this post was submitted on 05 Sep 2023
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Maybe the meme community isn’t the best place to ask but would cancer treatment not be covered by your health insurance in the US?
I keep seeing posts that people with long-term health issues have to pay for it themselves and that just feels like something you’d have the insurance for.
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
Not everyone in the US has health insurance or (more importantly) the same quality of health insurance. Insurers here have the final say on whether they'll cover certain treatments, medicines, procedures, doctors, practices, etc. as well as how much they'll cover, how much they'll charge the patient, or how much any use of the insurance will affect the price of said insurance going forward. Insurance often prefers you work with doctors, practices, facilities, etc. within their own list of approved doctors, practices, etc. and going outside of that list for any reason may cause you to have to pay for any goods or services out of pocket. Then lastly you have to remember that both health insurance as well as hospitals and clinics are generally for profit businesses trying to maximize profit and minimize costs.
And the little cherry on top of the whole situation is we're in a political landscape where even having universal access to healthcare is labeled as communist/socialist by many in a derogatory way.
Hard to hold down a job to pay for rent/mortgage, car payments, food, utilities, etc. While battling cancer. Your medical expenses may be covered to a small extent but you don't live for free when you are sick.
Hold on a minute. Does this mean health insurance in the States is linked to employment? So you lose your job, you lose your health insurance?
That's rather rude, and frankly, uncivilised.
For the most part Americans get their health insurance from their job (or spouse's job). Typically you'll get a few different options for plans to choose from. How expensive those plans are, and what they cover will depend on what insurance company your employer has selected.
You can select your own health insurance, and some people do for various reasons (like being self employed) but that tends to be SIGNIFICANTLY more expensive.
Additionally, even when you have insurance, there's always another fee or copay that you have to pay. If you have a somewhat complicated medication condition doctor visits, tests, procedures and medication can all add up to a lot, even with good insurance.
There's dozens of long videos detailing how it all works, because the whole system is pretty byzantine.
I have a friend with cancer that just lost his insurance since he's not old enough for Medicare and makes too much money from his retirement benefits (it's barely enough to pays his mortgage and eat here in Seattle). He's going try to wait 6 months until he can get Medicare but I don't think he will make it and he's only worried about losing his house. I think it will cost around 60K to get back on his meds and keep going to his weekly medical appointment (probably way more) for the next 6 months. He was so sick before he started going to the doctor and seemed to be responding really well to treatment. Was going to try do a Gofundme.com me page for him. It's so derepressing. damn just thought about if he's going to even afford his pain meds...I think he has that covered but yeah it really sucks. Medicare will even take your home if you spend past a certain life time maximum while your dying. Most people don't really know just how bad it is until you have to deal with it and it's purposely super confusing and the the Insurance company's make insane amounts of money and so they spend a lot of money to keep it this way. Personally, I'm looking at trying to move to an other country that has even a basic medical system that is affordable just so I'm not so discouraged from even going to the doctor because it's so expense even with insurance.
The powers that be decided to tie good health insurance to your job, which as a catch 22 is incredibly hard to keep if you have something serious that you would actually need the insurance for like cancer.
A lot of americans dont have insurances and those that do often have bad insurance where they have to cover most of the expenses themselves.