• bustrpoindextr@lemmy.world
    link
    fedilink
    arrow-up
    21
    ·
    1 year ago

    If you had no co pay you wouldn’t have had a $200 bill ( unless you went out of network and then fuck you for wanting to have a choice)

    • abraxas@sh.itjust.works
      link
      fedilink
      arrow-up
      12
      arrow-down
      1
      ·
      edit-2
      1 year ago

      Found the European (or just someone young who doesn’t know much about typical insurance shell-gaming).

      You have no copay, but most insurance plans include any non-preventative visit in the deductable. That means you are responsible for 100% of the bill until your $1500/yr deductible (in as low deductible-plan, a LOT higher in most plans) is reached. To look like they’re actually doing something, they treat the negotiated rate from the doctor’s MSRP as a “discount” (the doctor says $300, the insurance negotiates you to $200). The really ugly irony of that, is that if you were uninsured, many offices would have given you an NP for $70, and some have an “uninsured rate” of like $150.

        • abraxas@sh.itjust.works
          link
          fedilink
          arrow-up
          3
          ·
          1 year ago

          And the irony is that anything not covered (like your responsibility on a coinsure) does not apply to the deductable. Nor do copays.

          Literally the only thing left is “Maximum Out of Pocket”, but they even have ways around that.

          • ChamrsDeluxe@lemmy.world
            link
            fedilink
            arrow-up
            1
            ·
            1 year ago

            With the insurance I have now through my company, I already met tge deductible and haven’t been charged extra for anything. It’s really nice!

        • abraxas@sh.itjust.works
          link
          fedilink
          arrow-up
          4
          ·
          edit-2
          1 year ago

          No copay means no copay, what you’re describing is not no copay.

          Yes, “no copay means no copay”. Most insurance plans have BOTH a copay and a deductable on a large number of higher-end services like inpatient surgery and the diagnostics like CT. And I have had, and helped family shop for, healthcare plans that have no copay, but still have a deductable. Further, there’s a lot of PPO variants that have no copay or deductable, but have a coinsurance for everything.

          In my adult life, I have never seen a plan where your “typical” out of pocket for anything other than Primary Care or Teledoc was anywhere near zero, even if those plans approach $3000/mo.

          And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ). For a patient, money going out feels the same as money going out. Especially in large quantities.

          • bustrpoindextr@lemmy.world
            link
            fedilink
            arrow-up
            1
            ·
            1 year ago

            And you’re right. What I was describing was not a copay, but a deductable (please check the words I used, as I called it a deductable :) ).

            Sure but the conversation was about copay ;)

            • abraxas@sh.itjust.works
              link
              fedilink
              arrow-up
              3
              ·
              edit-2
              1 year ago

              Sometimes conversations get confused pretty quickly in thread format. I never understood why, but it IS hard to keep context in Lemmy. Let me reopen with what I was replying to:

              If you had no co pay you wouldn’t have had a $200 bill

              That’s what you opened with. The person above you didn’t use the word “copay” at all. They just complained about being charged $200 to get a note. Your reply was the quote above. My reply was “but most insurance plans have a … deductible”.

              The conversation was really about money out of pocket. I think you inadvertently thought it was about copays. It happens :)