this post was submitted on 05 Sep 2023
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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