I have a chronic condition. I also have health insurance. One treatment is $3500. My portion is $2000. If I weren’t insured, the cash price for the procedure would be $1000. But, since I have insurance, I don’t qualify for the cash price. Health insurance is a fucking scam.
I pay my monthly insurance premium to overpay for a medical procedure.
Yup. #UniversalHealthCareNOW
We need single payer health insurance. Same plan & benefits as Congress.
😲😡
Went into a medical supply for a pair of crutches. Was quoted some ridiculous price, well over 300. For these crutches?, I asked. - Well, insurance pays some. What insurance would this be under? None, I said. - Oh. In that case these are 80. And just guess why.
The supplier had to artificially inflate the cost, just to receive that cost from the insurance companies. If they billed insurance the actual retail price of equipment, they would get a fraction, losing money on every transaction. Procedures are, unfortunately, the same.
Health care should NOT be traded on Wall Street! When we are sick/injured others profit.
Highway F(kkk)ing Robbery... Eliminate some more CEO(s)...and their ginormous "bonuses."
This is INSANITY.
This is Obama’s healthcare system, designed and developed by the Heritage Foundation and made law by democrats.
Otherwise known as capitalism.
Yep.
And the $1000 is probably an overcharge as well…
Possibly. Then again, they may be paying inflated prices as well.
And people wonder why the masses turn to Youtube or Dr. Google for medical advice. I believe in science, but for some, a bottle of woo is cheaper than going bankrupt.
Even Medicare is a problem for older single ladies. Can't afford monthly premiums, don't qualify for Medicaid, but punished for the rest of their life if they don't join.
I am honestly considering not having insurance this year and just pay cash. I too have a chronic condition but it does't cost me as much as yours does. But I still think it'll work out better without insurance.
There is absolutely no reason we can not have universal health care. We're the only developed country without it. It all boils down to greed. People lining their pockets instead of making strides forward as a society that values it's people health and well-being. Health care is a human right.
Our country pays 58 billion per year to be kept from being as healthy as we could be.
Yes it is as a matter of fact all insurance is a scam and it all needs to go and that money needs to be reclaimed that was invested in it by every single individual that's been scammed
The advantages of universal healthcare! It is not insurance!
If and when they accept cash. Most are bound by contracts not to.
It's cool how each month I pay for health insurance, and if I get sick, I pay more.
Right? We psy for insurance and then we pay for services.
It certainly is.
And that's why they won't let us have Universal Health Care. When you work for the corporations instead of the people in this country you get bent over, fucked and not even kissed
Don't even get me started. I had a heart attack while uninsured, unemployed and here on a green card. Not bad but learned a lot. Insurance cost $48k but as I legally couldn't be forced through medicaid, cash cost $11k the only people that wouldn't settle for less were the Ambulance company.
If I'd been forced through medicaid as the hospital group wanted I'd have a $30k plus lien on my house and become ineligible for citizenship.
Can you request they don’t bill insurance and have you pay out of pocket? I’m sorry if this sounds stupid, but fuck that’s not right.
It's worse than that, at least here in Colorado it's actually illegal to do.
I have. They won’t.
Go to a different pharmacy/use an online one and just claim you have no insurance.
The only way around this is to buy from Canada or Mexico. It's totally bizarre that it's the case.
There are programs used in healthcare that are run to verify if a person has insurance or not. It's run with every encounter. There is no longer a way to lie your way into a lower cost.
Darn! You know I would ask @mcuban.bsky.social about this. His Cost Plus pharmacy, ask Mark if they run a snitcher program at his pharmacy. Where they check to see if you have insurance or not.
2/2 That appointment is crazy expensive at approx. 3k every 3 months. I have 3 health insurance plans, and I STILL have to come out of pocket for a portion of that.
Keep in mind that Ms. Piper said she has a procedure at that cost. Depending on what it is, it will affect the cost involved. I'll use myself as the example. I get botox for migraines, so the medicine is one cost, and it has to be done by my neuro team. 1/2
For prescriptions, have you tried CostPlusDrugs?
That is infuriating! Every practice I've been to has been happy to offer the cash option when asked. I'd lose my shit if they said no, especially if the cash option was cheaper!
True that!
One of the biggest swindle of "capitalism"
Funny how some Americans have told me, a Canadian, that I’m a fool for paying for everyone else’s healthcare.
And costs Americans $1.5 trillion per year for worse outcomes.
👍
Can confirm
That’s not always the case. And presumably you have a deductible, which helps limit annual out of pocket costs.
I call it “wiggle with system”. And this might not be the specific answer, I don’t know all the deets but cancel the insurance for 30 days. When you have been oppressed by systems all your life you gotta get creative. Theres another way. Think outside the box. Luigi!
All a grift. We are being played.
Maybe the key is to present as a noninsured person. My MRI place had one proce for insured and a much lower one for not insured.
I had an MRI previous to being insured and I paid $480 out-of-pocket for it. When I looked at the insurance price, it was over $3000.
The American healthcare system is a money making enterprise. We need a national healthcare system free at the point of use.
Isn't it wild how everything costs more WITH insurance, same for RX. Any mix of tradeoff between a higher premium and lower deductible or a lower premium and higher deductible,you still pay at least 10,000 to 15,000,basically out of pocket before they pay for anything with regular health insurance.😬
I tried to use a teleheath site, paying cash for services rendered. I entered my bday, which indicated I am 65+ & signaled I'm on Medicare. It would not allow me to opt out of using Medicare. The nominal cost for consultation and minimal cost for a basic antibiotic was no longer an option.
You all deserve Universal Health Care like the rest of the civilized world. Healthcare is a human right and not to make useless middlemen rich
Very well said 👏🏻
It’s basically a mafia middle man, getting paid for nothing, bullying is the whole time. If doge really wanted to make something efficient, they would’ve gotten rid of so-called health insurance. Imagine the amount of money that could actually go toward health care if we didn’t pay the mafia.
Private healthcare is the scam.
So wrong.
I feel this in my bones right now!!! It's the same with prescriptions! I can't get my med formulary covered because it's liquid and I'm allergic to the pills so I reached out to the mfg and two help programs and was denied because I have Medicare! I have Medicare and Medi-Cal (Medicaid) & no
heart pills. For dental it's even worse! I need over $20,000 in work because it's gone into my bones and it's cheaper if I didn't have insurance but since I do...
Universal healthcare and education. Having both would cure what ails us.
And also a golden handcuff. How many people stay in jobs they hate or where they’re undervalued or abused because they can’t afford to be without medical benefits?
Aftermarket insurance is driving up the cost of auto repairs in the same way. Repair shops raise their prices, forcing people to buy "extended warrantees". Then the shop overcharges the warrantee company whose bureaucrats don't seem to care. The whole system is rotten and keeps getting worse.
Absolutely! Cash is king when it comes to healthcare. We’ve opted out for years. I also see a primary care physician on a $100 per moth plan. RXs are cheaper if you pay cash too.
Here in progressive MA, my policy via the #HealthConnector costs me $1300 pm & since Jan 2025 has a $1000 deductible. I just got a bill for $1025.00 - for tick-born disease screening. My "insurance" covered $292.84. It's basically a $$$ COBRA policy. & I'm one of the Lucky ones.
Here is a test for Lyme disease, $100 www.questhealth.com/product/lyme...
In order to get the course of Doxy I needed I Had to go to the Dr. A home test isn't admissible
First of all, WHY is this test so expensive? Forget about who pays what portion. WHY is the test so expensive?
Because they can.
Socialized healthcare takes the PROFITS OUT of healthcare. I honestly do not understand why so many Americans are against it.
Nor me. When I was campaigning& canvassing for the ACA in Chicago some dude Spat In My Face😳
So, $15,600 a year in premiums to not be covered when you also paid out 25 bucks more than your 1,000 deductible for one test? I think we need an investigation into all kinds of insurance .All we insure is their profit.
Basically.
I never had insurance until I turned 63. It’s a sham for sure
Yes it is all about their profit
Health care "insurance" doesn't exist to help people get health care. It exists so that someone can make money off the fact that people need health care. It is long past time for the U.S. to have Universal Health Care like civilized countries do!
Duh! How else could an idiot like Rick Scott, Fla, scam Medicare AND get elected Senator! This country is FU!
I have insurance through my employer, but my PCP went to a Direct Primary Care model. I pay a fee each month but can get in same or next day, no waiting a week+. Getting tests through her cost less than the co-pays with insurance same w/vax &some meds, as well as office visits.
ALL insurance is nothing but a scam......one we are forced to accept.
With insurance you are simply paying the cost of future claims, over time. And if you DON'T have any claims, then you're simply a profitable contract.
We are marks, insurance is legitimized scam.
Interesting. And I often see cash prices that are 3-4x the negotiated price for insured. Either way, you are dead on re the scam
I'm on a biologic injectable for psoriatic arthritis. Insurance doesn't cover it, but the manufacturer will give it to me for free (after jumping a few hoops) because I'm on private insurance. Medicaid can get fucked? Or maybe Medicaid covers it. I'm not sure.
Sometimes the manufacturer will cover free drug for these patients where it bypasses insurance altogether for medicaid. Sometimes it's a matter of step-through therapies depending on formulary and then medicaid will cover. It can be really time consuming for patients and providers.
Any free drug programs have it written in the Ts&Cs that it is not available if you are on any form of government healthcare, including TriCare, or are uninsured. Underinsured, sure, but not if you are underinsured because of your government issued healthcare.
Hm I know they can't use the copay programs and whatnot but I have patients on free drug that are medicaid. I don't know specifics of the arrangements because that is worked out through the infusion centers. Maybe it's allowed on a temp basis or something? Not sure.
There is usually a temp period where they will provide drugs until they verify insurance. Infusions can definitely be different too. They'll cover the drug, not the cost of the infusion. I've looked at many savings program Ts&Cs in my job, and it just sucks. The people who need it can't get it.
Yeah I think with the infusions we're having to send to state subsidized infusion centers (university system) because the private infusion centers like the one at my clinic can't eat the infusion costs. But you've got me curious about the details. I'll have to ask.
And yeah for non-infusion meds I'm just having to do appeal after appeal. Tricare right now is the bane of my existence since a formulary change means kicking patients off a med that tons are on and have been stable on for years.
That really sucks
I've benefited from these programs myself for migraine meds. But it always feels like it could just get taken away with every program update. And ugh, formulary changes are so frustrating. Oh, this works great, but it costs too much, so we're just not going to cover it anymore.
Haha it's a migraine med I'm dealing with right now. In general they're getting more accessible but there are still some obstacles in some weird places that are completely unnecessary.
I've jumped through hoops for Botox, Aimovig, and now Qulipta. I have never paid a dime for Qulipta, which has almost cured me. I legit have no idea how much it costs, but I would pay it somehow. I also had to fail SO many drugs to get to this point.
We need a national health system free at the point of use like the do in other countries. I’ve been getting my prescription from Canada as it’s half the price.
Canada's isn't national, it's Provincial and there are some big differences between them.
I’m so sorry. This is awful. This is why I’m planning to retire in Mexico.
And it’s about to get worse, when everyone’s ACA premiums skyrocket because the Medicaid subsidies will be greatly reduced.
It most fucking is. I now pay as I go. I'll be eligible for Medicare in 6 months, but there's no guarantee it will still be in existence. I honestly can't wait until "she's in a better place" can be said of me. We could have had so much more without fascism...
Cant you elect to “self-pay”?
That’s why most billionaires don’t have it or need it. They just pay cash while we struggle.
The situation described above is terrible. I recently signed up for health insrnce on The Marketplace & there was not a single plan w/ a lower deductible than $2200/yr & any $ you spend that isn’t pre approved by the ins co will not count toward that deductible then they only cover a %. It’s a scam.
People without insurance pay more for same procedures, because insurance companies can get lower prices. So if you are too poor to get insurance you pay even more. But we need universal Medicare so insurance companies can be sidelined and EVERYONE can get health care.
Yep. Just like prescriptions. My cost for insulin was $40 until this last month. Now ? It’s $1500 a month! My copays went from $20 to $75 in 3 weeks. So much winning.
They’re a bunch of geeky kids with a magnifying glass who are turning this place into an ant farm.
Oh yeah.
When I had cancer, I was waiting on insurance to approve a procedure, the dr said if insurance didn’t pay they would charge me 50%, but insurance would be charged 150% when approved!😳
Pay the cash price. Had a similar situation once - High Deductible HP - Rack Price for imaging at the hospital GP sent me to - $8500, my share? $4500. Community Hospital, if I didn't use insurance - $1250. Wound up at a sports medicine clinic - $450. Shop around folks.
#SinglePayer4All
🫤
Our insurance is going up over $10k per person next year. We already pay over $24k (couple) in premiums a year, 8k deductible before they pay a dime. It's a scam.
My wife was prescribed a home blood pressure machine. Her copay would be $64. The pharmacist told her she could buy it off the shelf for $59
Interesting. I can get cash discounts here in midland but it’s never me paying less than what insurance reimburses them. I’ve checked my past EOB’s. Especially with my dentist who overcharges but I like her so 🤷🏻♀️
It's the health ins. that prevents you from getting the discount. They say if you get the treatment for $1000 they want the same pricing which isn't sustainable. Insurance Co prevent healthcare systems from helping the uninsured with discounts. It is costly to submit and work insurance claims.
It's insane. Your co-pay isn't even your co-pay. They can enter different codes once you say that you will just walk out and not get the treatment at all . That's what I did and somehow $1600 out of pocket became $147.
I had a heart attack at work and ended up losing my job as a result, and now my health insurance is trying to stick me with the bill by saying since I had my heart attack on my "last day" the procedure isn't covered.
Wow. I honestly feel that because Republicans created corporations are people, we should all be hiding our income. I hope you are receiving the care you require. You are an important voice.
So the provider won’t take the cash price because they’ve negotiated a higher payment from your insurer, and you think health insurance is the scam? Providers and the ridiculous rates they demand before giving you care is the real scandal.
My premiums annually are $13,000.00+ for my family. It's the best pan available for us. I have some serious health issues. I still pay thousands out of pocket annually. They want us all sick. The system is designed for us to eventually sell our life's accumulated assets for healthcare.
It’s corporate wealth insurance. It’s bankrupt the poor souls with bad health.
I had two spinal surgeries done in Germany. Nothing to do with cost. I had good insurance, but it was a procedure I could not get here. My insurance company, although it took a little wrangling was willing to pay for it because.… it was a fraction of the cost of what it would’ve cost them here.
We must move toward Medicare for All. Universal healthcare. Something other than the crap we have now. It’s ridiculous. I know I’m dreaming….
They are not the same. M4A is a bandaid solution patched on top of our existing flawed healthcare ecosystems. We deserve Universal Healthcare, like many other industrial countries have. Under the current regime it will never happen.
Very aware of that. And I agree. I do view M4A as a “bandaid” until we can develop a universal healthcare system. Stopping the bleeding, if you will. We do deserve universal healthcare. Absolutely. And yes, dreaming, & fully cognizant that it ain’t gonna happen with the bozo regime.
I’m homeless because United Healthcare refused to allow my neurologist to fix the 3 ruptured discs in my lower back and instead said “we’ll let you fix one”. I was told that the others weren’t necessary repairs while I still had function of my legs. I literally need to be paralyzed to receive care.
Yes, it is. It is organized crime. It’s why some folks actually cheered the execution of the United Healthcare CEO. Let me be clear, that is the wrong response, but I understand why they felt that way after being shaken down by these insurance companies that hold your health hostage.
It’s a Pyramid Scheme I’m betting your boat isn’t bigger than the United Healthcare CEO’s yacht
I lost my insurance a few months ago and my doctor only charges $30 for a visit. My insurance at the time was medicaid under the state breast cancer program.
This is what Obama’s ACA was meant to do. This Obama’s legacy working as designed.
That's why I don't buy Medicare plus plans
I have been looking for a new Dr after mine of 7yrs moved. When you call offices, they always ask abt your insurance. I don't qualify for Medicaid, but I've been told by multiple offices that they no longer accept it. So ppl who are on it will no longer have as many options. It's really sad.
Sounds insane, so of course it’s “legal”. You’ve got to wonder if the insurance company is somehow figuring out a way to pay zero behind the scenes…
That's why we need health care. That's also why Luigi was pissed.
You need a fake ID.
It is a total scam. It is unjust, it is unfair. It is inhumane.
Flat Tax and Universal Healthcare. Those are the only words I want to hear.
The biggest. And while we're at it, let's talk about "coverage" that for most people now involves a massive deductible that has to be paid before most claims are even considered. The deductible on our family ACA plan is $14k, which is incomprehensible and undefendable.
Biggest organized crime outfit in America. Cartoon by @pizzacakecomic.bsky.social
My cancer treatments cost $22,000 per month. I am lucky to have good insurance through my union that doesn't cost me an arm and a leg.
Indeed is.
Eeesh! 😮🙏
Jess, please write the long form of this if you haven’t already. This is the sort of thing that anyone with any values or concern for even just their own family will be outraged by We can help people see that this system really actually does hurt them. Many will believe their own hurt over the lies
I am doing just that ❤️
And name the companies involved.
You’re the best, Jess! 💙💙💙
See this is something Obama would have addressed. As part of Obamacare he would have written a rule, Insurance companies cannot charge you more in a co-pay than the cash payment charge of the treatment. Instead of building on Obamacare, the Republicans want to tear it down.
Sitting here in the UK, with a “free at the point of use” public healthcare system, and I just cannot bend my brain around the US healthcare system and how it can possibly be good/ethical. Nor can I rationalise why we have political parties that want to make our system more like yours. Insanity…
We didn't have a Nye Bevan to fight for us. We did have the AMA, that staunchly opposed Truman's plan for nationalized healthcare - because it would take away their autonomy. Where is that autonomy now, docs? You're pawns of the health insurance industry.
It’s really makes me sad, and my heart goes out to those who suffer under the fundamentally unequal and unethical US system (and who will suffer even more because of the Mango Mussolini). The US deserves better, in all senses.
Couldn't agree more - and very happy that my son is a UK citizen.
When l talk to friends about how much better we would be with a system like that l always get the same response: "oh but you have to wait months or years to see a specialist in those countries!". My response to them: " It takes months or years here in the U.S. with none of the benefits."
I recently had a close relative undergo cancer treatment - admitted on a Monday night, surgery 24 hours later, a stay in both critical care and recovery ward for about 10 days, and soon to begin chemo. It has cost precisely zero. The NHS has its faults, but there’s no way I’d swap systems.
And that's how it should be....in a country with representatives in government that care about its citizens. Clearly that is not America.
What. The. Actual. Fuck. 🤦🏼♂️
Looking at my CPAP supplies price🤣🤣🤣🤣🤣 Don’t get me started on the gizmo itself
Health insurance is for the shareholders not the policy holders 😡😡
I'm so poor (on SSDI) that I have Medicaid to pay for my Medicare, yet I have to pay $60 (trimonthly) out of pocket for one of my most significant medications because it's compounded and neither Medicaid nor Medicare cover compounded meds for some reason. It might not seem like much but...
...it's a lot when you receive literally the equivalent of federal minimum wage just because of an unfortunate accident outside your control that left you permanently disabled. I would gladly work what I'm able to work but finding a job with my restrictions is just about impossible.
We need universal healthcare. Disabled people have enough to contend with. You don’t need this extra stress.
They like to screw with our meds and treatments all the time too. Anything to save a buck. They cause serious harm and setbacks in progress all the time because they care more about a few bucks than people's lives. It's all horseshit.
I believe you. It’s awful and it doesn’t have to be this way. Our government does not care about its people. It makes me sick.
Similar thing happened for me when I got an MRI scan. We were told how much it would cost with our insurance (four figures). Then we asked how much it would be without insurance (three figures). I feel lucky they let me take it without running it through insurance.
For sure! All insurance is a scam. You pay and pay and then when you submit a claim they have your deductible, your costs until you meet a certain level, and then the best one is “claim denied” and your rates go up! The U.S. is the only industrialized nation that doesn’t have national healthcare.
Make it make sense
Here’s an interesting thought experiment. Suppose HI was illegal overnight. Would HC pricing automatically collapse to reasonable market levels? Would mortality rates increase? Would the wealthy have better outcomes?
Health insurance is simply the salesman between my health and my doctor,and there is no doubt it is a fucking scam!
We need to cut out the middleman here. They're ripping us off.
and Rs always say: “i don’t want guv’ment between me and my doctor!”….. but it’s immensely worse with health insurance between us and our doctors!!! my Canadian in-laws can’t comprehend why/how we do this.
The United States of America is a scam!
Complete scam. Wife had to get an MRI a few months ago. Out of pocket with insurance was $900. They did offer us a cash price of $450.
that's a good reason to endorse bernie-care
If you had an FSA account would that qualify you for the ‘cash price’? Maybe you do, dunno.
Luigi did nothing wrong.
Our health system is so backwards.
You can always pay out of pocket but it doesn't apply to your deductibles. That's part of the scam.
They won’t let me pay out-of-pocket when they have my insurance on file. I’ve actually begged them not to submit it to insurance, but I think it may be against Missouri law? I’m not sure.
Honestly, Jess, I’d dig deep into what they’re telling you. Maybe it varies state to state, but the states where I’ve lived don’t force you to use insurance. You just have to sign a disclaimer saying you know it won’t be applied to your deductible, you’re taking responsibility, blah blah.
I believe the guilty “they” here might be your provider and their billing staff.
Health Insurance - everybody wins except the insured.
We are not a serious—or intelligent—country.
my rheumatologist charges me with insurance, $300. That's out of pocket with my deductible. If I didn't have insurance, it would be $125. I'm going to say I don't have insurance anymore next time.
Yup. Its an industry where we pay them our hard-earned $ to hire people to deny coverage to us and to lobby for their interests.
Yes it is
That’s why America doesn’t have national healthcare.
It is specifically designed to be that way.
That contradicts my thought that health insurance had two components. One was insurance for true catastrophes . The other was as a buyers’ coop, negotiating better prices. That second one looks wrong based on your experience
Total scam
I was self-employed for several years and paid cash for everything, because I had to. I didn't have a lot of access to preventive care & diagnostics, but my normal/anticipated costs were not terrible.
Yep…when you have a for profit healthcare system…
So is homeowners insurance. The high deductibles and stunning number of things that aren't covered means I'm never going to file a claim. Yet they keep siphoning money from me.
Free Luigi!
Agree and hope you get treatment that helps some🤗
👹TOTALLY! I'm currently receiving dental work at Healthright 360 but my insurance Won't cover my Primary Care there! 😵💫☠️
Doctors in my area won't let you pay cash.
That's... Insane... I doubt ERs are prepared to go back to the bad ol days before the ACA when many had no insurance and had to use ERs for urgent care.
It sure is
All insurance types are scams.
My 80 year old doctor told me to only get Medicare basic! He said the more insurance you have the more you get charged! With Medicare basic you go to emergency rooms and get good care. They can only charge Medicare basic fees& they can’t turn you down.Medical insurance is a scam for American fools.
ya, so it looks like insurance conpanies don't want to be in the health care business anymore
Curious what health care provider is giving a huge discount for self pay. Typically self pay patients are charged tne highest since insurance and government payers reimburse below cost.
Such a scam.
The paperwork and administrative support required to complete the paperwork and follow up to get paid by insurance companies requires a minimum of three times the amount of getting direct payments. Yes .
Insurance companies provide ZERO benefit to the insured. They add cost, complexity and frequently just say NO to covering procedures and meds. Time for #MedicareForAll as soon as we can get the despot out of the White House.
Since Medicare has this same situation with the insurance companies, what we need, more accurately is “single payer” coverage. The government health agency that takes our payments and disburses money to healthcare providers, bypassing the need for insurance companies.
Yes. I don’t care what it’s called.
I pay $500 for a prescription that not only my insurance company won’t cover. My HSA wont cover it either. And it’s for a chronic condition.
I had a Dr client who quit taking insurance for exactly this reason. She said she can send a patient to get an MRI for $400 but if they file insurance it gets applied to their deductible where they’ll have to pay $1,500 for it. Plus, she’d been screwed by ins not paying what they owe her many times
it absolutely is. no question
How do ya’ll not revolt? How do politicians keep a straight face in elections?
youtu.be/RzT31WdpsIU?...
I have stopped using my insurance for my prescriptions. Instead I buy all of them on Mark Cuban’s CostPlus Pharmacy. The annual cost for ALL of them is less than a three-month supply of just a couple using my insurance. I expect tariffs will impact CostPlus but trust it will be fair.
Everyone was so worried about death panels in 2009 but what they didn't realize was that there already were death panels - health insurance companies.
We just got an estimate for a procedure, 150,000! Out of pocket, $5900. Insurance will only pay $30,000. Are they just making up numbers now?
I think so
Hospitals are supposed to publish all of their charges, listing various procedures and medications that they get paid for. It is called a chargemaster. Usually, they also report what price they have negotiated with the insurance plans.
This was an estimate. They sent it to us on Friday afternoon at 4:30. His surgery was Monday at noon. I spent the entire morning trying to get answers. I was told it’s an estimate based on other procedures and as such they didn’t have. Breakdown. Was literally a number on a sheet.
I understand. I was referring to your point about them making up numbers. The estimate is based on the 'charges', and you can see how much your insurance agreed to pay. There is very little in common between the two sets of numbers.
Whoa, it's worse than I thought.There must be a large investment on insurance profits on Wall Street.Maybe we should all invest in health stocks instead of paying for health insurance to pay for our medical bills.
Procedures that cost thousands with insurance in the U.S. cost mere hundreds with no insurance in Mexico. Most medications don't even need a prescription, you can just go straight to the pharmacy and pay cash.
That’s truly messed up! When I had cancer I met & exceeded my cap for the year in 4 months. After that I had to decide whether I paid for further treatment, or pay my mortgage. Amazingly my mortgage company worked with me & allowed me to pay $100 a month until my chemo was done. I repaid it all.
Yikes! As a self-employed person our family (w/5 kids) were rarely insured (in the 80s & 90s). Our experience was the opposite. We were charged the full amount for a short hospital stay. Had we been insured it would have been far less. Wow!
America is a fucking scam
My insurance refused to cover something my doctor said I'd die without and assured them that it was medically necessary. Hate insurance. California required one extra form last year on a med I've taken for 20 years. Now doctors won't prescribe it because their assistant can't do it. Hate doctors.
I have a chronic condition, in order to get treatment I would have to research and change my health insurance and then wait up to two years to see if the only hospital that offers the surgery I need will even see me. The whole thing is fubar.
My plan paid $9 for a test. My share was $25.
Making healthcare… from pharmaceuticals to insurance to hospitals NOT FOR PROFIT would unlock so many $$ for making it available to all !
Had a similar problem with a savings card for a medication issued by the pharma manufacturer. I qualified for the savings when my insurance paid for part of it. When my insurance changed and the medication was no longer covered at all, I didn’t qualify for the savings. Wtf??
Could you just tell them to run it without insurance? It would save you $1k. There’s a hospital here in Arkansas that posts their prices on their website. Twice I’ve had them do an MRI as cash, paid $550 vs $2500 with insurance.
$2500 being the deductible the insurance would require me to pay before they paid the 60% of the $550. Doesn’t matter that it’s only $550, I have to pay the $2500 in full.
Wait, WHAT?
Sending good vibes.
Yes it is. Medicare does the same thing for about 15% of the admin cost of insurance, and without all the denial of coverage crap
Exactly
*addition to my comment* My pills are $125 A PILL without insurance!! It's deafening to see how easy it is for disabled people to give up on living with prices like that! 😫😭😡👿💩
I have multiple sclerosis and I agree. 😤 We have to pay out of every orifice of our body to get care for it, but can't just pay through taxes to get "free" healthcare that would save our wallets & bodies. The medication I'm using for my nervous system would be as much as my HOUSE (85g) a YEAR!
Can you go to someone else and say you don’t have insurance?
I have “great” employer-sponsored health insurance. My prescription is $30 MORE using my insurance than it is to use a GoodRx coupon.
Did you check at @markhamillofficial.bsky.social Cost Plus pharmacy?
I'm in the same boat.I don't use my Prescription Insurance because by the time I pay the deductible & the cost,it's more than if I use Good RX.I keep it only because if I need a prescription that's really exorbitant & Good Rx or one of the others don't have it,the plan I have will cover some of it.
I use Good RX because the insurance won’t pay for the generic I need. They won’t cover the medicine unless I pay more so they can get a kickback. Scam!
Tell me more about this kick back scheme. First I have heard about it. Thank you
Pharmacy benefit managers use rebates from the drug manufacturers to make lists of covered drugs. Someone is benefitting from these rebates, but it is not the patients. This article seeks to defend PBM's, but for me it makes a good case for universal healthcare. www.statnews.com/2024/08/12/s...
For sure it's a scam.
That's so nuts it doesn't even seem real. I have two serious chronic conditions, but don't have to go through that, so now feel... lucky? Thanks, I guess, and hang in there.
😡 😢
Have you checked to see if Mark Cuban's Cost Plus online Rx can fill it for you? They don't carry everything, but they add new stuff all the time. A 90 day supply of my meds is $84 at Kroger (with an hour drive round trip to pick it up) is only $28 by mail from Cost Plus. It's worth taking a look.
Single payer. Some day.
I pay for my Medicare FFS and a gap plan, and I still had to pay a deductible? I called to question this and Blue Shield told me that it is a Medicare rule.
Same with my son’s ADHD meds. If I didn’t have insurance, they were be $75 with the coupon. But with insurance, they are $119.
It always has been, after I retired from the city, I bought coverage with Cobra from them. The monthly payments were about $500/month. We were self insured so it was the actual cost and much better coverage compared to Medicare. It would pay all of your treatment less 10% copay.
You can thank Doctors for that. You should have a choice to use insurance or not.
I was prescribed Nurtec for migraines. With insurance it would be $800+. I had to go onto the Nurtec website and request an rx card to get it free.
I have Medicare. Doesn't matter if it's part day, part B or part C/advantage plans. Because I have Medicare I can't get the low price of $25 through their coupon program because they won't allow it for Medicare recipients. So I have to pay $1000 a month or not get it at all. That's half my income!
Yeah the “death panels” they used to talk about with government funded healthcare—we who pay for insurance call them the Board of Directors.
And yet the best Obama could do was a bigger insurance plan. We were in control and still caved to business instead of taking care of workers. I’ve heard the excuses and they remain that, excuses. The democrats didn’t have the backbone even then to cross their donors, but they screw us daily.
And they send those inflated itemized "this is not a bill" accounting that just scares you into keeping your insurance because you know you can't afford to go $60,000 in debt.
This should be illegal. So many things about health insurance are wrong; In v. Out of network shouldn't be a thing. Dental and vision care should be included. Companies getting rich off of the misery of others. The list goes on.
As a CANADIAN, this post is extremely hard for me to understand!
We've experienced the same thing. We created a work around that works at the moment.
Healthcare in our country is broken because of for-profit parasites known as health insurance companies. A fiscally conservative approach to providing good care would cut out the leeches and provide the best care, together. See: most of the developed nations of the world.
If this year has not taught me anything since being diagnosed with cancer, it is how little my insurance really helped me. Once I lost my Medicaid in December, got diagnosed in January, it has cost me half of my savings, and I have another 7 treatments to go. 😔
I am so sorry, friend. This should not happen.
I had a similar situation lost all of the money I put towards my deductible in my marketplace plan,when I was required to switch to Medicare. I had to start my deductible over mid year.Also,found out that RX $ paid,does not go towards your RX deductible if you use the RX discount card THEY send you.
It sure is.
When I signed up for Medicare I didn't sign up for prescription drug coverage because the drug I was taking for my psoriasis was going to be thousands of dollars a month. Without that Rx coverage I was able to get the drug through the patient assistance foundation. Makes no sense.
100% a scam.
THIS!!!!!!!!! Don’t even get me started on dental insurance.
I live in the UK. My taxes fund my heathcare. If I need meds I pay a flat fee of £9.90 per item. Seeing a doctor is free, operations are free. Childbirth is free The UK spends 10.9% of GDP on Healthcare The USA spends 18% of GDP on Healthcare
my doctors are more than happy to let us go “cash” when it’s a better deal. The only negative is that it doesn’t get turned in so it doesn’t go against your deductible. And yes- it’s all horrible and stupid
Sometimes it pays, one needs to look carefully. There are people trained to help you find the best policies
So it's cheaper to be uninsured?
No, it's cheaper to pay cash.
Just trying to understand.
With or without insurance?
Depending on the provider, most small shops would likely prefer the cash regardless of insurance or not.
I will have to accept your word for it. I will say, in my area, all the little shops have been gobbled up by bigger fish.
Free healthcare and education are the birthright of civilised societies.
I take dimethyl fumarate (off brand Tecfidera) for MS. Name brand stuff is $5900 per month with insurance. Off brand is $3000 per month without insurance. I can get off brand from Costco for $75 per month without insurance. I can get it for as low as $30 if I track I on GoodRX.
*good = book
*Off brand is $3000 per month with insurance. Got autocorrected there.
I can get a year's supply in Europe without insurance for $1800-$2000. I could literally good a European vacation and come home with a year's supply of meds for less than I could buy a year's supply of meds through my insurance. It's sick.
In most cases, private health insurance companies are nothing more than parasites.
Yep
Medicare for all would eliminate the insurance industry. That's why we don't have it. They donate $$s and lobby against it. And America suffers.
Yes, that is a solution to people being gouged in order to get some health care. The insurance companies need to be sidelined!
Anywhere there's a lot of money changing hands look for the swindlers. There will always be swindlers.
And each can only be filled every 30 days, for only 30 days. With 1-2 weeks turnaround for ordering it, because they're "uncommon medications". (But us needing it every month isn't "common?") So the stuff we *aren't supposed to go without for even a day*, we're off of for 2 weeks out of every 6. 2/2
I have the same problem - thousands of dollars copay for *one* med per month! Then thousands more for all the other meds needed. All purchased at the pharmacies I'm *forced* to use, not local ones I choose. 1/2
EXACTLY. Most of my expat friends living in Mexico can afford to pay for their health care out of pocket, since it's about 1/3 of the cost of health care in America.
It is sad to read something so unbelievable, but immediately know it is true. This is because so many of us are experiencing the insanity and greed of the health care industry. This evil injustice has to stop.
Makes no sense. You’re better off without insurance in this situation.
