Just received a email from my doctor with a 288 dollar bill. Which confused me because I have health insurance. So call my healthcare provider because I should only have a co pay. I mean I pay 80 dollars out of every check for this plan.
Then the lady on the phone with zero empathy tells me that they only pay after I meet the deductible. Which is $7000!!! Like what the fuck. This is why the whole healthcare system needs to be burn to the ground and start over with universal healthcare. To make matters worse, spoke to my employer and they say I can’t cancel or make changes because its not an open window. WHY THE FUCK DO WE HAVE ONLY SET TIMES WE CAN MAKE CHANGES TO OUR HEALTHCARE PLANS that we pay for?
No wonder one of these parasites was a shot in the back. They are all monsters and anyone who works for them are no better. So fucking pissed right now! Seeing fucking red. Now got figure out how to come up with 288 dollars to pay the doctor bill!
Here is a hack with your company: they must allow you to update your selections if you are facing a “life event”. Take a look at their criteria, select which one applies to you, and send the request in.
Adopt a kid? Have a financial windfall? Suddenly develop a terminal illness? Suddenly discover that there is healthcare available through your spouse’s employer?
Do whatever you think fits, and they will give you the option to change.
I will try that.
You see, you need to make them money before they’ll even think about paying for anything. Isn’t it great? What an awesome idea for a healthcare system. Treat it exactly like auto insurance.
These are the only “qualifying life events” that let you quit/change your health insurance in the US:
https://www.healthcare.gov/glossary/qualifying-life-event/
But I guarantee you if you miss a couple payments they will drop you quick.
$80/paycheck is incredibly low cost. I’m assuming what you did was select the “high deductible” option when you enrolled in coverage. If so, there might be an HSA option you can still enroll in, where you save a bit of money in an account pre-taxes and can use it toward any medical expenses. I definitely pay for the “mid” plan my agency offers, which has a flat $30 copay for any outpatient visit
They only had one option.
But is it at least a proper HDHP that lets you contribute to an HSA, or did they really screw you over?
Our healthcare in this country does suck, and should be criminal. But, it’s the system that we have and until it changes it is the system we have to deal with.
I am assuming that this must be the first time you’ve used your insurance, so you are either young, in relative good health, or both. During Open Enrollment you were likely given a few options of insurance plans to choose from and it sounds like you went with the cheapest option without fully understanding what that entailed. The High Deductible Healthcare Plans (HDHP) are generally lower cost per pay period than a traditional plan because of the high deductible part. A HDHP is actually a good option if you are in relative good health and often don’t go to the doctor for a few reasons, the first being the cost of the premiums is much lower even if you do go to the doctor once or twice a year. Another reason the HDHP is a good option is that it gets you access to a Health Savings Account (HSA) which lets you put pre-tax money into the account each pay period. There are limits, and this year it’s $4400 for individual and $8750 for families. If your deductible is $7k, I’m guessing you’re part of a family plan… so you can either plan each year to put in the max out of pocket for your plan into your HSA, or you can max out your contribution. Maxing out your contribution, if you can do it, is the way to go because the HSA account is also another avenue for retirement savings. And, when you get a certain amount of money in your HSA you can start investing that money… I put anything above my deductible into the S&P and I’ve seen amazing growth over the past 20 years.
So a few things for you to look into:
- Do you already have an HSA account? And how much are you contributing? If you do, this is where you will find the $288 to pay the bill, even if you haven’t contributed enough to fully pay it yet, you can let your doctor know that you have an HSA account and they’ll setup a payment plan.
- Is your $80 per paycheck, plus the $288 still a better deal than the cost of a traditional plan? If that was a one time visit and you likely won’t go back, then it probably is still a better option.
- If you don’t have an HSA account, ask your employer why. It’s part of the HDHP and you should have access to one. If you don’t have one, still contact the doctor and ask about payment options. And keep your receipts because even if you don’t pay out of the HSA, the money you pay towards your high deductible is still tax free and you’ll get a bit back on your taxes next year.
Sorry this happened to you… I do hope you’re young and that this is just a learning experience. Our insurance setup in this country sucks, is difficult to understand, and no one really does a good job of explaining it, you just have to learn by trial and error, sadly.
No I am 46 last time I had this same healthcare with a different employer my co pay was 25 for doctors visit. The fucking deductible shit only came into effect for hospital visits or if had to have something done. But just to visit my doctor for a checkup? No apparently this is all my company wants to supply. Fucking fitting that I work for an insurance company.
Employers are able to sign up for different types of plans. Your previous employer paid more so that their employees had better coverage.
I’m sorry you’re dealing with this. It’s a terrible system.
As others have mentioned, you should have had the option when signing up for your current insurance provider to set up an HSA, HRA, or FSA. All three are types of debit accounts that you get to put money into for healthcare expenses pre-tax (so it’s money you earn but don’t have to pay income tax on).
If you chose not to elect for an HSA/HRA/FSA, this was your first mistake.
If you’d like to know more about them, how they work, and the difference between them, I’m happy to explain.
Additionally, you may have been offered a choice between several different insurance plans. It’s important to understand the differences between them, and select the best fit for your healthcare needs. The type of plan you select will drastically change not just your premiums and copays, but also your deductible, when that deductible applies, which of the above healthcare money accounts you can have, and more.
Our system is truly fucked. But at this moment, it is the system we live in, and arming yourself with the knowledge to navigate it effectively is your best defense. They certainly aren’t going to look out for you or help you if you find out you made a bad choice for your needs.
The math on optimizing these things can be daunting. If you are willing to describe your plan to me in detail I can offer advice on how to move forward.
Good luck ❤️🩹
But at this moment, it is the system we live in, and arming yourself with the knowledge to navigate it effectively is your best defense.
Puts on Luigi hat
Nah, yeah, this is a more effective solution.
Strike at the root of the disease, not just managing symptoms.
I know this is a crazy concept, but stick with me here…
… what if, and I’m just throwing this out there, not everyone is in a position where they can murder a CEO and there are actually millions of people impacted who each need to consider their own circumstances, allowing us to tackle the problem from multiple directions simultaneously over time?
I know, that’s probably insane, and everyone fits in a neat little box that lets you tell random people on the Internet that they shouldn’t bother learning to navigate a hostile system and instead “strike at the root of the disease” while invoking the image of a vigilante hero without offering any practical advice, but I figure maybe it’s worth considering.
Your advice leads to the problem only getting worse.
Its not sustainable, at scale, over time.
It infact causes further reliance on the system.
It ensures more suffering for more people, in the long run.
You could also maybe just figure out a way to practice of obtain medical treatment that is outside of the system.
That would require courage, less courage than trying to strike at the root cause, but probably more courage than most people have.
The system is broken.
There are various ways of attempting to respond to that, but uh, continuing to engage with the system that is actively, aggressively, nakedly exploiting you?
I mean, if you’ve got a humiliation fetish, sounds good!
Otherwise… nah this a literally evil joke at this point.
Normalcy bias, turns out, can be fatal, just as well the opposite can be.
You’re not wrong that the system is fucked and needs to be changed. The open window thing is particularly stupid.
Though, this is also how pretty much all insurance (auto, homeowners) works. You pay a Monthly Premium, that Premium is based on your risk to the insurer and your deductible. If something happens, you still have to pay the deductible before insurance will pay the rest.
Okay yes, BUT , in Canada, that deductible is sooooo much lower. I paid a $100 deductible. I can change my plan anytime, and I pay under $40 a month. US healthcare IS fucked.
Yes, that’s exactly what I said in my first sentence:
the system is fucked and needs to be changed
Sounds much better in Canada. Running healthcare as a for profit business is just not tenable.
Sounds like you chose the cheapest PPO plan available.
Maybe next time you should read what you’re signing up for? Unless you have a shitty employer that didn’t provide any details whatsoever(doubt), you should have been aware of your coverage limits and ratios before confirming your healthcare selections.
Next time choose a HMO option, but also don’t be surprised when it’s $300 a paycheck.
“It’s your fault for not already being intimately familiar with how our archaic and parasitic health insurance industry works.”
It’s been this way for decades. It’s been talked about endlessly for decades.
Yeah, I’m pointing the finger at people who don’t seem to care until they’re affected.
Again, I don’t like the current state of things. I want healthcare for all/single payer. But OP self admitted they’re in their forties and they’re just now complaining about healthcare in the US?
Yeah it is their fault. And it’s your fault for not calling them out on their shit either.
Not understanding how it works.
Scott Adams may have turned into a MAGA piece of shit later, but there are a few ideas he got right before he went off the deep end, and this was one of them:
