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That's where the OOP max comes in. As an example the health insurance pays 80 % after deductible. You pay your deductible and 20% of the rest up until the OOP max is met in which insurance covers 100%.
Example 2500/ded with 4000 OOP max (using my current as an example).
$150,000 bill.
I pay my deductible of 2500 plus my share of the 20% which is only 1500 because I pay a 4000 out of pocket max which includes the deductible. The insurance pays the remaining $146,000.
$7,000bill
I pay my deductible of 2500 plus 900 which is my 20% share of the remaining 4500 in which insurance will pay $3600.
Ah.. yes, I forgot about that when I responded to that poster.. t hank you for that.
I think high deductible health insurance coupled with an HSA was a hybrid attempt to do something closer to what the OP wanted. And I really prefer this type of arrangement.
If you have a deductible that is $5000 and have tax exempt money funding your HSA, this would put the cost relationship back where it belongs - between the doctor and the patient. It would get rid of the third party bs that is wreaking havoc. The doctor, if she/he wants to charge $150 for a run-of-the-mill office visit, will have to justify it to her/his customers. As it stands now a person pays a $20 copay, the doctor's office bills for $150, but it's not an allowable charge and is reduced to $50, or something similar. If the doctor is willing to accept $70, then that should come out of the HSA via the patient. The doctor would no longer need a billing department because it is all paid on the spot, just like when you get any other service.
In the event of something catastrophic, you would have the high deductible insurance.
A great deal of the cost of medical care comes from the relationship between the medical provider and the insurance company.
I'll give you an example of how ridiculous health insurance companies are. I am still covered under my mom's and step dad's dental plan, so I technically have two dental insurances. I have to get a crown put in soon and I still have to pay $370 out of my own pocket even though I have two insurances. Each insurance only pays 50 percent of the cost of the crown. These insurance companies get away with paying as little as they possibly can.
Or, you fly to Czech republic, that has one of the best dentists/dentistry in the world, and do your crowns for about $100 to 200. Used to be $60.
Even if you had health insurance that covered 80 percent, you would still have to pay some of the costs. For example, let's say you had a major surgery for $150,000. You would still have to pay $30,000 after insurance paid their part. Many people still don't have that kind of money laying around and would have to make monthly payments until everything is paid off.
You need to acquire some knowledge before posting. All Group plans have an out of pocket max, after which the patient pays ZERO. Mine is $1,400 per year. Two years ago, my eye surgeries cost about $35k. I paid grand total all year for that and everything medical $1,400.
Even a mediocre family plan would not have an out of pocket max approaching $30k.
Plus, smart folks use Flex Med to cover it, and cut taxes. The $1,400 cost me less than $1,100 out of pocket, as the FSA on it cut my taxes $300+.
Apparently no one here ever looked at their HC EOBs when they come in.
Say, a visit to urologist. Insurance billed: $376; contracted discount/adjustments $!75; patient portion $28.
You realize, that that urologist stays afloat and does very well, actually, by overbilling insurance, taking contractual discounted payment, and you pay a little bit of co-insurance? And this game is played everywhere and by everyone?
You know what will happen if you ditch insurances? Sure, some will die. But instant market adjustment will result in instant price adjustment. All those overblown HC costs will drop down to where market can pay for them. All doctors that do not provide good results will loose their patients or will be eaten by law suites. So much referred to "costs" for HC will strip their ballooned numbers and will adjust down to where they can be attainable. My bet, also, is that common folk will finally understand that HC is not a freebie and stop eating and drinking junk, minding their diets, and exercising, as best way to save on HC is to - yep, stay healthy.
You can make payments. I believe hospitals are willing to work with you if you at least make an effort to pay something. They might even be willing to cut some of the costs.
They do cut costs. Big time. Like by 2/3.
I know. Been there, done that. A little over 2 years ago.
Quote:
Originally Posted by kgordeeva
Healthcare is also very expensive because it costs a lot of money to process claims and then wait for the insurance companies to actually pay. Some of these insurance companies take MONTHS to pay. And they deny so many things.
Amen, brother!
Quote:
Originally Posted by Jo48
Screw insurance. I have a discount dental plan (not insurance) which costs $125 a year for family and I paid $3,000 for an entire 6 tooth front upper bridge with 2 teeth crowns which attach it. They won't limit you to number of root canals or crowns per year which INSURANCE did.
Well, if you are young and healthy, you are better off not paying health insurance premiums and just putting that money in a savings account. Yes, things can happen, but that's just life. A lot of people have these chronic conditions because they don't take care of themselves. Many people in America are overweight, smoke, drink heavily and do many other unhealthy things. If people just took care of themselves better, they would be less likely to get these diseases.
Baloney on 2 counts. If you have to pay the stinkin' government a penalty, there's no money for saving. And 99.99% of diseases are genetic. Yes, you can do things (or not do things) to minimize the risk, but everything starts with genetics.
You can make payments. I believe hospitals are willing to work with you if you at least make an effort to pay something. They might even be willing to cut some of the costs.
They can't cut cost. The MRI machine that cost $2 million dollars has been purchased. The nurses and doctors have salaries that are fixed. X ray films cost what they cost. The medication has been purchased.
You can't redeem a coupon and getting special discounts are rare.
Payments? Do you want to make payments that are $1000-$5000 or more per month. At only 1k per month, a person would pay $12k a year on a bill that's $120k? Ten years of payments for one illness? What about ongoing care or a new illness?
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