Good insurance won’t, but the problem is, most companies don’t provide “good” insurance. In most cases you are better off without it.
One company I worked for had the worst insurance I’ve ever seen.
I paid like $180 per paycheck JUST FOR ME! and I had no co-pay woooooHhhOoooo! Well anytime I’d go to the doctor i’d be fucked, with one visit really sticking out in particular: I went in knowing I had strep throat and just needed a doctors note. Doc took one look (didn’t do any tests or anything because it was really obvious) said "yep, you’ve got strep. " gave me my note, and I was oit of there in like 5 minutes… A week later? A $200 bill…. What…. The…. FUUUUUUUUUUUUUUCK!? Yeah bad insurance will ruin you.
The only time you’re better off without insurance is if you never use it.
The insurance company isn’t only paying part of the bill, even if it’s ridiculously expensive and pays laughably little of the bill.
They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want. They’ll charge you for every individual wet wipe at hilariously inflated prices. They’ll charge you for the presence of a tray in your room to set a drink down on. When a nurse pops her head in for 30 seconds suddenly you’re billed for an hour of her time. And you’re stuck with that bill, no matter what, without insurance.
The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.
The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.
Hospital margins are razor thin because of the constant battling with insurance companies (and the high payscale for doctors and surgeons, high cost of equipment, etc, obviously). They will often negotiate reasonable rates for uninsured people.
I was recently in the ER. Insured. I received a $2000 bill, “negotiated down” from $2,500. $1,800 of it was for 5 minutes with a doctor.
I had a friend recently (regularly… she’s a hypochondriac) in the ER. Uninsured. $500. Same ER. Same complaints. Same tests. Same treatment.
i just got a job with insurance for the first time in my life, now covering myself and two kids - pay is just enough to take them off state insurance. the high deductable plan still REALLY hurts to pay the premiums. but not having had insurance in my adult life, i can’t tell if it’s worth it or not - i have never gone to doctors i couldn’t pay for out of pocket at the time of service (so almost never).
I didn’t say that. Ignoring tax benefits, it’s better not to have insurance “9 years out of 10”. The tax benefits (employer insurance is paid is pre-tax) changes the equation a lot.
Admittedly, it also matters about what your doctors charge, and what your medical conditions are.
Heaven forbid, if you have a major critical event that puts you in the hospital for a month or two (happened to a friend this year), then insurance is the only way to maybe not be bankrupt, assuming they even treat you at all (past keeping you from coding) knowing you won’t pay.
The only time you’re better off without insurance is if you never use it.
This is absolutely not true. I have a high-risk, high-expense family member on my plan. Most years, we reach her deductible at the very end of the year and we’re ultimately paying all that money for “a rate plan”. Of the years we crossed the deductible and the insurance covered much of anything, it was still less than the $12,000 we shelled out that year in all but one case. In that one case, we saved about $5000, still a bit less than the overall money they’ve made off us. Literal cancer wasn’t enough to make health insurance a good investment.
We still need it for three reasons. First, “what if you end up needing $100,000 or more in medical procedures”. Second “the doctor won’t be able to see you for 6 months unless you’re insured” (though this sometimes goes the other way). And finally, it’s a lot less of a financial drain through my employer as a pre-tax expense. Napkin math makes it $3-4000/yr saved in taxes.
They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want
This might surprise you, but many offices have “uninsured rates” because hitting someone with a $2000 bill for 5 minutes of time is a great way to have someone in collections for years and not actually see the money. They often do that alongside inferior service like an NP instead of a Doctor, but I’ve never found an office or hospital group who didn’t do something for uninsured folks. And you’re missing that they charge these things for insured folks much of the time to leverage their negotiated rates with hospitals.
The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.
Oh, you’re not talking about usual hospital bullshit? You’re talking about fraud? Yeah. You call them on it once and that disappears from an entire bill. Most hospitals around here don’t do it anymore because there’s too much attention on them. TBH, the same hospitals you’re talking about are are often getting away with coding fraud, which is still reaching the patient’s wallet.
The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.
The “sky is the limit” is basically the only time insurance is cheaper than not being insured. And why the government really needs to become a singlepayer for healthcare costs.
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.
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.
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 :)
I went to see a gastrointestinal specialist two weeks ago and also had a five minute visit where he didn’t really listen to me about my issues and told me to call back in two weeks. I did, gave all my symptoms in detail to the nurse. A different nurse took two days to reply and the doctor still didn’t listen to my problem. Or I guess didn’t read it. And he’s the only gastrointestinal doctor in town. All the others within a 90 minute drive are either not taking new patients or won’t see me for 3 months, at which point, it will be too late. I haven’t eaten in 22 days. I’m basically fucked until I end up in a hospital.
Nope, when I ditched my insurance from that company and had to go to my regular doctor, it was $65 up front and I didn’t see another bill. It was the most bullshit thing I’ve experienced.
Good insurance won’t, but the problem is, most companies don’t provide “good” insurance. In most cases you are better off without it.
One company I worked for had the worst insurance I’ve ever seen.
I paid like $180 per paycheck JUST FOR ME! and I had no co-pay woooooHhhOoooo! Well anytime I’d go to the doctor i’d be fucked, with one visit really sticking out in particular: I went in knowing I had strep throat and just needed a doctors note. Doc took one look (didn’t do any tests or anything because it was really obvious) said "yep, you’ve got strep. " gave me my note, and I was oit of there in like 5 minutes… A week later? A $200 bill…. What…. The…. FUUUUUUUUUUUUUUCK!? Yeah bad insurance will ruin you.
The only time you’re better off without insurance is if you never use it.
The insurance company isn’t only paying part of the bill, even if it’s ridiculously expensive and pays laughably little of the bill.
They’re also negotiating the price down. Without insurance you’re pretty much bare assed to the healthcare industry, who can and will charge you whatever they want. They’ll charge you for every individual wet wipe at hilariously inflated prices. They’ll charge you for the presence of a tray in your room to set a drink down on. When a nurse pops her head in for 30 seconds suddenly you’re billed for an hour of her time. And you’re stuck with that bill, no matter what, without insurance.
The insurance company will require them to verify the hours billed, they’ll reject charges for shit they shouldn’t be billing for, and negotiate down the price of stuff they can bill for.
The difference even for simple visits can but several thousand dollars. For more serious visits the sky is the limit.
This isn’t necessarily true. I’ve seen and heard of multiple doctors who had a lower price for those without insurance.
That could be true for a GP or something like that, but not for a serious issue where you need tests for a diagnosis, a hospitalization, or ER visit.
Nah, a lot of hospitals do that.
Hospital margins are razor thin because of the constant battling with insurance companies (and the high payscale for doctors and surgeons, high cost of equipment, etc, obviously). They will often negotiate reasonable rates for uninsured people.
I was recently in the ER. Insured. I received a $2000 bill, “negotiated down” from $2,500. $1,800 of it was for 5 minutes with a doctor.
I had a friend recently (regularly… she’s a hypochondriac) in the ER. Uninsured. $500. Same ER. Same complaints. Same tests. Same treatment.
so is it better not to have insurance?
i just got a job with insurance for the first time in my life, now covering myself and two kids - pay is just enough to take them off state insurance. the high deductable plan still REALLY hurts to pay the premiums. but not having had insurance in my adult life, i can’t tell if it’s worth it or not - i have never gone to doctors i couldn’t pay for out of pocket at the time of service (so almost never).
I didn’t say that. Ignoring tax benefits, it’s better not to have insurance “9 years out of 10”. The tax benefits (employer insurance is paid is pre-tax) changes the equation a lot.
Admittedly, it also matters about what your doctors charge, and what your medical conditions are.
Heaven forbid, if you have a major critical event that puts you in the hospital for a month or two (happened to a friend this year), then insurance is the only way to maybe not be bankrupt, assuming they even treat you at all (past keeping you from coding) knowing you won’t pay.
This is absolutely not true. I have a high-risk, high-expense family member on my plan. Most years, we reach her deductible at the very end of the year and we’re ultimately paying all that money for “a rate plan”. Of the years we crossed the deductible and the insurance covered much of anything, it was still less than the $12,000 we shelled out that year in all but one case. In that one case, we saved about $5000, still a bit less than the overall money they’ve made off us. Literal cancer wasn’t enough to make health insurance a good investment.
We still need it for three reasons. First, “what if you end up needing $100,000 or more in medical procedures”. Second “the doctor won’t be able to see you for 6 months unless you’re insured” (though this sometimes goes the other way). And finally, it’s a lot less of a financial drain through my employer as a pre-tax expense. Napkin math makes it $3-4000/yr saved in taxes.
This might surprise you, but many offices have “uninsured rates” because hitting someone with a $2000 bill for 5 minutes of time is a great way to have someone in collections for years and not actually see the money. They often do that alongside inferior service like an NP instead of a Doctor, but I’ve never found an office or hospital group who didn’t do something for uninsured folks. And you’re missing that they charge these things for insured folks much of the time to leverage their negotiated rates with hospitals.
Oh, you’re not talking about usual hospital bullshit? You’re talking about fraud? Yeah. You call them on it once and that disappears from an entire bill. Most hospitals around here don’t do it anymore because there’s too much attention on them. TBH, the same hospitals you’re talking about are are often getting away with coding fraud, which is still reaching the patient’s wallet.
The “sky is the limit” is basically the only time insurance is cheaper than not being insured. And why the government really needs to become a singlepayer for healthcare costs.
If you had no co pay you wouldn’t have had a $200 bill ( unless you went out of network and then fuck you for wanting to have a choice)
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.
My deductible with that company was $5000 lmfao! Who the fuck is going to ever meet that in a year!?
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.
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!
I’m both American and have been on multiple different insurance plans. (Including a no copay plan)
No copay means no copay, what you’re describing is not no copay.
https://www.tuftsmedicarepreferred.org/healthy-living/what-difference-between-copays-deductibles-and-coinsurance#:~:text=Copays cover your cost of,time you visit your doctor.
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.
Sure but the conversation was about copay ;)
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:
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 :)
Nope, in network, that’s just how their insurance worked.
I went to see a gastrointestinal specialist two weeks ago and also had a five minute visit where he didn’t really listen to me about my issues and told me to call back in two weeks. I did, gave all my symptoms in detail to the nurse. A different nurse took two days to reply and the doctor still didn’t listen to my problem. Or I guess didn’t read it. And he’s the only gastrointestinal doctor in town. All the others within a 90 minute drive are either not taking new patients or won’t see me for 3 months, at which point, it will be too late. I haven’t eaten in 22 days. I’m basically fucked until I end up in a hospital.
Please no medical advice. Thank you.
I feel like the total bill without insurance would’ve been even more? Idk
Nope, when I ditched my insurance from that company and had to go to my regular doctor, it was $65 up front and I didn’t see another bill. It was the most bullshit thing I’ve experienced.