I have a very, very limited understanding of the subject, so take this with a lethal dose of salt, but I’m under the impression that the US healthcare system is an absolute minefield, and not everyone has equal access to it, even via insurance, in the ways you might otherwise typically expect.
That is correct. Let’s say me and my dad get cancer. We both have health insurance provided by our employers.
Dad:
Initial deductible (cost before insurance kicks in): $10,000
Max out of pocket (in network): $20,000
They cover initial treatment but the anesthesiologist is “out of network.” That charge goes to the separate deductible for out of network costs, dad pays $30k total, of a $500k “sticker price.”
Me:
Deductible: $4,200
Max out of pocket: $4,200
Initial treatment is covered by insurance, no provider listed as out of network. Total cost to me: $4,200 out of a $500k bill.
Every insurance is different, each hospital will do different things to get extra money, and you have no way of knowing what 1 piece of the treatment is out of network until after you’ve already had the treatment. Our system sucks
I have a very, very limited understanding of the subject, so take this with a lethal dose of salt, but I’m under the impression that the US healthcare system is an absolute minefield, and not everyone has equal access to it, even via insurance, in the ways you might otherwise typically expect.
That is correct. Let’s say me and my dad get cancer. We both have health insurance provided by our employers.
Dad: Initial deductible (cost before insurance kicks in): $10,000
Max out of pocket (in network): $20,000
They cover initial treatment but the anesthesiologist is “out of network.” That charge goes to the separate deductible for out of network costs, dad pays $30k total, of a $500k “sticker price.”
Me: Deductible: $4,200 Max out of pocket: $4,200
Initial treatment is covered by insurance, no provider listed as out of network. Total cost to me: $4,200 out of a $500k bill.
Every insurance is different, each hospital will do different things to get extra money, and you have no way of knowing what 1 piece of the treatment is out of network until after you’ve already had the treatment. Our system sucks