<p>" I don’t think hospitals and providers are as concerned about being paid by an insurance company as they are concerned that a patient can’t cover their portion."</p>
<p>I thought I was being specific but I was speaking only about my insurance company and the hospitals in my area. The hospitals are all in network and 90% of doctors are. There is no deductible and co-pays are minimal. If one goes in network people with my insurance don’t have to pay anything up front at hospital/ER and only small upfront co-pay at doctors. </p>
<p>Emilybee, nice link. I agree with the doctor. Interesting that the doctors are also a little careless about ordering ordering procedures. I like the first book the doctor wrote. Maybe I will pick up the second book. </p>
<p>If they are low income, in addition to a subsidy for the premium, they would also have reduced co-pays, deductible, and max out of pocket. It’s highly unlikely that a poor person would have to meet a $5K deductible, or anything close to it.</p>
<p>There are a lot of middle income people who don’t have $5K handy. But if they don’t have $5K, then they DEFINITELY don’t have the $20K or $50K that the uninsured procedure would have cost. $5K, mid-income people can pay, over time.</p>
<p>True, Fang. My unsubsidized DH chose a large deductible plan in order to keep the premiums down (same thing we do for our auto and homeowners). He does not have any ongoing health problems, so we knew that would probably be a winner for us. But, on the off-chance he does have an expensive event this year, we’ll have to come up with the deductible. We knew that when we purchased the plan. If we thought that his medical spending would be significantly higher next year, we might choose a lower deductible plan. Of course, then we’d be paying higher premiums, but that’s always the tradeoff with insurance.</p>
<p>I never understood this argument - have high deductible or go without insurance and possibly be hit with hundreds of thousands of dollars in medical expenses. Seems a no brainer to me . </p>
<p>But many people don’t put money away for medical care even though they really should have some stashed. It might not be the full deductible, but it ought to be something. </p>
<p>It only seems like a no-brainer to someone with something to loose. Reasonably healthy people with no savings who are scrambling to come up with the rent check every month can easily decide that paying to insure themselves against something unlikely this year which will still cost them more money than they have is not a great deal. There are a lot of them and they are not low income. Paycheck to paycheck living is very prevalent these days.</p>
<p>“There are a lot of them and they are not low income. Paycheck to paycheck living is very prevalent these days.”</p>
<p>So it’s better for them to forgo insurance and get thousands of dollars in bills? No one can predict the future. As I have shared on this thread, I came down with a chronic condition a year ago and it took two months to get a diagnosis. I had to see several doctors, get several tests, had one ER visit (no admittance to hospital) and 6 weeks of PT. My bills came to $15K! Fortunately I have insurance so I only paid OOP $300. I was in terrible pain so it wasn’t something I could just brush aside and hope I’d get better. </p>
<p>I just got two Debt Collection Notices last month for hospital lab bills from the ER visit totaling $16.45 (or something like that.) It was caused by a glitch in the hospitals billing system which was kicking out bills less than $10 and not sending them out - but it goes to show that they will come after you if you don’t pay. </p>
<p>^^They will simply declare bankruptcy. It’s a simple solution.</p>
<p>And you are extremely fortunate for the medical insurance you have. My DH and I just had colonoscopies. We used an in network Dr, hosp and anesthesologist. We still ended up with a final bill of close to $1,000 for the two of us. A mere $300 is pretty damn fortunate. </p>
<p>“They will simply declare bankruptcy. It’s a simple solution.”</p>
<p>I don’t think it’s a “simple” solution. It is a very serious step for someone to take that can have a lot of future implications. In addition, what happens the next year or the year after that? You cannot just keep filing bankruptcy every year. </p>
<p>Yes, I know I am fortunate in regards to my insurance coverage. My policy also allows for out of network coverage at 80/20 and our individual deductibles are very small - iirc $1000/per person. My insurance also includes dental & vision. </p>
<p>That being said, I would never ever go without, even if the cost/deductibles were as high as individual policies in the market or more. There would be many things I would sacrifice to make sure we were insured. We had to reduce our spending years ago when we were $88K in debt from infertility treatments (at the time they were not covered at all but a small amount compared to something like cancer, a preemie baby, etc.) and then adoption. We managed to pay it off in 5 years by cutting out practically everything (including going to one car.) I think my H was bringing home around $40k/year then. </p>
<p>Bookreader, I thought colonoscopies were covered in full as “preventative” care – unless they find something. Hopefully they didn’t find anything?</p>
<p>No, they didn’t find anything. We called the insurance co and dr office a few times. Neither office expected that it would be completely covered. Another CC poster sent me a message mentioning that after age 50 she thought it was free. Doesn’t seem to be the case for us. Maybe this is true in another state. I don’t know. I thought it would have been fully covered as well but my insurance co sure didn’t think so. Sigh. We have AmeriHealth.</p>
<p>I just renewed our health insurance for my company and employees. Our rates for a family went from 1400/mo to 2500/mo. Each employee now pays their own individual rate based on their age. I now pay for pediatric vision and dental, even though my children are over 18. </p>
<p>ACA supposedly mandated vision and dental for children (don’t know up to what age), but when I purchased health care this year via The Marketplace, I was thakfully able to avoid purchasing dental/vision for you under 18 year old. We pay our dentist directly and nothing could make me choose another dentist so it would be wasted money if I had to buy dental insurance. And he doesn’t need glasses, so what would be the purpose of vision insurance? </p>
<p>“No, they didn’t find anything. We called the insurance co and dr office a few times. Neither office expected that it would be completely covered. Another CC poster sent me a message mentioning that after age 50 she thought it was free. Doesn’t seem to be the case for us. Maybe this is true in another state. I don’t know. I thought it would have been fully covered as well but my insurance co sure didn’t think so. Sigh. We have AmeriHealth.”</p>
<p>Bookreader, here is the law regarding colonoscopy screening. </p>
<p>@bookreader If you have a grandfathered plan it would not be required to comply with the ACA. Or maybe the charges were for the facility or anesthesia? I am going to have to figure these things out also as my primary care doc wants me to get a colonoscopy. </p>
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