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Health insurance
(lemmy.world)
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this post was submitted on 12 Sep 2023
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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.
My deductible with that company was $5000 lmfao! Who the fuck is going to ever meet that in a year!?
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.
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!
I'm both American and have been on multiple different insurance plans. (Including a no copay plan)
No copay means no copay, what you're describing is not no copay.
https://www.tuftsmedicarepreferred.org/healthy-living/what-difference-between-copays-deductibles-and-coinsurance#:~:text=Copays%20cover%20your%20cost%20of,time%20you%20visit%20your%20doctor.
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.
Sure but the conversation was about copay ;)
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:
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 :)