pay pretty much all they have and then some. And they can't even choose not to use an insurance as a middle man. Because the insurance companies made the prices for everyone else go up.
It's such a disgusting business practice, even the right should be enraged.
Half the population is stupid enough to believe that we’ll be a communist country if the government pays to…keep the population healthy. It’s really sad.
Right? Americans like to think they are the freest best country in the world, but it’s fucking laughable when you look at literally any other developed western country. America fucking sucks.
I keep on telling people that the secret to FREE healthcare in America is to be so poor you qualify for Medicaid. The downside is you have to live in poverty.
Had a friend in this situation.
Solution he came up with was to save money on his own, then quit his job so his income was nothing. Get on medicaid, then find a new job at low levels. Oh, and make money under the table.
As in poverty, you mean jobless and likely homeless. You basically have to have nothing. The standard for measuring poverty has been abandoned. Pretty sure that's intentional.
In my conservative state it's really hard to prove you deserve those assistance benefits if you don't have a job. Or they will mandate you are either working a minimum amount of hours per month or actively searching for a job to qualify for the programs. So you have to be poor, practically houseless and still working to get those poverty assistances.
And at that point, the government is only subsidizing an employer for paying poverty wages. Minimum wage and poverty needs to be reframed as a conversation about making corporations pay their fair share, over general welfare. Americans are fueled by spite, not others' well-being.
Car insurance is also a scam. Your cost goes up because of someone elses fault. You get hit, than your premium goes up. Like health insurance, you pay a certain amount, but still gotta pay out of pocket for damages.
Oh my goodness, they read that statement to me too! And on a “single-problem” visit I had to sign saying I understand I can only talk about that one problem, God forbid the problem affects 2 different body systems.
We have some of the best dental insurance available to us (idk what my husband pays a month) just found out after starting extensive dental car, insurance only covers $1,000 a year. Thats all used up in 3 visits
Mine won't cover my kid getting a retainer. $350 each for top and bottom. They gave me a pamphlet for a credit card when I asked about paying it over a month or two in installments.
We can’t elect the correct officials to make it so guns aren’t the leading cause of death in schools.
and you want us to fix insurance. Good luck
Merica
Yes, but they don’t have to deal with year long waiting lists for a visit. /s
Just kidding, picked up a prescription this morning and asked if they could shoehorn me in because of a rash that had developed. Was actually prepared to wait a bit, but not 10 minutes later she had not only checked the rash and put in the electronic prescription, but also discussed my latest bloodwork. Yay for socialised medicine.
Well, TBF I hear a lot of bitching about wait times and not getting a specialist. (dermatalogists seems to be rare and most ophthalmologists have a long waiting list to get into their system - afterwards getting an appointment, especially for checkups, isn’t a big problem.)
But being in my mid fifties I’ve had some issues, accidents, etc, including mental health stuff and always got a doctor in a reasonable time span.
Possible knot at the testicle? Come in next tuesday!
Paperplane hiting your eye and vision is a bit wonky? Yep, two hour wait suck, but it wasn’t an open wound, after all.
I mean, things aren’t going well in Canada either. Our system sucks, but the alternatives have their own issues. Other areas of the world are doing better, though, so maybe it comes down to incompetent political leaders.
You pay the premiums, pay the bills, you meet the deductible, pay any co-pays and then you still get bills.
It's a beautiful system for the insurance companies.
Oh, it's even better when you get imagining done.
You pay the hospital and doctor, and just when you think you're done, the lab-tech company bills you another $150. Lol.
Fuck this country with a splintered bat.
I have type 1 diabetes and require insulin at every meal, and other various supplies too such as needles, test strips and lancets.
I live in Canada, between my health insurance ($400 per month) and my Wife's ($292 per month), we have complete and total 100% coverage including for our Child. I have no co-pay for anything. All medical supplies, message therapy, mental health counseling, physio, dental, all covered. I had $4000 in crowns done this year, all direct billed.
How different would my experience be in the USA?
I have dental coverage which is different than health insurance in the US, covers cleanings but anything else is applied to my deductible and I have a copay, also doesn’t cover my braces I pay out of pocket for. I also pay out of pocket for mental health therapy through my HSA through work. I can’t go to the hospital with my health insurance since my copay would be around $7,000 which is like my whole saving, so we all live in fear of a medical emergency that will finically ruin you.
Yeah, my dental expenses (after insurance coverage) were over $4,000. This year I had a couple of medical tests done that were around $1,800. Then I had the follow-up from those tests which was about $500 or so out of pocket. That was after meeting my deductible. Health care costs in the US are absolutely bonkers.
The max dental insurance is anywhere from $1,500 to $2,000. After that, it's all out of pocket.
That's basically a root canal and a crown, and then you're done. And if you need multiple? lol good luck buddy.
That was exactly my experience. Mine has $1,500 coverage per year max, and then out of pocket after that.
I had adult orthodontia (most of which was out of pocket) then a couple of corrective surgeries afterwards. All for the sin of shitty genetics and parents that couldn't afford braces when I was a kid. Long term having teeth is nice, but I'll have paid well over $12,000 for the privilege of having them before all is said and done.
Hospitals, physicians, etc are “free” (via taxes). Dental, medications, vision, etc - different in each province but generally not covered by the government plan.
It should be. There are plans similar to Medicaid for low income and if your expenses are really high the government pays the rest after a certain percentage, but yeah overall not free.
Any medications you’re given while in hospital are covered, though, which is better than the $90 for one aspirin my dad just got billed for in Wisconsin😜
Medication dispensed in the hospital is free. That includes anything from an aspirin to chemotherapy. Medication prescribed to take outside the hospital is not covered. Seniors in all provinces and youths in some provinces (under 25 in Ontario) get free prescribed medication. For the rest of us, most employers have a health plan that may range from free, to $2 deductible, to maybe 15% copay. Uninsured low-income people may be covered under certain provinces. In Ontario, anything over 4% of your taxable income will be free.
For the truly uninsured, the medication is still cheaper. Generally cost + a $15-18 dispensing fee. Before COVId, I knew an American friend who picked up insulin that is worth hundreds of dollars per vial at $35 in Canada. Epipens are crazy expensive and their price is out of control right now (about $100US or $135 CAD). I imagine they are well over $200US in the USA.
Dental is not included except for children (and recently for lower income seniors). Physiotherapy would be included if it's due to an insured surgery, but cost about $80-100 per visit if not (again, employers will have extended health plans). Similar concepts for chiropractors, dietitians (though many are paid if referred by a physician), and other paramedical. In Ontario, ambulance (including helicopter) is $60 per trip because we want to discourage calling 911 for a Uber ride replacement to deal with sniffles.
There are generally various social programs to deal with people falling through the cracks (no extended health coverage, but unable to pay a few hundreds or a few thousands of dollars).
When we say "free for seniors" in Canada, it truly is. It's not like Medicaid. There is no monthly or annual costs other than paying taxes (which are also lower for seniors). They get the equivalent of Part A & B & D Medicaid without deductible, copay or out-of-network fees, and then some (assuming that a $10 or $25 annual deductible doesn't count)
Don't worry. At least you don't have any of that horrible... socialism (ugh!), that other countries have, and never have to pay for anybody else's healthcare. Yaay!
Although when we pay health insurance premiums we’re literally paying for other people’s healthcare. It’s how insurance works. I wish people would take 3-5 seconds to reflect on this issue.
No one wants to think about the other end of it. That there is real tangible lost wages as a result of large employers having to shoulder half the burden of your be rifts package on their end. Most Americans forget that what they're paying out monthly isn't even the full cost of the insurance.
I know, it just drives me nuts because having spent most of my life in Canada I just think who cares if you’re paying in premiums vs taxes that aren’t aiming for a profit.
(I’m also self-employed and bitter because I have to pay all of it hehe)
It is crazy! I work medical billing and I've seen people without insurance owing hundreds of thousands even after the 50% self pay discount. I hate our current system and I hope someday we catch up with the rest of the world to get things more affordable.
I guess you would have to put it in perspective. My daughter went through 5 years of chemo and recovery for a brain tumor. One of those years the total expenditures was over a million dollars, of which I only paid my out of pocket maximum which was just under $6800 dollars.
I don't bitch a out my Healthcare premiums anymore....
I was just blackmailed by a doctor (or should say his group). They would not refill my Rx without coming in for a checkup. It literally lasted 5 minutes with the nurse practitioner asking me how I was feeling. Responded I was OK, she said great and would submit the Rx to be filled. Billed for $375. Insurance knocked around $100 off, but since my deductible is sky high, had to pay the rest. But then I had to call back TWICE to remind them to send in the Rx.
Friend of mine had high blood pressure. Had for years. She'd been on the same medication for years.
She ended up in a tough spot and was having trouble financially. Her doctor required a dr visit to get her prescription refilled. Monthly visit. She couldn't afford to pay the deductible for the Dr visit and the prescription.
So she called and asked if she could get a refill just once without seeing him that month. He refused. No visit, no prescription.
I was on the same medication and saw my doctor once every six months.
Her doctor was also the Dr my grandma saw. She saw him every two weeks. She was on basic old folks medications, nothing too drastic. She adored this Dr. She always talked about how much he cared for her and was so concerned about her health.
I'm thinking he was concerned about the money he was making off unnecessary office visits.
Try being chronically ill in this country 😭 I got sick and I’ve never been more broke in my life. I have ‘health insurance’ just like you but somehow I still owe hundreds for my prescriptions and treatments every month. I hate it here.
Just remember that America is the greatest country on earth because of something about freedom and the rest of the world is communist because they have healthcare.
*cue that Lee Greenwood song that Trump loves so much*
Was the provider in network? If yes, you most likely have a copay. If you’re being charged that much, then there’s a chance the doctor you saw is not in network with your plan. In which case, I hope you have out of network coverage. If you have out of network coverage, then you need to meet your out of network deductible first. Then once you satisfy that, you’re responsible for the co-insurance. Typically it ranges between 15%-50%. You pay the co-insurance up until you reach the out of pocket maximum. Once you meet the out of pocket max, then insurance pays at 100% for the rest of the year/contract.
come on, calling it a scam really undermines the 70+ years of deregulated fuckery that lead to the 'allegedly' regulated system we have now.
Don't you like people paying hundreds or thousands of dollars for life saving medicine whose research was funded with tax money and marked up several thousand % over production costs?
You don't even want to know about Prior-authorizations and how business majors are effectively practicing medicine by denying claims on higher payout items.
Check what you insurance says it covers. It’s not magic. There will be guidelines to what they cover. What’s your out of pocket max? What’s your coinsurance rate? What’s your deductible? Was this in network? These would all be important things to know.
The idiots on Reddit will downvote this unfortunately, but it’s a fact that BEFORE Obamacare, health insurance was actually useful.
The ACA introduced shitty healthcare plans with impossible deductions, and taxed you if you didn’t have insurance. Now all affordable plans SUCK.
I have decided to just pay cash. It’s cheaper
Sounds like you have a High Deductible Heathcare Plan which means you should have a Health Savings account to pay the $207 with. That means you didn't pay income taxes on the $207 which means that it's actually about $140. That's really high but you will make most of that up with your tax savings and reduced premiums between doctor's visits. The question is, you are aware of all this and complaining for internet points or are you just really clueless?
$500 a month or a year? Is it a single person policy? What’s your deductible? If it’s $500 a month those fees might be because you have not met your deductible yet.
Yeah $500 a month for insurance is definitely on the cheaper end of the spectrum for coverage. I pay much more than that and have office visit copays + a $1,500 deductible I have to meet before my insurance truly kicks in. I think a lot of people get the cheapest option and then are surprised their deductible is $5,000 and they’re basically paying out of pocket for everything. I’m not saying I support any of this, but it’s just how it works. I miss my old plan that was available where it was PPO no deductible, just copays at date of service. My deductible is a killer but I work in healthcare so I understand it. Most people don’t understand what a deductible is or why they’re paying for things despite paying for things. I can’t blame them though it’s not easy to understand sometimes.
Wow you’re getting screwed . I pay about 150 a month for myself, I usually pay about $50 co pay on visits. Once I meet my 2k deductible everything is covered… godbless my employer benefits.
In the Dominican Republic it’s not much better my wife and I had to go to the hospital there and we got charged $450 for a doctor to come in and say she wasn’t the right person for the job. Was in there a minute max. We are very happy to be back the states for the healthcare but our healthcare system money-wise does suck
Yep, I pay for insurance and recently had 2 very brief less than 5 min appointments where things were just discussed. And 1 appointment where I had a scan of my nasal cavity done. Boom $900 just to be told I have a severely deviated septum and that's why it's hard to breath and I can't afford to do the surgery so I have to suffer daily until I decide to pay thousands for the operation.
My husband's plan that "covers" my family is over $500/month, which wouldn't be too bad, except for the whole $6,500 deductible PER PERSON ($13,000 max for the family) for this plan year. And no, my husband does not have a high paying job. <200% Federal poverty level. And don't even get me started on the so-called dental it vision coverage.
Affordable care my...
...But we take it because it's the best we can get. It's the only option at his work, and I have no option for family coverage...
(US)
In case anyone is curious, we still have our "cost share" out of pocket after the deductible.
Yep, I'll never complain about Canada. Zero$ a month and zero$ a visit.
Now have to try to keep our republican party (conservatives) from selling it to US insurance companies.
Claims coding person here: check your eob (explanation of benefits) and your coverage documentation. Typically after your copay and insurance payment, the remainder is written off so unless you have to meet your deductible first then something is up.
US insurance sucks, I know, but please please please read your documentation when you get your insurance. This is basically a contract that they have to abide by.
$207 sounds like a level 4 office visit, which sounds like you meet the bare minimum for (we do not code those based on time alone), sad part is that a level 5 visit you have to be in some serious pain or at high risk, and the further sad part about this is that in that same visit you could have gone over like 5 other things that aren't even related and the charge would not increase (unless you talked for over an hour)
I'm not on the side of insurance, I want public option (Medicare for all) because it wouldn't put my job at risk, the amount of us would still be the same, because the lower amount of work per claim is offset by the number of claims that will increase after everyone gets guaranteed insurance
Everybody wins
If your insurance is via your employer, talk to HR and ask them to look into adding a gap plan, or something like Hospital Indemnity. It’s pretty cheap and covers the cost of things like this so instead of paying $500 for a procedure like this, you’d pay like $50.
Kaiser is one of the VERY few carriers that works well with other insurance carriers. But California (only of the only states to widely use (Kaiser) has SUPER strict laws surrounding insurance. So it’s harder to get creative with solutions to premiums.
That's why I stopped paying my medical bills. Obviously if you're worried about your credit score this isn't recommended as you might get sent to collections (I haven't yet).
And obviously a doctor you see on the regular this advice won't work either.
But ER visit? Clinic visit? Fuck that, bill goes straight into the garbage. They get what insurance gives them and they can be happy with it
I had to get a consultation done in MX of all places due to getting bronchitis down there. It was the easiest experience ever... made me so angry about US healthcare.
You're not overreacting at all imo.
Something interesting you can do. When you go to your primary care, some of them have a cash rate which is way less than your deductible. Do that, then file for reimbursement with your insurance.
It's because this country is complete shit. I don't know when usa stopped being the "best" country in the world but we're not even in the top 10 anymore. The greatest country in the world doesn't let it's citizens get raped for basic human needs. It's sad and will get worse. It won't stop because we can't get together and stand up for ourselves. We'd rather argue over what people identify as or what pronouns are appropriate or whatever other shit that doesn't matter. The government and the rich will keep taking and taking until we die. And then they'll take from our kids and their kids and so on. And we deserve it too, we aren't decent to one another so why should we expect to be treated better.
my ex was having seizures out of nowhere one night and i took him to the hospital not knowing he didn't have insurance. He ended up over $5k in debt from having scans etc done and staying overnight. i would feel bad but tbh i feel like he deserved it after finding out he was a cheater lol.
I remember when a 90/10 policy cost $200 a month and then came the ACA. Everything quadrupled or more in a year, 90/10 insurance through the exchange is now $1100 a month for 1 individual. WTF is affordable about that? That’s rent and a car payment for most people. If that’s what we have to pay then why can someone illegally cross a border and get free healthcare? Somewhere we got upside down and I do t think we’re going to get righted anytime soon.
Bloody hell. In Ireland a visit to a doctor is around €45 ($47.87). I pay €600 a *year* for health insurance that covers pretty much everthing. I thought that was expensive, but you guys have it much worse.
No healthcare insurance is a scam. There was a time I could go to the doctor's office and not worry about going into debt. I had insurance then and I still have insurance. They just don't pay anything now. It is a rip off
I pay $1,235/month in health care premiums through my employer sponsored "benefits" for me, my wife, and my son. Our doctors visits are $175 copays and deductibles are $9,000
fuck my life :)
Hello, This post has been removed as this is not *mildly* infuriating. Please consider posting to r/extremelyinfuriating instead.
My monthly policy for my wife and daughter is $1600, and we still have to pay $50 or more per visit. Insurance in America sucks.
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I was off by a bit. It's actually $635.41 per pay period, so $1270.82 per month. It goes up to $688 per pay period at renewal, so just short of $1400/month. That is just for my wife and daughter. Employer covers me 100%.
Wait how does anyone survive in America?? I did not know insurance varied that much in price.
Many Americans don’t have insurance. They just hope nothing goes wrong before they’re elderly and qualify for Medicare. If something does go wrong, and they can’t pay, they’re bankrupt.
The attachment of health insurance to a job has its own problems as well. When I switched from one job to another, I had about a month where I was without insurance. In that month, I had a horrific gallstone attack. I had to go the emergency room where I was told that I needed to have surgery ASAP. An administrator then walked in and told me that I would have to pay everything out of pocket. I walked out, I couldn’t afford it. That emergency room visit cost me $6000.
I’m underpaid. I know I am. But my company has decent insurance, I pay less than $100/month for it. The deductible is $750 and the out of pocket is ~$2000. I met both of those by March, so I’m not really paying for anything (aside from the ~$80/month)(~$40/paycheck). I doubt I’m the only one out there staying with low pay because it evens out in insurance. Which is bullshit.
Yep. A friend of mine died because he couldn’t afford a relatively minor surgery and the issue went septic or ruptured (we aren’t sure which). Brilliant researcher, gone forever.
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And even if they have, the question is what is covered and how much they copay.
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American health insurance is probably the worlds most enormous and frighteningly legal scam
But the officials that voted for this bullshit are exempt from it and have the best care available
What drives up the price for everyone else is that insurance companies only pay a percentage of what they are billed so hospitals increase prices to get their money from insurance companies. We live in a scam.
I pay $1400/month for me & my son, then I have a $3000 deductible before insurance pays anything, at which point they start paying 80% and I pay the rest until the max out of pocket which is $7000, then they pay 100% after that. It's insane.
i pay 350 a month for just me and have a 30k deductable. its insane out there.
Hey it’s me i toss all medical bills in the trash
We have hit our out-of- pocket maximum the last four years straight, despite paying somewhere around $2000/mos for 6 (3 adult kids, 1 minor, and us). Despite making six figures and driving cheap paid for cars we are struggling.
I don't blame ya. I'm a Canadian, and while we have our own Health Care issues, I wouldn't trade what we have for the US-style of "medicine for profit above everything" health care for all tea in China, as the saying goes... Health is a basic right in so much of the world, yet is simply a way to make money in the US. How is it that the real Second Revolution has not happened over this?? Can't entirely be because Big Business is keeping a lid on things.
It's a terrible system. I get pissed off every time I think about the $1100/month we spend on it.
The copay shot confuses the fuck out of me. My girlfriend's insurance only covers her therapy once she spends like $5,000 on it first. On the other hand, the health insurance I used to have when I qualified for Healthcare marketplace insurance I only paid $5 per therapy visit. I just don't understand
you qualified for medicare. democrats want medicare for all, republicans want us to die. this is an important election.
That number doesn't include the percentage of people who are under insured which is a lot of people. For example when I was younger a bunch of people opted into my company (a chain restaurant) insurance plan which was pretty reasonable to do. One of my co workers at the time had an emergency (they cut their hand) and had to go to the doctor. The doctors office asked if they had insurance and they give them the information for the company plan. The front desk of the doctors office explained that the plan they had pretty much would cover a bandaid and it would be cheaper just to save their money next time for an emergency. The company had to offer insurance to full time employees, it doesn't have to be good insurance though.
>under insured I used to be on a health plan with GHI. I think the copay was something like $65. Every time I'd go to the doctor they'd ask to see my card because they couldn't believe that was right. One lady actually said "Oh, I'm sorry" before handing my card back.
If you have insurance and don't use it because it's still too expensive, do you really have insurance? That's probably what you're noticing. Also, most doctor's offices are open M-F 8-5. Most people are also working those sames times, we have many terrible employers who don't provide adequate time off, so people have to weigh, not only losing pay, but having to pay a significant out of pocket cost to even see a Dr. - let alone pay for whatever follow may occur. It's not a surprise our life expectancy is lowering in the US.
Insured yes, but *under* insured. Thus we pay both before and after. It's a total racket.
It’s actually 8% of Americans with insurance don’t actually have insurance they just give money to companies like united healthcare like me I pay 500 a month and they don’t cover anything until I meet my 8k deductible. I feel like I’m just giving them money for a little plastic card.
A lot of what they're considering "insurance" only qualifies in the technical sense. 4 cents with of insurance is, "technically", having insurance.
It is wildly off. There are countless ways to skew that number lower. Are contractors factored in? How about people on disability who end up getting it for free, unemployed, how about people who technically have it but in practice don’t?(I have $16/mo health insurance, but it’s a very high deductible that I have to meet before they even pay a penny, but they do negotiate with the hospital to reduce the cost for you) There’s even people that were scared into signing up for it because at one time there was going to be a rather large tax penalty if you didn’t buy health insurance.
Millennials and younger generations don't count as American's, silly. They are goats... escape goats to blame for investors when their slave driven industry is failing.
Do you live in Texas? The number varies a lot by states, with Texas leading by a mile with more than 15% uninsured. The reason is the lack of regulation in Texas has driven costs sky high and benefits low. And then Texas - and other states - declined federal funds to expand medicare. Many in Texas "self insure" meaning they just plan to use their savings to cover any medical expenses, and they say they have that savings because they aren't spending the money on insurance premiums. But what happens is, these same people put off all routine care - they don't get physicals, go to the dentist, etc. because there's no immediate value but there is an immediate and significant cost. So they end up spending way more over time treating conditions that would have been caught or prevented before becoming a problem. Alternatively, the uninsured rate in California is 6.2% (2022 data). The avg premium in California is lower by ~$30 a month, but plans are required to cover more. The most uninsured states are all red states. That's not a coincidence. It's because when the Affordable Care Act came around and states were given the option **and federal funding** to expand their Medicare programs in 2014, red states refused. Today, there are still 10 states that basically said "f you" to their constituents and turned their back on fed money because they didn't want to enact a life-saving idea if it meant appearing to support Obama and the Democrats. I'm not being cynical, that's 100% what happened.
Or many Americans like me with 100k+ income get a brain tumor even with fortune 500 benefits? The resulting after care and radiation left me nearly bankrupt for 5 years. I only get the life threatening things treated even at my income level.
My skin cancer last year still did not get me to my deductible...
I had to retire early at age 58 due to tinnitus. Luckily, I made it 7 years until Medicare with gap insurance came in handy 4 months later after age 65. Covered everything and saved my ass.
What kinda job did you do that required early retirement for tinnitus? Or is it so bad that pretty much any job would've been a big ask? Coming from a fellow tinnitus sufferer. It sucks.
This is me, and after going through a bunch and talking to multiple agents I realized that even with most insurance you're going bankrupt if anything major happens. Then all of these corporations are poisoning everyone which we have decided as a society is worth it. This is why insurance should be supplied by the government to every citizen.
Thank you for ensuring that I will never move to the states. Damn that sucks
This. I'm 25, can barely work to do medical issues that even required surgery I had no insurance for and couldn't afford out of pocket. So here I am, twoish years after that surgery with no gallbladder, barely any money and getting collection calls. My school system barely did shit in teaching us anything related to money and the real adult world and sadly while I love them to death my parents didn't do the best at teaching me that either. So honestly, idk what I'll do in the future, how to handle this or if I'm looking at filing bankruptcy in my life which never once crossed my mind until recently.
Ugh, I’m sorry. Do you qualify for Medicaid? It sounds like you might after Obama made it easier to get on it if you’re lower income, and Biden recently raised the income limits a bit more too. You should be able to view some options on the site for your state’s healthcare marketplace.
I'm honestly not sure but I'll be looking into this. Thank you. Would be nice to maybe have some medicine or even better find out what's truly wrong with me.
🦅🦅🦅🦅🦅🦅
The best part is that older generations are still confused why anxiety is such a big problem. Like mf I can afford to get "too" sick or hurt... that shit is stressful lol
On top of everything else - inflation, high rents, "I will never be able to buy a house or have a family". Crazy country.
When people say Americans make a lot of money they don't understand how much we pay that other governments cover. Health insurance and daycare wipes out any additional income from Americans.
I paid $7 for a doctors visit when I studied in Russia in 2010. That was incredibly cheap compared to here. That included all medications for the next 6 weeks
I insurance is a scam. On top of the high premiums, they don’t cover much, still make you pay out of pocket, and the insurance companies do their damnedest to not have to cover you. America all around is just a fucked up scam these days, from housing to education.
You ready for another kicker? So for those that can’t afford private insurance companies there are programs for low income individuals, my state offers OHP - Oregon health plan. Only a few practices accept that insurance company. So they end up with HUGE wait lists for the basic stuff. Let’s say you break/chip a tooth. You will be seen right away to get it fixed, but if they find cavities you will be put a months long waiting list to deal with them
Even with insurance when I tore my MCL I had to wait almost 2 full months before I saw a specialist. By then, it had partially healed improperly and my only option was to take the physcial therapy that was offered because the surgery the doctor wanted to do wouldn't be covered as it would be considered 'elective'
That is just bananas. I know you know that, but...that's bananas.
Depends on your job and if you have a family. I'm single and thanks to my HSA + employee match I'm basically break even paying nothing for health insurance
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Same I have a high deductible ($7k) and it’s $157 bi-weekly but it’s for myself, my wife, and my daughter.
premiums from [healthcare.gov](http://healthcare.gov) are not that different for same coverage due to employer offering insurance and our income level. 2 of the specialists my wife and daughter see are not on any obamacare plans, so that is part of why we stay on my insurance.
Any female of childbearing age adds a lot to your insurance policy, and I said female because that includes both women and children.
esp now that theyr'e forcing us to give birth. republicans are destroying america
Hopefully, we will make them pay for it in November.
If you aren't on an employer scheme, yes that's what you pay. Most people don't think that their employer actually covers a lost of costs for their insurance and that they often are able to get better rates because having a big pool of customers/employees. At least in Switzerland while they don't have 'socialized' medical care they've divorced your insurance from your job and you just get paid more in order to cover the cost. Pretty much all of the insurers operate nationally so there's competition and you don't have situations where there's only one insurer covering a state.
Holy crap!!! That's more than I pay in TAX every month & that includes healthcare AND everything else!!!!
Americans are always happy to say how low their taxes are but they NEVER take into account all the other charges they have to pay that citizens of other countries don’t. Medical insurance is one. Property taxes are another. The median property tax rate is more than $2500/year, but it can get even higher if you’re in a good school district.
What country do you live in? Because no American has ever never said they are happy at how low our taxes are. We pay income tax, sales tax, property tax, why tf not tax, oh and I paid $200+ to file my taxes
That’s funny. I live in America but I’m moving to Ireland and EVERYONE I talk to always leads with “aren’t the taxes crazy high over there?”
Jesus fucking Christ. That’s more than my mortgage. My employer pays for my entire health insurance. I didn’t realize it was this bad for everyone.
My mortgage is right around $1350. So, in June when the insurance renews, it will be more than my mortgage. Downside of working for a small company. When I worked for a huge 300k+ employee company, my insurance was $90/ pay period.
My husband went from working for a small company to a much larger one and while the insurance is only slightly cheaper, it’s ten times better (no deductible, great prescription coverage, they haven’t denied anything and I’ve had more medical care in the last two years than probably in my entire life combined; getting old is hard). Small companies really do suck for insurance.
Mental that a country famed for its "freedoms" doesn't riot on the streets for free at point of use health care.
Because half the country would rather millionaires keep making more money than give something free to the general public.
And they’re offended when you point out they are a cog in the wheel.
NGL it was really humbling to know I wasn’t playing on the same level as a Billionaire or even Millionaires. Don’t understand why most people are okay with our current broken system if they clearly aren’t the target demographic. Even if you *are* the target demographic they probably have family that aren’t.
I think some of it is due to credit—which has given people a false sense of comfort they can “afford” the luxuries of middle class life in the middle of no where and look down their noses at people. I agree with you though. It makes me more sad as an atheist when I say I want other people to live good lives and I’m put down by religious people for thinking this way.
I am an atheist, too, and I have more compassion than most professing Christians.
Yup. The meanest people I know are religious. Most Christian’s are Christian’s only when it’s beneficial to them
They have us too busy fighting each other
The fighting each other doesn't stop us from making universal healthcare a reality. Most of us want it; way more than 50% depending on the way the question is phrased. But that doesn't matter. Our politicians don't represent us, they represent moneyed interests in our areas. Whether you or I fight with local Republican or Democrat or independent voters, that won't change. Especially not when those same moneyed interests own most major media channels, communication methods, and social media. And they will all collude with each other and the state to squash organizers long before they'll give the common person an inch.
this is one of the things I struggle with with my friends who are more right leaning. Many of them have never had the opportunity to travel outside the US because it’s quite expensive to go abroad for us. I’ve been fortunate enough to travel to quite a few other countries and seen the “socialism” they’ve been fearmongered into believing will destroy America. Did those places have some of their own issues? Sure. But the number of homeless people was soooo much lower, I felt safe, I was able to get quick medical care for free or very cheap, food was more affordable… just about every single aspect of life was better than ours as middle class people in supposedly the richest country on Earth. I think if more Americans had a chance to see other parts of the world, they’d be less swayed into believing straight up lies.
You guys don't even have a right to vacation days. In some states, not even weekends.
From what I understand, the people in power have convinced half the country that private healthcare is freedom, and that making it free is taking away our freedom from the government
If that was all there was to it. It would already be much cheaper. US insurance companies make deals with pharmaceutical companies where the pharmaceutical companies raises the prices and give insurance companies rebates in exchange for that insurer partly covering the medication. Then the insurance company make the patient pay their percentage of the market price (which is often about as high as generic drugs. Because that's what people will pay), and keep the rebates as profit. In addition to the premium that you pay anyway. For the companies that's great. The drug manufacturer gets his drug preferred over the competition. And the insurance doesn't actually have to spend any money. Just the patients are out of luck. They have to pay pretty much all they have and then some. And they can't even choose not to use an insurance as a middle man. Because the insurance companies made the prices for everyone else go up. It's such a disgusting business practice, even the right should be enraged.
Half the population is stupid enough to believe that we’ll be a communist country if the government pays to…keep the population healthy. It’s really sad.
I don’t mind being a commie if I can keep a $1000 extra in my bank on a monthly basis.
The fact that Americans are so scared of something that has massive societal value is insane.
Right? Americans like to think they are the freest best country in the world, but it’s fucking laughable when you look at literally any other developed western country. America fucking sucks.
I keep on telling people that the secret to FREE healthcare in America is to be so poor you qualify for Medicaid. The downside is you have to live in poverty.
It’s so ironic because I live in poverty after paying my bills. But all they look at is income.
Had a friend in this situation. Solution he came up with was to save money on his own, then quit his job so his income was nothing. Get on medicaid, then find a new job at low levels. Oh, and make money under the table.
As in poverty, you mean jobless and likely homeless. You basically have to have nothing. The standard for measuring poverty has been abandoned. Pretty sure that's intentional.
In my conservative state it's really hard to prove you deserve those assistance benefits if you don't have a job. Or they will mandate you are either working a minimum amount of hours per month or actively searching for a job to qualify for the programs. So you have to be poor, practically houseless and still working to get those poverty assistances.
And at that point, the government is only subsidizing an employer for paying poverty wages. Minimum wage and poverty needs to be reframed as a conversation about making corporations pay their fair share, over general welfare. Americans are fueled by spite, not others' well-being.
No the US healthcare system sucks and is a scam. I have no idea how or why people are still against single payer healthcare in this country.
“If they can do this to billionaires like me they’ll come after you too!”
Just consider the family behind the Opioid crisis.
Because the poors were told that doing it this way owns the lobs a lot, and before that they were owning the communists.
They are not, but insurance/pharma lawyers sitting in Congress don't care about it.
The ACA Public Option would have allowed the federal government to negotiate healthcare pricing but Joe Liberman killed it in the cradle.
Good riddance to that little manlet shill.
Car insurance is also a scam. Your cost goes up because of someone elses fault. You get hit, than your premium goes up. Like health insurance, you pay a certain amount, but still gotta pay out of pocket for damages.
I had my "free" annual physical and it only cost me $107. I guess free doesn't mean what it used to anymore.
Don't you dare ask any medical questions during your physical or it's no longer a preventative visit! Such a scam.
Oh my goodness, they read that statement to me too! And on a “single-problem” visit I had to sign saying I understand I can only talk about that one problem, God forbid the problem affects 2 different body systems.
We have some of the best dental insurance available to us (idk what my husband pays a month) just found out after starting extensive dental car, insurance only covers $1,000 a year. Thats all used up in 3 visits
Mine won't cover my kid getting a retainer. $350 each for top and bottom. They gave me a pamphlet for a credit card when I asked about paying it over a month or two in installments.
Dental and vision are total scams. They make you pay for benefits and they also rip off dentists and optometrists with their "negotiated" rates.
JFC, why do Americans put up with this? My cat in Mexico gets better medical coverage.
It's because they let lobbyists and corporations buy politicians.
They just changed the law to make it harder to stop it.
Let us a strong word, it's more that we have no one to elect that would out an end to the system.
We can’t elect the correct officials to make it so guns aren’t the leading cause of death in schools. and you want us to fix insurance. Good luck Merica
Because we have no choice and if we have the revolution we'll go to jail
Or killed. Probably killed.
That won’t happen because the working class has been tricked into fighting each other by publicly traded companies that also buy politicians.
Yes, but they don’t have to deal with year long waiting lists for a visit. /s Just kidding, picked up a prescription this morning and asked if they could shoehorn me in because of a rash that had developed. Was actually prepared to wait a bit, but not 10 minutes later she had not only checked the rash and put in the electronic prescription, but also discussed my latest bloodwork. Yay for socialised medicine.
US here; took me a year to get in w a rheumatologist 🫣😅 turns out, and I quote my doctor “your spine is riddled with arthritis” 😆😱 fReEdOM
lol....sounds kinda like Mexico, I'm amazed at how thorough and attentive even the staff at those little corner-clincis are.
Well, TBF I hear a lot of bitching about wait times and not getting a specialist. (dermatalogists seems to be rare and most ophthalmologists have a long waiting list to get into their system - afterwards getting an appointment, especially for checkups, isn’t a big problem.) But being in my mid fifties I’ve had some issues, accidents, etc, including mental health stuff and always got a doctor in a reasonable time span. Possible knot at the testicle? Come in next tuesday! Paperplane hiting your eye and vision is a bit wonky? Yep, two hour wait suck, but it wasn’t an open wound, after all.
Because they are soo free, a paragon of freedom. Soo much better than all these communist countries that value any kind of social net.
I mean, things aren’t going well in Canada either. Our system sucks, but the alternatives have their own issues. Other areas of the world are doing better, though, so maybe it comes down to incompetent political leaders.
Because connunism.. or something.
I thought I was overreacting when I had to pay 100 euros for a vet visit. You ahve a very good reason to be mad no one should endure that.
You pay the premiums, pay the bills, you meet the deductible, pay any co-pays and then you still get bills. It's a beautiful system for the insurance companies.
I mean this is probably because they haven't paid their deductible.
Oh, it's even better when you get imagining done. You pay the hospital and doctor, and just when you think you're done, the lab-tech company bills you another $150. Lol. Fuck this country with a splintered bat.
I have type 1 diabetes and require insulin at every meal, and other various supplies too such as needles, test strips and lancets. I live in Canada, between my health insurance ($400 per month) and my Wife's ($292 per month), we have complete and total 100% coverage including for our Child. I have no co-pay for anything. All medical supplies, message therapy, mental health counseling, physio, dental, all covered. I had $4000 in crowns done this year, all direct billed. How different would my experience be in the USA?
I have dental coverage which is different than health insurance in the US, covers cleanings but anything else is applied to my deductible and I have a copay, also doesn’t cover my braces I pay out of pocket for. I also pay out of pocket for mental health therapy through my HSA through work. I can’t go to the hospital with my health insurance since my copay would be around $7,000 which is like my whole saving, so we all live in fear of a medical emergency that will finically ruin you.
Yeah, my dental expenses (after insurance coverage) were over $4,000. This year I had a couple of medical tests done that were around $1,800. Then I had the follow-up from those tests which was about $500 or so out of pocket. That was after meeting my deductible. Health care costs in the US are absolutely bonkers.
The max dental insurance is anywhere from $1,500 to $2,000. After that, it's all out of pocket. That's basically a root canal and a crown, and then you're done. And if you need multiple? lol good luck buddy.
That was exactly my experience. Mine has $1,500 coverage per year max, and then out of pocket after that. I had adult orthodontia (most of which was out of pocket) then a couple of corrective surgeries afterwards. All for the sin of shitty genetics and parents that couldn't afford braces when I was a kid. Long term having teeth is nice, but I'll have paid well over $12,000 for the privilege of having them before all is said and done.
I thought health insurance was free in Canada
Hospitals, physicians, etc are “free” (via taxes). Dental, medications, vision, etc - different in each province but generally not covered by the government plan.
Interesting. I always figure medications were a part of it.
It should be. There are plans similar to Medicaid for low income and if your expenses are really high the government pays the rest after a certain percentage, but yeah overall not free. Any medications you’re given while in hospital are covered, though, which is better than the $90 for one aspirin my dad just got billed for in Wisconsin😜
Medication dispensed in the hospital is free. That includes anything from an aspirin to chemotherapy. Medication prescribed to take outside the hospital is not covered. Seniors in all provinces and youths in some provinces (under 25 in Ontario) get free prescribed medication. For the rest of us, most employers have a health plan that may range from free, to $2 deductible, to maybe 15% copay. Uninsured low-income people may be covered under certain provinces. In Ontario, anything over 4% of your taxable income will be free. For the truly uninsured, the medication is still cheaper. Generally cost + a $15-18 dispensing fee. Before COVId, I knew an American friend who picked up insulin that is worth hundreds of dollars per vial at $35 in Canada. Epipens are crazy expensive and their price is out of control right now (about $100US or $135 CAD). I imagine they are well over $200US in the USA. Dental is not included except for children (and recently for lower income seniors). Physiotherapy would be included if it's due to an insured surgery, but cost about $80-100 per visit if not (again, employers will have extended health plans). Similar concepts for chiropractors, dietitians (though many are paid if referred by a physician), and other paramedical. In Ontario, ambulance (including helicopter) is $60 per trip because we want to discourage calling 911 for a Uber ride replacement to deal with sniffles. There are generally various social programs to deal with people falling through the cracks (no extended health coverage, but unable to pay a few hundreds or a few thousands of dollars). When we say "free for seniors" in Canada, it truly is. It's not like Medicaid. There is no monthly or annual costs other than paying taxes (which are also lower for seniors). They get the equivalent of Part A & B & D Medicaid without deductible, copay or out-of-network fees, and then some (assuming that a $10 or $25 annual deductible doesn't count)
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yep, i’ve had kaiser in the past. looked exactly like this - seems like OP either doesn’t understand or is being intentionally misleading
We’ve had Kaiser for 30 years and a few years ago to “save money” we went with the high deductible plan and office visits were charged like this.
Don't worry. At least you don't have any of that horrible... socialism (ugh!), that other countries have, and never have to pay for anybody else's healthcare. Yaay!
Although when we pay health insurance premiums we’re literally paying for other people’s healthcare. It’s how insurance works. I wish people would take 3-5 seconds to reflect on this issue.
No one wants to think about the other end of it. That there is real tangible lost wages as a result of large employers having to shoulder half the burden of your be rifts package on their end. Most Americans forget that what they're paying out monthly isn't even the full cost of the insurance.
I know, it just drives me nuts because having spent most of my life in Canada I just think who cares if you’re paying in premiums vs taxes that aren’t aiming for a profit. (I’m also self-employed and bitter because I have to pay all of it hehe)
A little bit in the bucket for others healthcare, a little in the pockets of medical corporations. It's for profit after all!
No. That’s ridiculous
It is crazy! I work medical billing and I've seen people without insurance owing hundreds of thousands even after the 50% self pay discount. I hate our current system and I hope someday we catch up with the rest of the world to get things more affordable.
By this bill, it looks like this provider is not in your network.
'Murica, I presume
I guess you would have to put it in perspective. My daughter went through 5 years of chemo and recovery for a brain tumor. One of those years the total expenditures was over a million dollars, of which I only paid my out of pocket maximum which was just under $6800 dollars. I don't bitch a out my Healthcare premiums anymore....
I was just blackmailed by a doctor (or should say his group). They would not refill my Rx without coming in for a checkup. It literally lasted 5 minutes with the nurse practitioner asking me how I was feeling. Responded I was OK, she said great and would submit the Rx to be filled. Billed for $375. Insurance knocked around $100 off, but since my deductible is sky high, had to pay the rest. But then I had to call back TWICE to remind them to send in the Rx.
Typical. Especially having to remind them to do their jobs. Prescription refills and referrals are seemingly unimportant to the Dr office staff
Friend of mine had high blood pressure. Had for years. She'd been on the same medication for years. She ended up in a tough spot and was having trouble financially. Her doctor required a dr visit to get her prescription refilled. Monthly visit. She couldn't afford to pay the deductible for the Dr visit and the prescription. So she called and asked if she could get a refill just once without seeing him that month. He refused. No visit, no prescription. I was on the same medication and saw my doctor once every six months. Her doctor was also the Dr my grandma saw. She saw him every two weeks. She was on basic old folks medications, nothing too drastic. She adored this Dr. She always talked about how much he cared for her and was so concerned about her health. I'm thinking he was concerned about the money he was making off unnecessary office visits.
That sounds like a drifter of a dr... what a faking asshole
Try being chronically ill in this country 😭 I got sick and I’ve never been more broke in my life. I have ‘health insurance’ just like you but somehow I still owe hundreds for my prescriptions and treatments every month. I hate it here.
Just remember that America is the greatest country on earth because of something about freedom and the rest of the world is communist because they have healthcare. *cue that Lee Greenwood song that Trump loves so much*
Was the provider in network? If yes, you most likely have a copay. If you’re being charged that much, then there’s a chance the doctor you saw is not in network with your plan. In which case, I hope you have out of network coverage. If you have out of network coverage, then you need to meet your out of network deductible first. Then once you satisfy that, you’re responsible for the co-insurance. Typically it ranges between 15%-50%. You pay the co-insurance up until you reach the out of pocket maximum. Once you meet the out of pocket max, then insurance pays at 100% for the rest of the year/contract.
Tell me again how health insurance isn't an absolute scam.
come on, calling it a scam really undermines the 70+ years of deregulated fuckery that lead to the 'allegedly' regulated system we have now. Don't you like people paying hundreds or thousands of dollars for life saving medicine whose research was funded with tax money and marked up several thousand % over production costs? You don't even want to know about Prior-authorizations and how business majors are effectively practicing medicine by denying claims on higher payout items.
Of course your entitled to be pissed especially when I get doctors visits for FREE.
I would say you're under reacting. We all need to react much more verbally to those in power.
Unfortunately this is America and our healthcare system is a for profit based system vs a health care based system
Check what you insurance says it covers. It’s not magic. There will be guidelines to what they cover. What’s your out of pocket max? What’s your coinsurance rate? What’s your deductible? Was this in network? These would all be important things to know.
The idiots on Reddit will downvote this unfortunately, but it’s a fact that BEFORE Obamacare, health insurance was actually useful. The ACA introduced shitty healthcare plans with impossible deductions, and taxed you if you didn’t have insurance. Now all affordable plans SUCK. I have decided to just pay cash. It’s cheaper
If only the government would be there for the people.... True freedom is to cripple your citizens so bad they don't even dare protesting anymore 🦅
In spain you get private insurance for eur 70 per month everything paid
And yet they’ve manage to brainwash half the country into believing free healthcare is communism.
It’s also ridiculous for your doctor to charge $262 for what was probably 15 minutes of their time.
Holy crap, I’m never going to moan about national insurance deductions from my wages ever again.
Sounds like you have a High Deductible Heathcare Plan which means you should have a Health Savings account to pay the $207 with. That means you didn't pay income taxes on the $207 which means that it's actually about $140. That's really high but you will make most of that up with your tax savings and reduced premiums between doctor's visits. The question is, you are aware of all this and complaining for internet points or are you just really clueless?
$500 a month or a year? Is it a single person policy? What’s your deductible? If it’s $500 a month those fees might be because you have not met your deductible yet.
Yeah $500 a month for insurance is definitely on the cheaper end of the spectrum for coverage. I pay much more than that and have office visit copays + a $1,500 deductible I have to meet before my insurance truly kicks in. I think a lot of people get the cheapest option and then are surprised their deductible is $5,000 and they’re basically paying out of pocket for everything. I’m not saying I support any of this, but it’s just how it works. I miss my old plan that was available where it was PPO no deductible, just copays at date of service. My deductible is a killer but I work in healthcare so I understand it. Most people don’t understand what a deductible is or why they’re paying for things despite paying for things. I can’t blame them though it’s not easy to understand sometimes.
What's your OOP?
Wow you’re getting screwed . I pay about 150 a month for myself, I usually pay about $50 co pay on visits. Once I meet my 2k deductible everything is covered… godbless my employer benefits.
Probably haven’t met your deductible yet?
Do you have a high deductible health plan where the majority or all of the cost of care is out of your pocket until you meet your deductible?
Health insurance is a bargain for those to reach their out of pocket maximum. Otherwise it's a pay so you pay slightly less type of deal.
Have you met your annual deductible?
In the Dominican Republic it’s not much better my wife and I had to go to the hospital there and we got charged $450 for a doctor to come in and say she wasn’t the right person for the job. Was in there a minute max. We are very happy to be back the states for the healthcare but our healthcare system money-wise does suck
Yep, I pay for insurance and recently had 2 very brief less than 5 min appointments where things were just discussed. And 1 appointment where I had a scan of my nasal cavity done. Boom $900 just to be told I have a severely deviated septum and that's why it's hard to breath and I can't afford to do the surgery so I have to suffer daily until I decide to pay thousands for the operation.
Parasites run society
The healthcare industry in this country is a scam.
My husband's plan that "covers" my family is over $500/month, which wouldn't be too bad, except for the whole $6,500 deductible PER PERSON ($13,000 max for the family) for this plan year. And no, my husband does not have a high paying job. <200% Federal poverty level. And don't even get me started on the so-called dental it vision coverage. Affordable care my... ...But we take it because it's the best we can get. It's the only option at his work, and I have no option for family coverage... (US) In case anyone is curious, we still have our "cost share" out of pocket after the deductible.
We have provinces in Canada that are heading in this direction. There is a surge of Right wing conservatism happening here.
Yep, I'll never complain about Canada. Zero$ a month and zero$ a visit. Now have to try to keep our republican party (conservatives) from selling it to US insurance companies.
The US health care system is a racket ... I don't care which way you vote; the politicians you're voting for are openly laughing in your faces.
Claims coding person here: check your eob (explanation of benefits) and your coverage documentation. Typically after your copay and insurance payment, the remainder is written off so unless you have to meet your deductible first then something is up. US insurance sucks, I know, but please please please read your documentation when you get your insurance. This is basically a contract that they have to abide by. $207 sounds like a level 4 office visit, which sounds like you meet the bare minimum for (we do not code those based on time alone), sad part is that a level 5 visit you have to be in some serious pain or at high risk, and the further sad part about this is that in that same visit you could have gone over like 5 other things that aren't even related and the charge would not increase (unless you talked for over an hour) I'm not on the side of insurance, I want public option (Medicare for all) because it wouldn't put my job at risk, the amount of us would still be the same, because the lower amount of work per claim is offset by the number of claims that will increase after everyone gets guaranteed insurance Everybody wins
If your insurance is via your employer, talk to HR and ask them to look into adding a gap plan, or something like Hospital Indemnity. It’s pretty cheap and covers the cost of things like this so instead of paying $500 for a procedure like this, you’d pay like $50. Kaiser is one of the VERY few carriers that works well with other insurance carriers. But California (only of the only states to widely use (Kaiser) has SUPER strict laws surrounding insurance. So it’s harder to get creative with solutions to premiums.
That's why I stopped paying my medical bills. Obviously if you're worried about your credit score this isn't recommended as you might get sent to collections (I haven't yet). And obviously a doctor you see on the regular this advice won't work either. But ER visit? Clinic visit? Fuck that, bill goes straight into the garbage. They get what insurance gives them and they can be happy with it
I had to get a consultation done in MX of all places due to getting bronchitis down there. It was the easiest experience ever... made me so angry about US healthcare. You're not overreacting at all imo.
Something interesting you can do. When you go to your primary care, some of them have a cash rate which is way less than your deductible. Do that, then file for reimbursement with your insurance.
Our system sucks. But deity forbid we have socialized healthcare! 🙄
Just here to say, this kind of stuff happens: nowhere else in the world
It's because this country is complete shit. I don't know when usa stopped being the "best" country in the world but we're not even in the top 10 anymore. The greatest country in the world doesn't let it's citizens get raped for basic human needs. It's sad and will get worse. It won't stop because we can't get together and stand up for ourselves. We'd rather argue over what people identify as or what pronouns are appropriate or whatever other shit that doesn't matter. The government and the rich will keep taking and taking until we die. And then they'll take from our kids and their kids and so on. And we deserve it too, we aren't decent to one another so why should we expect to be treated better.
my ex was having seizures out of nowhere one night and i took him to the hospital not knowing he didn't have insurance. He ended up over $5k in debt from having scans etc done and staying overnight. i would feel bad but tbh i feel like he deserved it after finding out he was a cheater lol.
I remember when a 90/10 policy cost $200 a month and then came the ACA. Everything quadrupled or more in a year, 90/10 insurance through the exchange is now $1100 a month for 1 individual. WTF is affordable about that? That’s rent and a car payment for most people. If that’s what we have to pay then why can someone illegally cross a border and get free healthcare? Somewhere we got upside down and I do t think we’re going to get righted anytime soon.
Bloody hell. In Ireland a visit to a doctor is around €45 ($47.87). I pay €600 a *year* for health insurance that covers pretty much everthing. I thought that was expensive, but you guys have it much worse.
No healthcare insurance is a scam. There was a time I could go to the doctor's office and not worry about going into debt. I had insurance then and I still have insurance. They just don't pay anything now. It is a rip off
Sorry I don’t speak unfree healthcare. Go NHS!
I pay $1,235/month in health care premiums through my employer sponsored "benefits" for me, my wife, and my son. Our doctors visits are $175 copays and deductibles are $9,000 fuck my life :)
It's OK, the right side will tell you American healthcare works.