Hey all, I’m British so I don’t really know the ins and outs of the US healthcare system. Apologies for asking what is probably a rather simple question.
So like most of you, I see many posts and gofundmes about people having astronomically high medical bills. Most recently, someone having a $27k bill even after his death.
However, I have an American friend who is quick to point out that apparently nobody actually pays those bills. They’re just some elaborate dance between insurance companies and hospitals. If you don’t have insurance, the cost is lower or removed entirely. Supposedly.
So I’m just asking… How accurate is that? Consider someone without insurance, a minor physical ailment, a neurodivergent mind and no interest in fighting off harassing people for the rest of their life.
How much would such a person expect to pay, out of their own pocket, for things like check ups, x rays, meds, counselling and so on?
A lot of it depends on what insurance you have and what insurance you have depends on who you work for.
I had EXCELLENT coverage with Kaiser Permanente, and other than a couple of hundred dollars a pay check and an in-office co-pay for treatment, I never had a bill.
When I had my heart attack, the Emergency Room was $150. 8 days in the hospital and open heart surgery from the head of the department was $100. The prescriptions and all the oxygen bottles I could carry was $100.
4 weeks into recovery, my company got bought. :( The new company didn’t do Kaiser in Oregon. If I lived in California or Washington, I would have been fine, not Oregon.
So they switched my insurance to Aetna which meant I lost all of my doctors and had to start over at a new hospital. Kaiser is members only and I was no longer a member.
Naturally I started having complications, congestive heart failure. That was an ER visit followed by 7 days in the hospital.
Under the new insurance, they start by paying 80% and there is an out of pocket maximum of $6,500. Once you pay that, all other treatment is free the rest of the year. No co pays, nothing.
So I hit my $6,500 about 1/2 way through January. Goodbye signing bonus! But all the other complications I had the rest of the year were covered 100%.
Now… if I had NO insurance? 15 days in the hospital x 2 hospitals? Open heart surgery? All the tests and such? 24 oxygen bottles? A million dollars, maybe more?