Medical Insurance in the US
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@marcinozga said:
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
I don't know why it happens, do insurance companies refuse to pay so doctors refuse to do the service? Do doctors just not like doing it? No idea. But something makes US doctors commonly refuse this surgery (commonly enough that I know like four first hand examples). No matter what the reason is, the result is still a lack of coverage. The insurance companies have many routes to avoid paying for things even if the law says that they have to.
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@scottalanmiller @BRRABill @coliver @marcinozga @Dashrender
Y'all need to get yourselves some socialism.
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@scottalanmiller said:
@marcinozga said:
That's really special case and I guess affects tiny fraction of US population. For huge majority, health insurance is much cheaper than not having it and end up paying out of pocket.
Perhaps that is true. But for a decade of my life that has not been true and I know several people who have run the numbers, and live in the US full time, and still find it cheaper to be without insurance. People on this forum, too. Sure, it might be under 50% of people, but I don't think that it is a tiny sliver, either. It's way too common when normal people doing normal things can pay the penalties and still save money on long term health care. And I'm super healthy, I have one of the best medical track records possible, and I still am not affordable.
But you're not - you have sleep apnia.
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@scottalanmiller said:
@marcinozga said:
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
I don't know why it happens, do insurance companies refuse to pay so doctors refuse to do the service? Do doctors just not like doing it? No idea. But something makes US doctors commonly refuse this surgery (commonly enough that I know like four first hand examples). No matter what the reason is, the result is still a lack of coverage. The insurance companies have many routes to avoid paying for things even if the law says that they have to.
I had to fight for over a year to get my insurance to pay for my hospital stay after having my appendix out.
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@MattSpeller said:
@scottalanmiller @BRRABill @coliver @marcinozga @Dashrender
Y'all need to get yourselves some socialism.
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I work for the government now... my plan is basically as good as you can get in the US without driving to Canada for everything. I would love it if everyone was on my plan...
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@Dashrender said:
I'll disagree with you here again. You could have US insurance, come back to the US, have that surgery, all for the cost of US only insurance - which for your entire family would be way less than $30K/yr. Would you have to fly back to the USA - yes.. but we aren't talking about life threatening thing.
Except I've had US insurance and none of this was true. The cost was higher than that, the coverage was worse. Say what you want, but not everyone gets these offerings. I'm talking real life, not hypotheticals. Everyone with their affordable healthcare in the US is like people with Android phones. They all say it works until you show that it doesn't then they say it's because you did something wrong.
If I moved to the US my healthcare options would decrease, then you'd blame me for moving back. It's always blame the people who can't get good coverage.
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@coliver said:
I pay 4k$/year for Cadillac insurance right now. Pretty much everything is covered and expenses out of pocket cap out at $1,000. Those expenses are few and far between as even most prescriptions are covered with a 5$ deductible.
Does that $5 deductible come out of the $1000 yearly cap?
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@Dashrender said:
But you're not - you have sleep apnia.
True, true. And I've always paid for it fully out of pocket to make sure that my insurance would not be affected and to get better care. So that costs zero to the insurance people.
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@Dashrender said:
@coliver said:
I pay 4k$/year for Cadillac insurance right now. Pretty much everything is covered and expenses out of pocket cap out at $1,000. Those expenses are few and far between as even most prescriptions are covered with a 5$ deductible.
Does that $5 deductible come out of the $1000 yearly cap?
Sure does.
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I had better healthcare in an Third World African country then I get here.... (with insurance). Now that I pay cash I get great healthcare.
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I just went onto the healthcare exchange and priced out my family.
Family of 4, was $1876.34 a month. That's a NO DEDUCTIBLE plan.
Now, that's not cheap ($22,512 a year) but it's for a no deductible, no co-pay plan.
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@MattSpeller said:
@scottalanmiller @BRRABill @coliver @marcinozga @Dashrender
Y'all need to get yourselves some socialism.
runs far and fast from thread
I grew up in socialist country
Who knows, perhaps Bernie Sanders will become the next president. -
@Dashrender said:
Let's say you get US coverage insurance by a US company only for use while in the US - Let's say it costs $15k/yr and you get insurance for world traveler, non-US. How much is that? I'm betting that adding those two together come to way less than $40K.
US insurance is not available like that. You pay for the full year or else you pay the tax penalty. Trust me, we've checked. There is no "temporary" option like that. But it is a good idea and everyone wonders why there isn't that option.
So your plan would end up being the full cost of US and full cost of traveller insurance all at once.
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@scottalanmiller said:
@marcinozga said:
Turn down by insurance? I'm guessing hospital or doctor wouldn't turn you down, as burst appendix is fatal. I would sue insurance company.
I don't know why it happens, do insurance companies refuse to pay so doctors refuse to do the service? Do doctors just not like doing it? No idea. But something makes US doctors commonly refuse this surgery (commonly enough that I know like four first hand examples). No matter what the reason is, the result is still a lack of coverage. The insurance companies have many routes to avoid paying for things even if the law says that they have to.
Yep. Just because you have insurance, that DOES NOT guarantee actual service. I know at least 1 person very well who was going for an MD before OC, and decided that an RN would make him more money after it passed. Scale that up from one person's very close friends to an entire nation, guess how service is being effected!
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@Minion-Queen said:
This is only me using the insurance. If husband or son ever need to use it well the costs go up from there.
Also assuming nothing serious happens, which is kind of the definition of insurance.
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@scottalanmiller said:
@Dashrender said:
Well in that case you're fringe case - and while I agree that there should be provisions for that in the law - The situation is not screwing you into a 40K a year plan. You can probably get an insurance plan in crete for significantly less if you so desire while you are there, and the next place, etc.
Thankfully no. The situation is simply screwing me into paying out of pocket (which is essentially zero) and having to pay the tax penalty for being uninsurable.
If there wasn't a penalty to mock us for being uninsurable it wouldn't be so bad. But it is literally a form of mocking us for having not been given an option. It's downright mean.
No reason to have insurance on Crete. We CAN get it here, but that would be silly. Insurance outside of the US is SO low.
You're not uninsurable though - you've already said you could get a US only plan and you could get an international traveler's plan - so you're not uninsurable, not even uninsurable in the USA - you Choose to not have insurance in the US because the cost outweights the benefits in your mind for the dozen or less weeks a year you spend in the US. Definitely not the same as uninsurable.
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@BRRABill said:
Family of 4, was $1876.34 a month. That's a NO DEDUCTIBLE plan.
That's not horrible, but it is really high considering it would provide zero coverage for us. It doesn't even remotely offset the tax penalty. And Texas offerings are not as good as many states. We put in a lot of time on this, I don't think we found anything even that good, and that's not good enough to consider at all.
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@marcinozga said:
@MattSpeller said:
@scottalanmiller @BRRABill @coliver @marcinozga @Dashrender
Y'all need to get yourselves some socialism.
runs far and fast from thread
I grew up in socialist country
Who knows, perhaps Bernie Sanders will become the next president.I feel the Burn haha - we're cheering for him here in Canada. It'll be a frosty day in hell before he gets elected though.
If he moved north he could probably run our Conservative party and kick our PM's butt in the next elections.
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@Dashrender said:
You're not uninsurable though - you've already said you could get a US only plan and you could get an international traveler's plan - so you're not uninsurable, not even uninsurable in the USA - you Choose to not have insurance in the US because the cost outweights the benefits in your mind for the dozen or less weeks a year you spend in the US. Definitely not the same as uninsurable.
Sorry, I'm uninsurable under Obamacare. I can buy insurance that does not qualify for Obamacare that would cover me.
I choose not to be covered in the US because I am NOT covered by US insurance. I'm allowed to pay for it, but it doesn't provide healthcare coverage. If that's what you call insurance I think we found where the confusion is. I define insurance by it providing insurance against bills. You seem to be defining it as the ability to take my money.
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@scottalanmiller said:
That's not horrible, but it is really high considering it would provide zero coverage for us. It doesn't even remotely offset the tax penalty. And Texas offerings are not as good as many states. We put in a lot of time on this, I don't think we found anything even that good, and that's not good enough to consider at all.
Actually I put in an Austin, TX, ZIP code and it was significantly cheaper.
$1394 a month was the highest plan they offered. But on that plan you have a $30 co-pay for doctor visits.
This is through the web, though. But the prices are similar to others I have seen.
