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This is a GOOD thing. The whole point of insurance (of any kind, business, car, home, health, disability, life) is to protect you from the financial impact of a catastrophe you aren't expecting and can't afford. Not to subsidize ordinary, mundane expenses such as some perfectly manageable and reasonable doctor bills!
If you want "insurance" to cover everything, you'll end up paying MORE in the long run, since you have to pay higher premiums not only for the health care cost itself, but for the increased overhead resulting from middle-men and bureaucracy costs...
Low deductibles are a colossal waste of money in the long run, especially once you factor in just how much staff and how many hours in a medical clinic are spent on billing insurance for reimbursement. If the patient just freaking paid for it, you'd avoid all the nonsense!
Bull. We are switching to new plans next year, with MUCH higher deductibles, and I just spent several hours analyzing my costs/premiums for the last 2 years of claims. My costs will increase far beyond any decreases in premiums.
That depends entirely on your age and your health. And even then, you are not immune from accidents. For example, suppose you tear your ACL playing tennis or skiing. By the time you have paid for doctors, scans, knee braces, possibly surgery, etc. etc., with a high deductible plan you are thousands of dollars out of pocket.
Sure, but $5000 out of pocket will be recouped by lower premiums. The difference in premiums for a 30-year-old between high deductible and very low (< $1000) deductible is almost $200/month. At that rate you could have an accident every 3 years and still come out ahead with the high deductible!
Bull. We are switching to new plans next year, with MUCH higher deductibles, and I just spent several hours analyzing my costs/premiums for the last 2 years of claims. My costs will increase far beyond any decreases in premiums.
If you have a lot of health issues then yes, it may. But for the majority a low deductible seems to be just a forced financial commitment device designed for people who don't have the discipline to save the difference in premiums for an emergency.
And, on average, you saved more than that amount out of your premiums.
Insurance is supposed to cover you in face of something you could not otherwise afford. The only real reason to buy a plan other than a high-deductible plan is either:
Your risk profile is higher than would be expected for your age group
You're living paycheck to paycheck.
A plan with a $25K+ deductible would work great for me, for example. I have much more than that saved, and I'm very healthy male at age of 24.
Here is something to think about:
Let's suppose that you suffer a torn rotator cuff after a bad fall. According to the NIH the best case scenario is going to cost about $26,000 for surgery, which you can afford since you have $25,000+ saved up. What happens when you break your arm the next year (about $4000) or you need a new car, or you put money down on a house before any of your accidents.
I'm glad that you have managed to save such a hefty sum, but the average American household has only $5000 saved, and most have less than that.
Sure, but $5000 out of pocket will be recouped by lower premiums. The difference in premiums for a 30-year-old between high deductible and very low (< $1000) deductible is almost $200/month. At that rate you could have an accident every 3 years and still come out ahead with the high deductible!
The problem not many of us are 30 years old and those that are only manage it for one year. You are trying to take one scenario and extrapolate it across the population. And it simply doesn't work.
I envy those with good plans this year. We are going from a decent plan, $1k ded, $1,900 OOP for 1 person, $3,800 for a family, to a new plan with a deductable of $1K and max family OOP of $5,800. There is no more single patient max OOP, so the insurance does not pay 100% until the family max is met. So this means we will have to pay OOP $3,900 MORE next year than this year, and at the same time pay even MORE for premiums. This will hit me hard, as my wife has cancer and her Dr. bills are in the tens of thousands per year. And I work for an insurance company! I will have to get a second job to pay for her medical bills next year, most likely.
And I **have** done it (or at least valiantly attempted to).
I'm telling you that it doesn't work (absent providers interested in being transparent).
The last point -transparency- is the root problem.
Too few providers, especially beyond the GP level, have any consciousness of it.
I was literally given blank stare of confusion that I wanted to know costs beforehand.
"Huh? Why do you need to know that? No one else has ever asked"
Nope.
I've practiced medicine for almost 40 years. As a primary care provider and a provider of medical ancillary services in the past, I have approved such breaks for patients, as well as coaching them for other facility discounts. And as a patient I have received such breaks from other facilities. As have the rest of my family.
I'm sorry that your personal experience hasn't panned out for your benefit. You might not be asking the right person. Many times it takes some digging and/or repeat calls.
I'm sorry that your personal experience hasn't panned out for your benefit.
You might not be asking the right person.
Many times it takes some digging and/or repeat calls.
Which is why I described the lack of transparency as the primary problem.
Which is why I described the exercise of getting data as "like pulling teeth".
The providers don't want to reveal their pricing or be clear about policies.
As it stands they have no authority imposing that expectation on them.
They'll continue to dig in their heels when pressed.
Maybe one day we'll have a medical industrial complex that works for patients.
I won't be holding my breath waiting for it though.
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