• @abraxas@sh.itjust.works
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    10 months ago

    Found the European (or just someone young who doesn’t know much about typical insurance shell-gaming).

    You have no copay, but most insurance plans include any non-preventative visit in the deductable. That means you are responsible for 100% of the bill until your $1500/yr deductible (in as low deductible-plan, a LOT higher in most plans) is reached. To look like they’re actually doing something, they treat the negotiated rate from the doctor’s MSRP as a “discount” (the doctor says $300, the insurance negotiates you to $200). The really ugly irony of that, is that if you were uninsured, many offices would have given you an NP for $70, and some have an “uninsured rate” of like $150.

    • ChamrsDeluxe
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      310 months ago

      My deductible with that company was $5000 lmfao! Who the fuck is going to ever meet that in a year!?

      • @abraxas@sh.itjust.works
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        310 months ago

        And the irony is that anything not covered (like your responsibility on a coinsure) does not apply to the deductable. Nor do copays.

        Literally the only thing left is “Maximum Out of Pocket”, but they even have ways around that.

        • ChamrsDeluxe
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          110 months ago

          With the insurance I have now through my company, I already met tge deductible and haven’t been charged extra for anything. It’s really nice!

      • @abraxas@sh.itjust.works
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        10 months ago

        No copay means no copay, what you’re describing is not no copay.

        Yes, “no copay means no copay”. Most insurance plans have BOTH a copay and a deductable on a large number of higher-end services like inpatient surgery and the diagnostics like CT. And I have had, and helped family shop for, healthcare plans that have no copay, but still have a deductable. Further, there’s a lot of PPO variants that have no copay or deductable, but have a coinsurance for everything.

        In my adult life, I have never seen a plan where your “typical” out of pocket for anything other than Primary Care or Teledoc was anywhere near zero, even if those plans approach $3000/mo.

        And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ). For a patient, money going out feels the same as money going out. Especially in large quantities.

        • @bustrpoindextr@lemmy.world
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          110 months ago

          And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ).

          Sure but the conversation was about copay ;)

          • @abraxas@sh.itjust.works
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            10 months ago

            Sometimes conversations get confused pretty quickly in thread format. I never understood why, but it IS hard to keep context in Lemmy. Let me reopen with what I was replying to:

            If you had no co pay you wouldn’t have had a $200 bill

            That’s what you opened with. The person above you didn’t use the word “copay” at all. They just complained about being charged $200 to get a note. Your reply was the quote above. My reply was “but most insurance plans have a … deductible”.

            The conversation was really about money out of pocket. I think you inadvertently thought it was about copays. It happens :)