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What I'm paying to find out I don't have breast cancer. I have insurance. (Ultrasound and mammogram in the USA)
(lemmy.world)
this post was submitted on 03 Feb 2024
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Mildly Infuriating
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For those unaware how Health Insurance works in the states.
You can have health insurance all you want. Especially if this bill is recent, they will cover a large part of the cost, but most people are still on the hook for Usually between $1000-1500 of all healthcare before insurance REALLY kicks in. This is called the Deductible (and Out of Pocket) expense. You also pay a 'Premium', essentially a subscription cost that normally comes directly out of your paycheck.
For single coverage, just yourself, it's about $1200. For family coverage, where your insurance covers everyone in your house, It's usually double that. So ~$2,500-3,000.
So this person probably hasn't had any bills yet this year. Once they pay about $1500 in costs, everything after that becomes (mostly) free. Depending on what you have, insurance will pay anywhere from only 80% - 100% of the cost from whatever the procedures and meds are.
Then funny part is that some places in America the cost is so high, this might be a situation where their insurance DID kick in already and their insurance is still making them pay that much. Or it's a case where you get a bill for that much but your insurance hasn't paid it yet... so it looks like you're supposed to... so you do... then two months later you get a check for that amount.
It's so. Damn. Silly. And I resent Republicans every day for it. That's not even the Fascist MAGA Theocracy republicans. Just your stock standard ones lmfao.
So if I had insurance like that and I actually had cancer I'd pay the first $2,000 and then literally all treatment after that would be free regardless of cost and then I just pay like the standard insurance price?
Presumably your insurance would then go up after that or does it only go up for other cancer related stuff?
well it depends.
for major surgeries, no. after you satisfy your deductible, you're likely to pay a co-insurance on your procedure.
co-insurance is the percentage you're personally responsible.
so lets say your procedure is billed by hospital for 50,000. and your co-insurance is 20%.
you would be paying 20% of the 48000, so 9600.
up to your "out of pocket maximum", which can be like 15000 to 30000 or whatever.
if you've already paid like 10k already this year then you would just be paying up to 5k for ur cancer treatment.
confusing? yes. fuck health insurance so much.