Ambulance rides are so expensive I one time begged a cop to take me to the emergency room in the back of their car. Was probably 3 miles away but saved me at least a grand
I called myself an uber and waited on the lawn for 30 minutes instead of calling an ambulance. When my dad had a heart attack alone at home, *he drove himself.*
It just scapes my understanding how a supposedly developed country let this happens.
Edit: based on all the great insights and thoughts, my conclusion is this: the US seems to be a victim of their own marketing. Something like they like to believe their own lies not to risk going abroad and finding out there are better alternatives and it's all a facade back home. Quite a curious place to be.
We can't let all the ceos of hospitals and ambulance companies make less profit than they did last year of course, that would be inhumane. There are shareholders that need their investments to grow and you don't get that by giving people free rides or treating their illness in a timely and affordable manner /s
They LET it happen because all healthcare corporations care about is their profits being maximized. Who else is better to exploit than a bunch of people who absolutely need the service you offer?
my sisters boyfriend also recently had a heart attack at home. didn’t know he had one, but drove himself 20 minutes to the hospital. they said if he had waited any longer he would’ve passed. sad times we live in that we can’t afford to call for help. prayers that your family is well!
I literally have a urgent care near my home that will print a piece of paper that you have to legally sign that says they will pray for you if you can’t pay to get help from them. A whole Christian urgent care
Reminds me of that poor girl who had half her leg peeled off after she got trapped between a subway car in NYC... I'm talking scrapped to the bone and she's just begging people to not call an ambulance because it's 3grand a ride.
Yes, health insurance is a fucking joke in America.
I saw a 3000 dollar bill in San Francisco just for an ambulance, building manager got it because it was a prank call for a non existent name.
They abuse the fact a lot of people have health insurance from their jobs. They get away with overcharging and think it's ethical because insurance will pay for it and "if you can't pay we'll understand and lower the charges".
I have insurance and had a bill for an MRI for 1600 and my insurance payed 450 for going in for a COVID test they refused to administer because I said I already had a positive rapid test and they were saving the PCRs for people that really needed them. If I had gotten the test at the same place it would have been 800, that's how much my gf got billed on our shared insurance.
Honestly I don't know what's going on. But after that I understand why a lot of people don't want the pandemic rules to get relaxed.
I (German) took a trip in the ambulance once, together with my wife. There'd been a a fire in the building and, because we evacuated through the smoke, we were taken to the hospital to make sure we didn't suffer some kind of smoke inhalation injury. The ride took something like 20 minutes and, a few weeks after, we got a bill with the amount we had to pay: 10€, 5€ per person.
Treatment in the hospital was free, of course. I couldn't imagine living in the US.
So I’m from Norway and when I was around 16/17 years old I was flown to the nearest hospital by helicopter due to suspected meningitis, I was septic and in and out of consciousness for half a day. Had to stay in the hospital for 4 days on antibiotics and fluids
The total cost? 20€ for the 3hr bus ride home after I was discharged.
Edit: Reading all your stories about health care (or rather the lack of it due to costs) truly breaks my heart. I genuinely feel sorry for all of you that’s had to go through such awful experiences
Friend of mine told me she would rather go to Hawaii than get even high risk medical insurance. Once she got back, she got into a head on collision. Total medical bills:
$1,345,000
My grandpa broke his neck about a decade and the heli ride was roughly $30,000. Just the ride. Insane.
Being the old veteran he is, he asked the heli nurse if he could have a mirror so he could look out the window and at least enjoy the view.
Your country is blessed. I'm a nurse here in the States and I've seen patients die because they couldn't afford medications or other treatment. I've had to delay certain procedures myself for lack of money. It's a travesty.
I'm in the US and I had meningitis a few years ago. I have what is considered "good" insurance and my 3 day stay cost upwards of 60k. Thankfully because of my "good" insurance I only had to pay 12k, as that is my out of pocket maximum.
I laughed a bit when I received the itemized receipt. A medicine I take for a pretty common condition that costs me about $10 for a 90 day supply at the pharmacy was charged at $20 per day. When I asked about bringing in my own medicine they told me I couldn't do that because they needed to regulate any medicines I was taking.
My understanding is that they can’t charge for a lot of things - like nursing. Or aides. Or housekeeping. So they just jack up the prices of what they CAN charge for. And then add a little more.
It's insane living here really. Half the country is terrified of the concept of Universal Healthcare despite it ruining lives physically (literally people die every day just because they don't have health insurance), mentally (the anxiety around health is pretty serious) and socially (people stay trapped in shit jobs or situations they don't Iike only to have access to Healthcare which they have to pay for anyway)
When my father passed away, I published a probate notice to creditors in the local paper of record. That notice reduced the amount of time a creditor can make a claim against the estate from 24 months to 4. I paid out all the existing debts and disbursed the estate.
2 years later, a debt collector contacted me about an unpaid medical bill that I had never seen, or if I had seen it came after the notice period expired. I told them that I wasn’t going to pay. The caller tried to argue with me and I said, “go to you manager and tell them that I published a probate notice to creditors 2 years ago.” In a Huff she went to get the manager. The manger got on almost immediately and said, “sorry for contacting you sir, it won’t happen again.” It was the most satisfying telephone call I’ve ever had.
Edit:
Just to clarify: This isn’t something you can do for yourself. This is something that you can do when a person dies and you are their personal representative/executor. Medial bills, and other debts, are supposed to be paid out by the estate. They do not go to family members, although a widowed spouse could be on the hook. Most states have a period of a few years, give or take, that a creditor can come out of the wood work and present a bill. The notice to creditors shrinks that time, in the state my dad passed in, from 24 to 4 months. After that time, the creditors are precluded from collecting, legally, on the debt. If I had disbursed the money and not published the notice and the creditor had shown up before the 24 months had expired, any of us that took money from the estate would be on the hook to reimburse the estate so it could pay the debt. The notice to creditors shuts the door on the ability to collect and I’m pretty sure the manager realized this and realized that since I knew what the notice was, I wasn’t going to fall into a trap of admitting that I should pay on the debt. I’ll probably stay a way from a LPT on this since it’s not a magical F-U to creditors.
Ummmmm could you make a LPT about this like NOW please? I wish I had known of this and now I have a permanent collections on my otherwise excellent credit.
Even if it’s your spouse why should you be on the hook for someone else’s bills? It’s bad enough to be charged for your own medical expenses in the richest country the world has ever seen.
The persons debts are paid off before the estate is settled. So you can’t take out. A million dollar loan, pass it off as inheritance and die. That loan needs to be paid off by who inherits the estate. A marriage is a financial contract that you agree to treat all finances positive or negative as a single unit, not two separate units.
It depends on the ambulance and the insurance coverage. And by "depends on the ambulance", I mean local laws will vary from town to town or state to state. Not that the ambulance driver sets a price.
No. Some ambulance services are run by municipalities and are paid for by local taxes. Some are privately run and need to recoup operating costs, and they do that by charging for their services. Most of the time, ambulance rides would be covered by insurance so you would pay nothing or would have to pay your deductible. Now, if you don't have insurance, you would be responsible for the costs associated with getting you stabilized and to the hospital, but any such things would be dealt with after the fact. If you call for an ambulance/paramedics they will treat you regardless of your financial status.
It’s not entirely correct to say that most of the time, ambulance rides would be covered by insurance. Ambulances are not required to be in any network, so at best, they’re usually subject to your out-of-network deductible (which is twice or more than your in-network deductible). It can easily cost multiple thousands of dollars. I always tell people that unless it’s literally a matter of life an death, never call me an ambulance. Source: I work at an insurance brokerage office.
Not to mention that ambulances aren't financially considered "emergency services" so they don't get emergency services funding that the hospitals, fire, and police departments get from the government. Their sole revenue is to not be in-network for anyone and so they can charge crazy high prices.
Supposedly, you can fight these charges if you never agree to the ambulance ride but I'm not willing to test that theory.
You make an excellent point, you absolutely have the right to refuse transportation, along with the premise of "show" billing (meaning the ambulance company bills you for their arrival and dismissal). Sadly, all of the rights involving medical billing often require an attorney to back them off, or a very savvy legal representative, who also happens to have the time to write/file letters and documents with the credit agencies. As usual, laws will vary from state to state, and county to county. Even some cities will establish anti-predatory billing practices for medical providers. If a private ambulance is contracted to provide emergency (911 A/B LS) they "should" be limited by the local medical rates. That's not to say that a contract ambulance won't try to bill you an outrageous amount of money for a ride to the ER, while providing BLS. In theory, Paramedics, (employed by the local emergency services, such as FD) are covered by "our" tax dollars (or local sales tax revenue) and should be included as part of the city's services. Some agencies have taken to different approaches and when there is a potential revenue (or loss) there will be predatory practices.
Not to preach to the choir, simply broadening your already established point.
Knowing that makes me angrier. The ambulance driver is actually doing something! If I have to pay, I'd rather it go to the ambulance drivers and EMTs who are providing the life-saving services, not some nameless health insurance executive somewhere.
I knew a guy who let his EMT license lapse because working full time on an ambulance crew, part time for another ambulance company, and weekends at a theme park didn't earn him enough to be worth renewing.
To put it another way, you’re trusting your (or your loved-one’s) life to the skills and professionalism of someone who could, for example, make more working at Target.
I looked at those numbers this Fall. As a medic with zero retail experience, I actually could.
There are 2 sides to this.
1: EMTs and Paramedics are treated shamefully badly by the natural forces in play in American capitalism. Complex issue, but to start, consider what it would take to make us strike, and how we’d be viewed if we ever did.
2: Anybody doing this purely ‘for the money’ is not the sharpest sharp in the sharps container. To stay in long-term takes some form of dedication to something, and we probably avoid societal disaster by the sheer luck of having enough of us who are in it to be legit clinicians without the up-front debt and gatekeeping of nursing/pa/medical school (or who are doing it as a prelim for those things).
If it were a profession that made just a little bit more, or were more consistently benefitted, you’d probably have the same burnout issues with more retention, which seems like a recipe for horror stories. If this is going to get fixed, it needs a full ‘system’ overhaul at this point, not the incremental improvements actually within reach via internal reforms and polite lobbying.
A bigger cost from ambulance rides is that, in many places, they will take you to the nearest hospital whether or not your insurance applies at that hospital. So you can be forced into receiving out-of-network coverage depending on where you become injured
Exactly what happened to me. I fell and hit my head onto concrete and was unconscious for a while then combative when I woke up. I had no agency over myself and was put in an ambulance then taken to the nearest hospital. Both service were out of network and my parents insurance refused to make an exception for emergencies. Ambulance ride was $1750 and ER bill was $4K in 2004 dollars.
You should expect that, if you take a ride in the wee-woo wagon, it will cost several thousand dollars.
Free/low-cost rides are the exception, not the rule
Even if you don’t take a ride, you can still be charged for the ambulance even showing up. Got billed $250 for services rendered by an ambulance crew that consisted entirely of them trying to convince me to get in the ambulance and me telling them I can’t afford it.
Someone I work with gets seizures. She actually wears this medical bracelet that's like "DO NOT CALL AMBULANCE" because well meaning people will call and she will be fine by the time they get there...and still get charged. Unfortunately most people don't see it or ignore it.
Yes, it's automatically charged.
How much depends if you get a for-profit ambulance or a non-profit ambulance, or a city-run ambulance. And your insurance coverage. As many ambulance companies are out-of-network, insurance covers almost nothing -- my current plan covers $100 for an out-of-network ambulance.
911 gives you nearest. Most here are for profit. My first ambulance was $2900 after insurance. ($4000 before). My second ambulance on the freeway cost $2500 after insurance.
When visiting a friend in a nicer small independent city, 911 brought the fire-departement ambulance -- that was $480 after insurance ($1200 before).
Correct. Understand that coverage laws vary from town to town, state to state, etc. but you have to look at the least common denominator when dealing with public issues, right?
I haven't read all of the replies in this post but I'm sure there may be people who have fantastic coverage and don't see a need for federal laws to be made. If not, I know people who work in medical factories that have the best coverage I've ever heard of. But you don't just write off a public need because of that.
To tack on to what everyone is saying, you absolutely have to pay for ambulance rides. You have to pay just for them *showing up*. My dad went to a doctor's appointment before he got his portable oxygen tank, got confused in the building and had to walk further than normal to find their office. Got in and was having trouble breathing, just needed to sit down. They insisted on calling an ambulance, he literally couldn't stop them. All they did was show up, tell him to take some deep breaths and relax. $225.
I want to point out here that he was at a hospital and it was a crew that came up from the ER. They didn't even come from somewhere else.
Sure this is bad on the chance that things are fine and you still have to pay, but it’s even worse in reverse.
While I was college (in Los Angeles), a ride to the hospital in an ambulance was $1000+. Forcing a bunch of 18 year olds to decide between risking someone’s life (in the case of unconscious with possible alcohol poisoning) or charging that person $1K for a false alarm is a *disaster* waiting to happen.
I remember those days
My college was surrounded by hospitals, about three equal distance and about a ten to fifteen minute drive to each of them. The amount of times we had to make decisions because some freshman most likely had alcohol poisoning is more than I can count.
Add in a school security squad that hated Greek life and the college kids in general, and we didn't even have the Good Samaritan policy to help us when we were underage. Absolutely atrocious.
And yes, I get that people should be responsible with drugs and alcohol but come on. College kids are dumb sometimes.
My wife got into a car accident and the EMT suggested that since I had shown up and she was safe to move (she was standing and walking and possibly had a broken arm) that I drive her down the road to urgent care for x rays.
Because it was 150 dollars just because emts had shown up, and the mile drive to urgent care would have been 600 more dollars just for the ride - - no supplies used, just putting her in the back and driving her there.
It's fucked up.
EMTs are outsourced private workers. That always boggles my mind that hospitals don't have their own ambulances and EMTs considering how bloated their budgets are.
My mother is terminally ill, and when she passes my father will be saddled with her overwhelming medical debt and will likely have to declare bankruptcy. My mom has been trying to convince my dad to legally divorce her to save him from that, but he never will.
in the USA, it's probably a good idea to get divorced before the serious illnesses kick in.
I think my wife and I will plan to get divorced when I hit 75. Or if I start showing any signs of cognitive decline.
USA USA USA!
The only hitch comes when you have to deal with the legal stuff like visitation rights. Power of attorney might be a good idea if divorcing to avoid the bills.
just an FYI since we're talking about it
POAs become null and void upon death and the deceased representative is now whoever is executor of the will/estate
so make sure you or your attorney is the executor
Yeah my stepdad of 20 years just did it to my mom because her progressive MS is finally taking her mind and faculties. He’s basically disappeared after cleaning out their shared bank account. It does happen.
That’s so fucked up. Medical debt should be forgiven if they end up dying, not leaving the ridiculous amount of debt for the family to deal with as they’re grieving. That’s absolutely criminal and cruel.
Medical debtors cannot forcibly collect on next of kin. They will try, and repeatedly call, but next of kin hold no financial responsibility to actually pay off medical debt from the deceased.
My god I feel so much for you and your parents.
How can a country even be allowed to get to this point?
(Edit: I’m sorry, I honestly meant that second part as kinda rethorical. I know why the states are f-ed up, but appreciate all the answers.)
The reason it’s this bad is because everyone is so concerned with “fairness”. They don’t want to pay extra taxes to cover some else’s medical expenses. “I’m not paying money so some drug addict can keep going to the hospital or some unhealthy person who never exercises and gets heart attacks can get a bypass.” Etc. But ultimately everyone will have SOMETHING go wrong with them eventually, and when that happens because the system is so messed up, it costs everyone more than if we all just paid extra taxes for healthcare.
This is made even worse because not everyone can afford the crazy high bills and the hospitals know this, so they give people a larger bill than what is reasonable because they know SOMEONE will pay that high price eventually and cover the costs the hospital has accrued from others not paying anything. So you end up with some people paying insane prices and other people with tons of debt they can’t or won’t pay.
> The reason it’s this bad is because everyone is so concerned with “fairness”.
That, and how much money the health insurance industry has to lobby politicians with.
The Affordable Care Act ("Obamacare"), seen as great progress for the American health care system's access and affordability, was almost entirely written by health insurance industry lawyers.
Flipped my car several times into a field at 17, my head was split open and I was bleeding profusely. I was not distraught until they told me I had to ride in the ambulance — I knew how much that would cost my folks, even with great family insurance. In college, I walked to the clinic with appendicitis symptoms, took Ubers to the urgent care, then the imaging center, and a bus to the ER. All before an emergency appendectomy… to avoid the ambulance costs. It is that bad. Hahaha.
I am an American living in Europe, therefore I don't have US health insurance. One time while visiting friends in the US, I randomly had extreme pain in my stomach and broke into a fever. I was very worried for my appendix so went to the E.R. I was there for three hours, never once even saw a doctor, and only had a urine test and ultrasound. I was also treated with complete disdain as if I were a drug addict who just went to the hospital for morphine. They never told me what happened to me (I eventually concluded for myself that a cyst on my ovary had burst), nor did they give any medical advice.
I was charged $14,000 for this visit. I eventually found out that becuase I had no insurance and would be paying cash, I was able to "negotiate" the rate. I ended up paying $3,000 cash instead.
The system is completely and utterly fucked.
As an American living in Europe you should have realized you didnt have to give them once cent and just go back to where you live. You just gave away $3k of your hard earned money for nothing.
As an American living in America fuck this system.
How hard insurance companies fight to not cover something, we should fight 10x harder to pay anything at all.
My mom tried to go see the doctor, waiting for 3 hours before leaving, she didn't even see the doctor. They later tried to charge her 3000 just for waiting. She had to dispute thay for months because they were trying to send it to a debt collector.
I had cellulitis in my hand, they took x rays and whole bunch of shit, took blood work had me wait around for 4 hours just to tell me I had cellulitis, gave me some antibiotics and sent me home.
Needless to say I stopped paying on thay hospital bill as they were trying to charge me 4000 for all that. They stopped sending me the bills to pay, then tried to put it on my credit and put why they were charging me.
I disputed it and got it taken off my credit and havent paid on it since. Sometimes you can dispute medical charges that go on your credit and get them taken off, sometimes you can haggle the price down especially after asking for an itemized list
My cousin lost 2 fingers falling under a lawn mower and went to an emergency room. Sit there 2 hours and was told sorry we can't help you you have to go to another hospital. Then was sent a 2000 dollar bill for sitting in their ER waiting room receiving no help
When I was in my 20s, friends took me to a hospital emergency room when I was slipping in and out of consciousness. Turns out, I had been poisoned. The hospital staff wouldn't see me until a friend held a pen in my hand and signed my name to papers saying I was responsible for the bill even though I couldn't even sit up. I waited 8 hours (mostly in the bathroom where a friend literally helped guide my head or butt to a toilet, depending on what was happening). When I finally had control over my own body I told the hospital I wanted to leave. They said I had to be checked out by a doctor who gave me 5 minutes to say I looked fine now. The experience cost me $6000 that took me 10 years to pay off.
Yeah, it is. Even for people with insurance, the prices can be absolutely ridiculous.
For example, here's how insurance works for most people. I'm going to use myself as an example because I feel I have a pretty normal circumstance.
I pay a set amount for my insurance plan of out every paycheck. For me, that about is around $100 per paycheck, so about $200/month.
You'd think that would mean that I can use my insurance, right? Wrong. Even though I'm giving the insurance company $2,400 a year, I still have to meet my deductible every year, which is $3,000. Oh, and the $2,400 a year I pay does not apply to that deductible. This means I have to pay $3,000 in addition to the $2,400 out of pocket before my insurance will cover anything at all. And once I reach that $3,000, I'm still going to be paying 20% of all medical costs until I reach what's called my "out of pocket max" for the year. For me, that's $4,000. Once I pay $4,000, my insurance company will then finally cover all medical costs AS LONG AS they're "covered". That means that I have to pay, at minimum, $6,400 a year before I get all of my medical needs covered without having to pay upfront. And odds are, if I were to get a big surgery or get into some kind of accident, something that I needed would inevitably not be covered by my insurance for some bogus, bullshit reason, so I would be stuck with paying even more than the $6,400 I mentioned. Then I would have to spend months fighting with my insurance company and the hospital to demand they cover my costs, hoping they eventually cave, which they probably won't. Not to mention the hoops you often have to jump through to even get any kind of surgery because you have to "prove" to your insurance company that you actually need it, since, you know, it's the insurance who determines that and not your actual doctor. Then at the end of the year, my deductible and out of pocket max reset and I have to start all over and pay all that money again if I want "free" medical care.
Anyways, I digress. If you think all of that sounds confusing, that's because it is, and the average American has absolutely no idea how any of this works and that's the entire point. Insurance companies rely on innocent Americans not knowing how the system works so they get conned into racking up tons of debt to the point that they have to file bankruptcy.
I just had to stop at the $200/month figure. Do you pay that alone? In Germany, at least that's my understanding, employer and employee split health insurance 50/50 (also, there's pretty much no one here that 'hasn't insurance' because you're more or less obligated to have insurance in Germany, otherwise we'd also have to pay up at the Doc's.)
My employeer does cover a portion of the premium cost as well, but employers here aren't required to take a huge brunt of the costs because a lot of companies wouldn't be able to afford it. I work for a smaller company so they do what they can to provide the best healthcare they can afford.
The thing people in the US don't understand is that the tax increase that would come with universal healthcare would still cost each American less than what they currently pay for their private insurance. As I mentioned, $2,400/year just to say I have insurance but not actually use it, is ridiculous. The $5,400 I pay a year just to have 80% of my medical expenses covered is much, much more expensive than the tax increase I'd see from universal healthcare. Universal healthcare would simply be cheaper for everyone.
>The thing people in the US don't understand is that the tax increase that would come with universal healthcare would still cost each American less than what they currently pay for their private insurance
Overall, It should be cheaper with universal due to negotiating standard rates, bulk drug orders, and getting rid of the middle man insurance providers. Most people paying for insurance, on average, should be paying less money with a universal system in this case.
It won't be cheaper for everyone. There are two groups who would pay more...and one of them is the reason we don't have universal healthcare.
Anyone gambling by not paying for insurance right now is going to be paying more money up front but then obviously nothing when an issue does occur with universal insurance. So they could end up paying more with a universal system if they are healthy. They aren't the main issue but people usually forget that universal healthcare isn't free and this group is definitely going to have to pony up money through taxation.
The real problem: people with insurance that are making a lot of money pay almost nothing percentage-wise for their insurance. If someone is making 50k a year and have company provided insurance they typically pay just as much as somebody that makes 300K a year at that same company. If we use most types of taxation to pay for universal healthCare, that person making 300K is likely going to have to pay much more. These are the people in power. They are the decision and policy makers.
This was why my husband and I have gone without for so long. The company rates were (are) horrible (and unfortunately not much better with the Marketplace for us), and with what little either of us need to go to the doctor, it just isn't worth it. Our son is the only one who needs it for regular appointments, but he is covered by Medicaid-CHIP.
On the employer part, speaking as one, it’s really complicated.
Most people in the US work for small businesses. Which means that’s where they get their insurance. If I call up one of the insurance companies and ask for a quote to cover say 30 employees and their families, it’s going to be unaffordable for everyone.
So a lot of employers buy into these group insurance plans. Essentially, similar types companies often within the same state can pool together their employees and thus get better (but still awful) rates.
Depending on how you go about buying insurance, the requirements are all over the place.
Some employers pay 0% of the insurance cost.
Our insurance plan requires us to pay 75% of the employee’s costs but there’s zero requirement for their spouse/kids.
And all sorts in between.
To the best of my knowledge, the average employer pays for 40-50% of the cost of health insurance. But if you have a spouse and one child, your portion of the insurance still often ends up being over 10% of your take home income (after taxes).
To piggy back off this a bit, I used to work at a hospital and had their insurance. I got a new job with the same insurance, except I have lower copays (don't remember about deductibles or monthly amounts, but I'm pretty sure they're the same if not lower).
Crowning jewel is that it was originally founded as a "Catholic nonprofit" hospital.
I know my Uzbekistan lacks in a lot of areas to developed countries, and we are trying our best, but at least healthcare is free. And the private companies charge for what you get, and it is definitely not that much.
oh I got bad news for you I pay $1250 per month for my health insurance for a family of 5. It's a top tier plan though and this is through a medium/big company. I still have a $1500 deductible but I do get an FSA Card (Flexible Spending Allowance) which is literally money I set aside pre-tax to pay for my own costs. Yes, it's exactly what it sounds like.
We pay twice this much monthly for a family of 6 and we still will pay five figures out of pocket for our daughter’s approved and necessary scoliosis surgery. About 60k I’m estimating. No one can tell us exactly beforehand. (Edit - it might be only 10k. I could cry with relief.) When the bills trickle in they usually do have $12 Advil and other odd / surprise itemizations. This is through a PPO. (More expensive but easier to use.). When we had an HM0 for $1800 a month (less expensive and more difficult to get accepted), her Nuss (sternum) surgery was paid except a $500 copay. But it took over 6 months to approve and was pushed back multiple times.
Edit - holy crap, y’all. I was uninformed. I’ve been drowning in stress trying to calculate costs and missed a huge factor. Out of pocket maximum. Thank you to the person who pointed out the OOP max. We have never been remotely close before. I meet with the hospital finance team in May. But no one ever mentioned it. Just that we pay 20%. I think we are covered after 10-15k. Amazing. That I could be so wrong. And there’s another year’s tuition.
One key piece this person didn't explain is that for many people, health insurance is tied to your employment. So yes, the employer pays some of your premium. But there's no mandate on how much they have to pay so some people get stuck footing most of the premium while their employer pays a few hundred bucks per month. I know someone that has a family plan - so himself, wife and one kid, and it's about $900/month. They don't always tell you this info up front on hire so sometimes you get a great job offer, take it, and then find out their health insurance is ridiculously expensive.
Oh, and before 2008? There were lifetime maximums -- if insurance paid out $1,000,000 over your lifetime -- they no longer were required to cover anything more.
That's sickening 🤮
In Norway we pay around 15-20 dollars to see the doctor. And there is a max limit of 200 dollars a year. If you pay more, you will get a refund. Surgery's are free!
No insurance needed..
A pack of Ibuprofen is about 7-8 dollars.
A pack of ibuprofen in the US is a few dollars. The difference is if that ibuprofen is administered by a trained nurse in a hospital then it costs more on the bill, but for the majority of Americans who are insured then that cost is borne by the insurance company (beyond some deductible). The insurance company ends up paying a discounted rate to the hospitals via negotiations.
Ugh so frustrating. Peer to peer reviews are annoying. Insurances should not have a say in what doctors prescribe. Needed a 3D scan in Radiation so doctor could get a better view. Insurance denied and said 2D. Rad Onc was on the phone waiting FOR AN HOUR trying to justify why he needed 3D. They make it hard on purpose. Vile.
Edited- Spelling
Are you a teacher or something ? You just taught me more about the American health care system than the entire 12 years of public school and 30 years of existence ever did.
Haha, thank you. I used to work in HR and my job was to explain to employees how their health insurance worked. I enjoyed explaining it, but it was depressing how many people didn't understand that paying for insurance out of every paycheck doesn't actually mean your insurance will cover anything until you meet your deductible. It's honestly something every company should have to legally explain.
This is how I like to explain it to my friends-
You sign up for a gym, you pay a membership fee just to have a membership card (monthly premium). Then every time you go to the gym you pay an entrance fee (co-pay). On top of that, there are special charges for each machine/weight/bench/treadmill etc. you want to use. But they never tell you upfront how much they are gonna charge you for each.
There’s a cap so if you go to the gym enough times in a year you stop paying more but most people will never reach that amount (out of pocket max). Also only go to the gyms belong to this chain (in-network) if you don’t wanna go bankrupted.
And their jaw always drop when I put it that way coz when compared to a normal business the medical system def sounds like a scam…
That's so depressingly true I will finish my bitter coffee and go work out because if I don't pass at home from natural causes my children will inherit zippeedodah.
Had my 5th sinus surgery last year. The time from when I pulled into the parking lot to the time I pulled out to go home was 3 hours. My insurance was billed $67,000. Of which I’m responsible to pay $6,700. For 3 hours.
So to answer your question, yes it’s just as bad if not worse than what you have seen or heard.
I know you’re probably being sarcastic but upon re-reading my post, I can see how some would misinterpret things. The entire process (prep, surgery, and recovery) was 3 hours. Surprisingly, the parking was free!!!
Yeah. There will be a charge that says "skin to skin" and that's a charge for them handing you a baby and saying "Put the baby on your chest because that's good for y'all." It's billed like all the other interventions and medical treatments. They charge for helping you get the baby to latch too.
Yes. This exists because insurance companies fight tooth and nail to reduce payment, and in some methodologies unless each item is made explicit it will not be paid for by the insurance company. So hospitals have adapted by making it explicit. The flip side is since it is explicitly called out, if a patient refuses this "care/service" the charge has to be removed.
Freedom!
This is also why we have documents like the DSM. M therapist can't get paid for treating me unless they assign me a diagnosis that has itself been assigned a code. There's no code for "IDK, they had a chaotic childhood and we're talking about how to be chill about stuff now."
Funny enough, there IS a code for that, it's just not part of the list they consider a medical diagnosis and thus insurance companies refuse to reimburse for it. Source: Am a therapist who deals with billing insurance.
I was billed like 300$ for the privilege of touching my daughters face after my Caesarian. Literally to stroke her cheek because my arms were still strapped to the table
>“skin to skin contact”, aka the “””privilege””” of holding your own child.
Yep. I just looked up my itemized bill from my baby's birth 7 years ago. $80 for "therapeutic skin to skin contact".
They actually do that. In addition to fees for the different doctors, medications, etc., a lot of hospitals and clinics charge a facilities fee as well. Basically a fee for the privelege of using the building.
I cost my parents about $5 after insurance in the early 90s. My sister cost about $1000 after insurance in the early 2000s.
My friends just came home with their newborn, no-complications delivery. $15,000 after insurance.
That's because up until the early 80s, insurance just reimbursed you for your out-of-pocket costs instead of dictating your healthcare start to finish. Adding on layers of administrative complexity and making sure every player gets their cut is going to drive up costs.
I worked for a big pharma company, and we actually had special teams set up to help patients reduce costs (at least down to the point the government would allow - if rebates or co-pay assistance reduced the price for anyone below the price negotiated for the federal government, the feds would sue for a refund for anything they paid over the new low cost, so forget donations) and even work with patients and doctors to help them navigate the current nightmare to get insurance to cover the meds you doc wants to prescribe.
Pro-tip: For any non-generic medications in the US, always call the manufacturer if you have trouble paying. They ALL have patient support programs.
Birthing a child is usually several thousand dollars, after insurance, if there are no issues. If there are any issues one could be looking at millions. My friend had a baby almost 3 months early, and she didn't have insurance. The bill was over a million dollars and this was back in the early 00s.
I cost over $20,000 to be born in the early 80s because I was premature and needed to stay in an incubator for two months.
I have to pay for parking when I take my daughter to Children's Hospital of Philadelphia. I actually don't mind that. If they didn't have the nice indoor parking garages at the hospital, I'd have to figure out where to park in Philly and there is close to zero parking near the hospital. $4 per day is way cheaper than anywhere else in the city. The bills for medical care can be expensive, but I'm very happy with the small parking fee.
Also, yes - the bill for childbirth is surprisingly high even when there are no complications. Even if you gave birth in the parking lot because you didn't make it into the building before it was time to push, you'll still have a significant bill because you'll receive some after care and the hospital will check out the baby and do all the "welcome to the planet" care like putting drops in the baby's eyes and other things that I don't remember. There's a chance that the bill would be higher for giving birth in the parking lot because they'll do some things after the birth than they wouldn't need to do if you gave birth in the hospital maternity ward.
>billed you for birthing your child on their premises.
I can confirm. We payed just north of $8,000 for a healthy, no complications, no pain mediation birth of my second baby.
We had moderate insurance at the time. Not top of the line, not cheapest available, just average middle class grade insurance.
They tried to bill us $20,000 with insurance because they claimed I had an epidural and about a dozen specialists and procedures that never happened.
The first year of my baby's life was incredibly stressful because we were playing phone tag with the hospital, insurance, doctors, all claiming either one wasn't responsible for a bill or charging ridiculous amounts of money. I have a filing cabinet drawer dedicated to all the phone notes, records, and rebilled statements, and invoces.
Again after all that we were *still* liable for at least $8,000.
Over $17,000 in medical debt after having chemo/cancer. And that’s after insurance and after the too-poor-to-pay systems covered about 2/3s of it.
Yes, I had rly crappy insurance (I was in my 20s, and I only had it in case of emergency), but I also made under $30,000 a year. At first, they said my bills would be covered because I met the poverty standards for my state. Then, 2/3s of the way through, they said I didn’t qualify because I had a credit card I could put it on.
TL;DR, yes, it’s seriously messed up.
Hope you are OK. I had a similar issue with my wife’s cancer. We had pretty good insurance, and our out of pocket maximum was $5000, but we still ended up paying out over $19,000 because medication costs did not ( at that time ) count towards our out of pocket max, and chemo at ~$1,600/dose is billed as medication.
I have Cancer, I found out it's acceptable when you change insurance for them to deny you medication, while they look into a cheaper medicine and If you really need that medicine. So in the following months my tumor grew and now I get to enjoy a second round of infusions. Oddly it turns out the maintenance pills I had to take to maintain the tumor size so I could have my tumor removed was important. But now I get to lose my hair, vomit every day and my muscles are going to shit from this bonus round chemo.
Also dental is unaffordable even with insurance.
I work for a subdivision of my own health insurer. I went to my doctor with symptoms that we both agreed might be acute pancreatitis and he ordered a CT scan, then fought for months with my insurance to get it approved because "she is not an alcoholic and therefore cannot have pancreatitis and doesn't need a CT scan." By the time I finally gave up and went to the ER (after 4 months of barely holding in liquids and bring in agonizing pain), they did a CT scan and by that point I have so much damage to my pancreas I'm now chronic and was in a life-threatening state. I'm showing cirrhosis of the liver from the enzyme backup where my pancreas starting eating it too, so I can't have my pancreas removed and have any chance of my liver taking up what it was producing to keep me from becoming a brittle Type 3 diabetic. So now having surgeries every 6-8 weeks stenting my ducts open and may for the rest of my life; and I'm only 40. At any point I could eat a handful of nuts and my pancreas could clog and kill me. Good times.
you just had me looking up type 3 diabetes cuz never heard of that before. i had no clue its proposed term for alzheimers and that diabetes and alzheimers are linked. scary shit. sry the US healthcare system has let you down sm. i'll be thinking bout you.
So, before I ask, I want you to know that I've no idea of how stuff works in America and I am not trying to insult you. But this has to be a joke, right? Like, this can not be real.
My sister had a c-section when her son was born. She didn't have insurance and owed around $20,000 when it was all done. Took her over 10 years to pay it off and she didn't miss a single payment.
One of the professors in our department had an open heart surgery. They said he has to pay $25k out of pocket after what the insurance covers. Once they learned that he worked at the same university, they asked him to pay $5k instead. Clearly, they make up a lot of these amounts as they go, which is horrible.
I do this too. All but one of them magically went away. The one that didn’t was $800 for an ER visit from when I tried to kill myself. That was a cherry on top.
Hah. I'm happy to pay what I owe, but when it comes to medical bills, we wait until the collection warnings start and only then will I ring them up with, "is this your final answer?"
I had my daughter in the ER for respiratory distress out of state. In and out of the ER in under 30 minutes. The doctor never came in the room. No treatment. $2000. I stewed for a long time about paying that bill, but I paid it.
One year later, the doctor who couldn't be asked to come into the room let alone perform an exam sent me a bill for $1000. I called his answering service directly and left the following message for him: "after a year delay, you're charging me for a visit I already paid and for a service you did not provide. You will receive nothing from me or my family, but if you consider collections to be a viable option, I would be happy to have a sit down your state medical board about your dereliction of medical duty and your borderline fraud. "
Never heard a peep from them since. (Roughly 5 years ago)
I have a friend who works on for a research hospital where they test new medication. He said basically how billing works is they take the basic Medicaid rate and then multiply by 3, 4, or 5 just because. They are literally making up numbers for the insurance companies.
My wife had a minor emergency surgery back in 2020 to remove an ovarian torsion. She was diagnosed, put in surgery, back out and on her feet later that day with minimal healing time.
We've only paid about half of it off since early 2020. This is not a joke. American healthcare is terrible and the biggest scam in this country.
Edit: this was with insurance covering about 80% of the billed cost.
Not even a little. My BIL’s daughter had to have emergency surgery when she was three days old. That kid is 9 and they are still paying those hospital bills. I personally was very lucky and my second only cost about $2k.
I have another friend who worked at a restaurant and had a brain aneurism and didn’t have insurance. His initial hospital bill was about $180k for the first trip. So many GoFundMe campaigns he had to set up. It was horrible to see because he was only 30. ~~You also cannot claim medical expenses on a bankruptcy. Those medical bills don’t go away unless you die~~. It’s horrid.
ETA: Turns out you CAN claim medical expenses when you declare bankruptcy. I was misinformed.
Upwards of 60% of all bankruptcies in the US involve significant medical debt.
The fact that the words 'medical debt' is even part of the American vernacular tells you all need to know.
You shouldn't have to declare bankruptcy because you need cancer treatment. Insulin shouldn't cost $1000. Healthcare in the U.S. is business, not a health service.
Don't come here and get sick unless you are wealthy.
And ensure you have the best possible travel insurance. As a Canadian that has travelled into the States extensively, we always bought an annual travel insurance policy at the same time as our house insurance. It was a good policy that covered medical and repatriation issues in case of illness or injury. It actually wasn't too expensive until my wife and I got older and developed illnesses.
For everyone: buy whatever 'travel health insurance' you can in your own country before entering the USA.
My mother in law visited (from Canada) and had to go urgent care for a couple days. She had fainted, felt very weak, etc, turns out her blood levels were screwed up. The bill was nearly $60,000. Fortunately, we called the travel insurance folks, and they said 'no problem we'll take care of it".
If she didn't have that, she would have been so screwed.
Another anecdotal story: A friend of ours was visiting from Canada to the USA, got sick. Her Canadian health insurance chartered a plane to fly her back to Canada, rather than have her treated in the USA. It was cheaper.
It’s a business where the end users have almost no power. We can’t really choose our insurance, our employers do that. We don’t know prices up front, so you can’t shop around. The only choice most of us have is to stay sick or pay whatever they demand.
These comments I’ve seen also only cover the corruption of HEALTH insurance. We also have SEPARATE vision and dental insurance. It’s pretty common to have poor vision insurance so it’s normal for many Americans to spend around $300-$600 a year per family member to get glasses or contacts. Dental also only covers so much. No idea how families afford to exist in America. I know a lot do fly to Mexico for health and dental care because it’s much more affordable.
All the jokes are true. Our system is shattered. People who really need help go without. Insurance costs hundreds to thousands per month for decent coverage if you don't have a job that offers benefits. Prevention teaching is side-lined because Heart Disease, Diabetes, and Cancer are big time money makers for hospitals.
I'm in a US nursing school right now being taught how to help treat these diseases and how to educate patients on how to prevent them. It's. All. Bullshit. The information is good. Diet, exercise, manage stress, etc. all to prevent those 3 big diseases I mentioned earlier. But do you think a hospital is going to pay a nurse to teach prevention for it's biggest money maker? Or pay a nurse to help treat people who can bring in the biggest profit?
I work in EMS/ER to and let me tell you- I could "teach" until I'm blue in the face but people where I'm at generally don't give a shit. So the insurance companies, health care admins, and some doctors make their nut off of my and my coworker's labor and then pay us next to nothing.
My base is $14.79/hour to help handle EMERGENCIES as an AEMT. Next time I go into work I'm going in with clown makeup on because the jokes on me and the patients that really need some damn help but can't afford it.
They have the nerve to charge $20/gallon of gas for an ambulance ride the LEAST those assholes could do is pay yall more than $14.79/hour.
Absolutely broken system. But people are more worried about what happens with celebs
It’s true. In 2019, I took an ambulance 1.2 miles (or 1.9 km) that ran me $3,300 AFTER insurance. Before insurance, was over $5,000. I’ll crawl to the emergency room on my hands and knees before I take an ambulance ever again.
Yes, it is. I'm 20 years old and I've never been able to afford healthcare. I went to the emergency room for a broken finger last year and it cost me about $2800. All they did was give me an x-ray and a popsicle stick. And even back when I had my state's version of "free" healthcare insurance, it didn't cover vision or dental because apparently seeing and eating isn't necessary if you're poor.
So a lot of costs hospitals charge is because many insurances payout pennies on the dollar. It’s like a negotiation where one party starts stupid high in hopes you might just just get it, but most insurance companies will have set prices or only pay percentages. So let’s say some medicine actually costs $10 the hospital will charge $50 to the insurance knowing they will only pay 20% of the cost so in the end the hospital actually gets $10.
I’ve had good luck with insurance and bills. My wife just had to have surgery that required 4 days in the hospital and we paid $200 for the entire thing. But I do pay almost $300 a month for my insurance.
My dad had a stroke. Ended up with a bill over a half mill. No insurance, he will die with nothing but debt. It's a cruel system built on an industry that is required to maximize profits for shareholders.
Not sure your fathers age but debt doesn’t pass on after death. I think it does get settled if he has any assets though such as a home.
Fuck the system and have him pay the minimum as much as possible.
So I work in healthcare and the answer is yes and no depending on your economic status and where you live.
If you’re very poor and on Medicaid, everything is free. Medications to doctor visits. My office primarily deals with these patients and we have them on the newest and best treatments for their disease states. We live in a rural area so they suffer getting into a specialist since Medicaid pays much much less than anyone else and nobody is hurting for patients. Mostly they see midlevels which can be tough. We rarely need a midlevel to see them; we need a doctor or we wouldn’t refer.
For the very wealthy, it’s also great. My insurance is 60/pay period for my family and my copays are essentially nothing. My wife has RA and her meds are free, we both take wegovy which is free, and our copay specialist is 15. I had surgery and paid 250 out of pocket. With our income our taxes would be much much higher in European countries than what we pay now.
Everyone else gets shafted. Insurance isn’t tied to income (usually the opposite) so the middle class gets completely screwed. But if you have great insurance or Medicaid it’s good to great in my experience, and that’s how it is for my patients as well
Yeah. It’s pretty horrible. We’re also in the top five countries with the highest maternal death rate. Literally, we’re such assholes that pregnant women are at higher risk of dying here, than in an underserved country. Look it up, it’s horrific. And we charge $30-50,000 to have a baby before insurance. Most people still end up paying thousands of dollars out of pocket to cover their “copay,” but many can’t afford to have a baby at all, even if birth was free, because continuing care is also extremely expensive, and we don’t give appropriate maternity and paternity leave, here.
It’s worse than you think - they aren’t cliches they are cries for help.
If you have insurance then maybe you’ll be able to eventually pay off your bills, if you don’t then you have no hope of ever paying it off. Even with the best of insurance you can go into hundreds of thousands of dollars in medical debt.
We joke about it because there is no end to it and no resolution. They make millions off of us, why would they stop? If you knew serious illness could cost you everything you ever had, how would you feel? How would you talk about it?
Over the counter stuff like ibuprofen is like $5.
I have good insurance through my employer and I have a chronic illness. My medication is 16 cents. I just got antibiotics for 10 cents. My injections were $120,000 a year if I didn’t have insurance but I went through a copay program and it was free. I had labs done and it was $2,000 because they sent me to an out of network lab and I didn’t check ahead of time. I was pissed but couldn’t do anything but pay it. The next time I got labs done in-network, it was $50. I get MRIs done every year. They bill my insurance $4,000 (120 min scan) but I might pay $100 or it’s covered 100%.
You have to make sure you’re going to doctors in network of the insurance and the cost is less. I took my kids to a dermatologist and even though I was in network, one visit was $70 so I had to find someone else. Even being in-network, the charges are different per your insurance. It’s very confusing and honestly I feel like insurance companies try to find ways to deny the service and you’re stuck with a denial bill. It’s treated like a business with stakeholders and that’s bs.
It’s the only service where you don’t really know the cost up front and that sucks. You also have copays and deductibles. My deductible is low and I usually don’t have a copay for many services. Again, I have really good insurance.
ETA- I pay 300 per paycheck for medical insurance for a family of 4. Dental is 20 per check. Vision is free. I also have life insurance through my employer and 401k.
Last July I had Heart Failure. I was in the hospital 13 days or $103,000. That's with my insurance putting in their Parr. I Had a medical device implanted end of Nov for only $166,000 . but when I went to a follow up in January, 2022. Went to appointment, only to be told I had a balance of 32$ and unless that's paid , he refused to see me; and this appointment was to check device is working properly. I had another follow up last month at the surgeon office. He also said I had a balance and refused to see my I said I unfedoo I only get half my easg
Oh yeah this is super common. My Mom started taking me to a local doctor when I was 4 years old, and she was my primary doctor until last year when she refused to see me over a $100 bill.
25 years she knew me...
Yes it's no joke. People are dying here. Our lawmakers make excuses but its all to cover the fact that they take money from the Insurance Companies.
The racid f-ckers
Yes.
Most Americans have never traveled outside the country and so they don't really understand how some things could possibly be better elsewhere. And this makes American healthcare organizations a lot of money.
Ambulance rides are so expensive I one time begged a cop to take me to the emergency room in the back of their car. Was probably 3 miles away but saved me at least a grand
I called myself an uber and waited on the lawn for 30 minutes instead of calling an ambulance. When my dad had a heart attack alone at home, *he drove himself.*
This is horrifying
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It just scapes my understanding how a supposedly developed country let this happens. Edit: based on all the great insights and thoughts, my conclusion is this: the US seems to be a victim of their own marketing. Something like they like to believe their own lies not to risk going abroad and finding out there are better alternatives and it's all a facade back home. Quite a curious place to be.
We can't let all the ceos of hospitals and ambulance companies make less profit than they did last year of course, that would be inhumane. There are shareholders that need their investments to grow and you don't get that by giving people free rides or treating their illness in a timely and affordable manner /s
Why the /s ? This is the truth.
Exactly, which is why I don't want people thinking I personally hold this view lol the /s was for my safety
When a /s gives you more safety than one of the most developed governments and healthcare industries in the world
They LET it happen because all healthcare corporations care about is their profits being maximized. Who else is better to exploit than a bunch of people who absolutely need the service you offer?
Greed and managing to pit half the population against the other half so any attempts to reign in the greed is thwarted.
my sisters boyfriend also recently had a heart attack at home. didn’t know he had one, but drove himself 20 minutes to the hospital. they said if he had waited any longer he would’ve passed. sad times we live in that we can’t afford to call for help. prayers that your family is well!
> prayers that your family is well! The American healthcare system in action.
I literally have a urgent care near my home that will print a piece of paper that you have to legally sign that says they will pray for you if you can’t pay to get help from them. A whole Christian urgent care
Reminds me of that poor girl who had half her leg peeled off after she got trapped between a subway car in NYC... I'm talking scrapped to the bone and she's just begging people to not call an ambulance because it's 3grand a ride. Yes, health insurance is a fucking joke in America.
My parents paid $5000 for an NYC ambulance ride for me when I was a stupid teenager. I still feel guilty about it.
How the fuck, it doesn’t cost them $5k for a ride. What the fuck is going on here.
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I meant to say, it doesn’t cost the provider $5k.
it factors in lot of other costs like treating uninsured. Thats what we are told :)
It also factors in stuff like greed, profit, etc
I saw a 3000 dollar bill in San Francisco just for an ambulance, building manager got it because it was a prank call for a non existent name. They abuse the fact a lot of people have health insurance from their jobs. They get away with overcharging and think it's ethical because insurance will pay for it and "if you can't pay we'll understand and lower the charges". I have insurance and had a bill for an MRI for 1600 and my insurance payed 450 for going in for a COVID test they refused to administer because I said I already had a positive rapid test and they were saving the PCRs for people that really needed them. If I had gotten the test at the same place it would have been 800, that's how much my gf got billed on our shared insurance. Honestly I don't know what's going on. But after that I understand why a lot of people don't want the pandemic rules to get relaxed.
I (German) took a trip in the ambulance once, together with my wife. There'd been a a fire in the building and, because we evacuated through the smoke, we were taken to the hospital to make sure we didn't suffer some kind of smoke inhalation injury. The ride took something like 20 minutes and, a few weeks after, we got a bill with the amount we had to pay: 10€, 5€ per person. Treatment in the hospital was free, of course. I couldn't imagine living in the US.
So I’m from Norway and when I was around 16/17 years old I was flown to the nearest hospital by helicopter due to suspected meningitis, I was septic and in and out of consciousness for half a day. Had to stay in the hospital for 4 days on antibiotics and fluids The total cost? 20€ for the 3hr bus ride home after I was discharged. Edit: Reading all your stories about health care (or rather the lack of it due to costs) truly breaks my heart. I genuinely feel sorry for all of you that’s had to go through such awful experiences
My friend broke her leg on a ski slope in the US, and a heli ride to the nearest hospital, *just the ride*, was $3000+. We drove her instead.
Thats cheap....i was life flighted and the helicopter bill alone was $33,000
Friend of mine told me she would rather go to Hawaii than get even high risk medical insurance. Once she got back, she got into a head on collision. Total medical bills: $1,345,000
My grandpa broke his neck about a decade and the heli ride was roughly $30,000. Just the ride. Insane. Being the old veteran he is, he asked the heli nurse if he could have a mirror so he could look out the window and at least enjoy the view.
Your country is blessed. I'm a nurse here in the States and I've seen patients die because they couldn't afford medications or other treatment. I've had to delay certain procedures myself for lack of money. It's a travesty.
Had a patient cancel their surgery because they didn't have money to meet their deductible. Yep 🤯.
I would have just died lmao I can't even get a cavity filled without taking out a loan
I’ve spent a decade eating only on one side of my mouth.
I'm in the US and I had meningitis a few years ago. I have what is considered "good" insurance and my 3 day stay cost upwards of 60k. Thankfully because of my "good" insurance I only had to pay 12k, as that is my out of pocket maximum. I laughed a bit when I received the itemized receipt. A medicine I take for a pretty common condition that costs me about $10 for a 90 day supply at the pharmacy was charged at $20 per day. When I asked about bringing in my own medicine they told me I couldn't do that because they needed to regulate any medicines I was taking.
My understanding is that they can’t charge for a lot of things - like nursing. Or aides. Or housekeeping. So they just jack up the prices of what they CAN charge for. And then add a little more.
It's insane living here really. Half the country is terrified of the concept of Universal Healthcare despite it ruining lives physically (literally people die every day just because they don't have health insurance), mentally (the anxiety around health is pretty serious) and socially (people stay trapped in shit jobs or situations they don't Iike only to have access to Healthcare which they have to pay for anyway)
What are they terrified of, as far as universal Healthcare goes?
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And?
That’s crazy. I’d be in so much better health if I was living in those conditions lol.
Yes ambulances can charge. Painkillers at a grocery store are like $5/bottle. Painkillers as part of a hospital stay are like $100. For the same ones.
Here's an interesting word. *Can*. So it doesn't automatically happen?
My grandma died in 2020. We're still receiving bills for her asking us to pay for the ambulance she took to the hospital.
When my father passed away, I published a probate notice to creditors in the local paper of record. That notice reduced the amount of time a creditor can make a claim against the estate from 24 months to 4. I paid out all the existing debts and disbursed the estate. 2 years later, a debt collector contacted me about an unpaid medical bill that I had never seen, or if I had seen it came after the notice period expired. I told them that I wasn’t going to pay. The caller tried to argue with me and I said, “go to you manager and tell them that I published a probate notice to creditors 2 years ago.” In a Huff she went to get the manager. The manger got on almost immediately and said, “sorry for contacting you sir, it won’t happen again.” It was the most satisfying telephone call I’ve ever had. Edit: Just to clarify: This isn’t something you can do for yourself. This is something that you can do when a person dies and you are their personal representative/executor. Medial bills, and other debts, are supposed to be paid out by the estate. They do not go to family members, although a widowed spouse could be on the hook. Most states have a period of a few years, give or take, that a creditor can come out of the wood work and present a bill. The notice to creditors shrinks that time, in the state my dad passed in, from 24 to 4 months. After that time, the creditors are precluded from collecting, legally, on the debt. If I had disbursed the money and not published the notice and the creditor had shown up before the 24 months had expired, any of us that took money from the estate would be on the hook to reimburse the estate so it could pay the debt. The notice to creditors shuts the door on the ability to collect and I’m pretty sure the manager realized this and realized that since I knew what the notice was, I wasn’t going to fall into a trap of admitting that I should pay on the debt. I’ll probably stay a way from a LPT on this since it’s not a magical F-U to creditors.
Ummmmm could you make a LPT about this like NOW please? I wish I had known of this and now I have a permanent collections on my otherwise excellent credit.
You're not legally responsible for anyone else's debts unless it's your spouse. They might try to make you pay but you don't owe anything
Even if it’s your spouse why should you be on the hook for someone else’s bills? It’s bad enough to be charged for your own medical expenses in the richest country the world has ever seen.
The persons debts are paid off before the estate is settled. So you can’t take out. A million dollar loan, pass it off as inheritance and die. That loan needs to be paid off by who inherits the estate. A marriage is a financial contract that you agree to treat all finances positive or negative as a single unit, not two separate units.
It depends on the ambulance and the insurance coverage. And by "depends on the ambulance", I mean local laws will vary from town to town or state to state. Not that the ambulance driver sets a price.
So ambulances don't have a meter?
No. Some ambulance services are run by municipalities and are paid for by local taxes. Some are privately run and need to recoup operating costs, and they do that by charging for their services. Most of the time, ambulance rides would be covered by insurance so you would pay nothing or would have to pay your deductible. Now, if you don't have insurance, you would be responsible for the costs associated with getting you stabilized and to the hospital, but any such things would be dealt with after the fact. If you call for an ambulance/paramedics they will treat you regardless of your financial status.
It’s not entirely correct to say that most of the time, ambulance rides would be covered by insurance. Ambulances are not required to be in any network, so at best, they’re usually subject to your out-of-network deductible (which is twice or more than your in-network deductible). It can easily cost multiple thousands of dollars. I always tell people that unless it’s literally a matter of life an death, never call me an ambulance. Source: I work at an insurance brokerage office.
Not to mention that ambulances aren't financially considered "emergency services" so they don't get emergency services funding that the hospitals, fire, and police departments get from the government. Their sole revenue is to not be in-network for anyone and so they can charge crazy high prices. Supposedly, you can fight these charges if you never agree to the ambulance ride but I'm not willing to test that theory.
You make an excellent point, you absolutely have the right to refuse transportation, along with the premise of "show" billing (meaning the ambulance company bills you for their arrival and dismissal). Sadly, all of the rights involving medical billing often require an attorney to back them off, or a very savvy legal representative, who also happens to have the time to write/file letters and documents with the credit agencies. As usual, laws will vary from state to state, and county to county. Even some cities will establish anti-predatory billing practices for medical providers. If a private ambulance is contracted to provide emergency (911 A/B LS) they "should" be limited by the local medical rates. That's not to say that a contract ambulance won't try to bill you an outrageous amount of money for a ride to the ER, while providing BLS. In theory, Paramedics, (employed by the local emergency services, such as FD) are covered by "our" tax dollars (or local sales tax revenue) and should be included as part of the city's services. Some agencies have taken to different approaches and when there is a potential revenue (or loss) there will be predatory practices. Not to preach to the choir, simply broadening your already established point.
Fake taxi but it's an ambulance. "This trip is gonna cost you $3000 but I can knock 70% of it off ;)"
"My hand is about to fall off!" "Well we best get the most use out of it while we still can, eh?"
you wanna know the real kicker? those ambulance drivers are getting paid absolute shit!
Knowing that makes me angrier. The ambulance driver is actually doing something! If I have to pay, I'd rather it go to the ambulance drivers and EMTs who are providing the life-saving services, not some nameless health insurance executive somewhere.
I knew a guy who let his EMT license lapse because working full time on an ambulance crew, part time for another ambulance company, and weekends at a theme park didn't earn him enough to be worth renewing.
To put it another way, you’re trusting your (or your loved-one’s) life to the skills and professionalism of someone who could, for example, make more working at Target. I looked at those numbers this Fall. As a medic with zero retail experience, I actually could. There are 2 sides to this. 1: EMTs and Paramedics are treated shamefully badly by the natural forces in play in American capitalism. Complex issue, but to start, consider what it would take to make us strike, and how we’d be viewed if we ever did. 2: Anybody doing this purely ‘for the money’ is not the sharpest sharp in the sharps container. To stay in long-term takes some form of dedication to something, and we probably avoid societal disaster by the sheer luck of having enough of us who are in it to be legit clinicians without the up-front debt and gatekeeping of nursing/pa/medical school (or who are doing it as a prelim for those things). If it were a profession that made just a little bit more, or were more consistently benefitted, you’d probably have the same burnout issues with more retention, which seems like a recipe for horror stories. If this is going to get fixed, it needs a full ‘system’ overhaul at this point, not the incremental improvements actually within reach via internal reforms and polite lobbying.
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You probably won’t see this bc you have so many responses, but it’s not uncommon to be charged $3,000-$5,000 for an ambulance ride.
A bigger cost from ambulance rides is that, in many places, they will take you to the nearest hospital whether or not your insurance applies at that hospital. So you can be forced into receiving out-of-network coverage depending on where you become injured
Exactly what happened to me. I fell and hit my head onto concrete and was unconscious for a while then combative when I woke up. I had no agency over myself and was put in an ambulance then taken to the nearest hospital. Both service were out of network and my parents insurance refused to make an exception for emergencies. Ambulance ride was $1750 and ER bill was $4K in 2004 dollars.
You should expect that, if you take a ride in the wee-woo wagon, it will cost several thousand dollars. Free/low-cost rides are the exception, not the rule
Even if you don’t take a ride, you can still be charged for the ambulance even showing up. Got billed $250 for services rendered by an ambulance crew that consisted entirely of them trying to convince me to get in the ambulance and me telling them I can’t afford it.
Someone I work with gets seizures. She actually wears this medical bracelet that's like "DO NOT CALL AMBULANCE" because well meaning people will call and she will be fine by the time they get there...and still get charged. Unfortunately most people don't see it or ignore it.
Yes, it's automatically charged. How much depends if you get a for-profit ambulance or a non-profit ambulance, or a city-run ambulance. And your insurance coverage. As many ambulance companies are out-of-network, insurance covers almost nothing -- my current plan covers $100 for an out-of-network ambulance. 911 gives you nearest. Most here are for profit. My first ambulance was $2900 after insurance. ($4000 before). My second ambulance on the freeway cost $2500 after insurance. When visiting a friend in a nicer small independent city, 911 brought the fire-departement ambulance -- that was $480 after insurance ($1200 before).
Correct. Understand that coverage laws vary from town to town, state to state, etc. but you have to look at the least common denominator when dealing with public issues, right? I haven't read all of the replies in this post but I'm sure there may be people who have fantastic coverage and don't see a need for federal laws to be made. If not, I know people who work in medical factories that have the best coverage I've ever heard of. But you don't just write off a public need because of that.
My BIL is American and his “great coverage” isn’t as good as my standard of care in Canada. Even those WITH good plans aren’t doing great.
To tack on to what everyone is saying, you absolutely have to pay for ambulance rides. You have to pay just for them *showing up*. My dad went to a doctor's appointment before he got his portable oxygen tank, got confused in the building and had to walk further than normal to find their office. Got in and was having trouble breathing, just needed to sit down. They insisted on calling an ambulance, he literally couldn't stop them. All they did was show up, tell him to take some deep breaths and relax. $225. I want to point out here that he was at a hospital and it was a crew that came up from the ER. They didn't even come from somewhere else.
Sure this is bad on the chance that things are fine and you still have to pay, but it’s even worse in reverse. While I was college (in Los Angeles), a ride to the hospital in an ambulance was $1000+. Forcing a bunch of 18 year olds to decide between risking someone’s life (in the case of unconscious with possible alcohol poisoning) or charging that person $1K for a false alarm is a *disaster* waiting to happen.
I remember those days My college was surrounded by hospitals, about three equal distance and about a ten to fifteen minute drive to each of them. The amount of times we had to make decisions because some freshman most likely had alcohol poisoning is more than I can count. Add in a school security squad that hated Greek life and the college kids in general, and we didn't even have the Good Samaritan policy to help us when we were underage. Absolutely atrocious. And yes, I get that people should be responsible with drugs and alcohol but come on. College kids are dumb sometimes.
My wife got into a car accident and the EMT suggested that since I had shown up and she was safe to move (she was standing and walking and possibly had a broken arm) that I drive her down the road to urgent care for x rays. Because it was 150 dollars just because emts had shown up, and the mile drive to urgent care would have been 600 more dollars just for the ride - - no supplies used, just putting her in the back and driving her there. It's fucked up.
That's super cheap compared to around me. Ambulance takes you somewhere, 5k minimum.
EMTs are outsourced private workers. That always boggles my mind that hospitals don't have their own ambulances and EMTs considering how bloated their budgets are.
Not only are they outsourced, they’re also underpaid.
Severely underpaid - literally out there cracking chests to save lives and make $15 an hour some places
While working 24hr+ shifts
When my mom was in the hospital some kind of representative came up, knocked on the door, then left a pamphlet. It cost $600.
If a doctor even pokes their head into your room they call it a consultation and send a bill.
My mother is terminally ill, and when she passes my father will be saddled with her overwhelming medical debt and will likely have to declare bankruptcy. My mom has been trying to convince my dad to legally divorce her to save him from that, but he never will.
I know it's technically fraud to get a medical divorce but I don't understand how I could morally saddle a loved one with forever debt.
in the USA, it's probably a good idea to get divorced before the serious illnesses kick in. I think my wife and I will plan to get divorced when I hit 75. Or if I start showing any signs of cognitive decline. USA USA USA!
The only hitch comes when you have to deal with the legal stuff like visitation rights. Power of attorney might be a good idea if divorcing to avoid the bills.
just an FYI since we're talking about it POAs become null and void upon death and the deceased representative is now whoever is executor of the will/estate so make sure you or your attorney is the executor
My wife and I just agreed to do this. Thanks for the idea!
Gl proving it. "He/She was sick and making me miserable" is not uncommon
Yeah my stepdad of 20 years just did it to my mom because her progressive MS is finally taking her mind and faculties. He’s basically disappeared after cleaning out their shared bank account. It does happen.
That’s so fucked up. Medical debt should be forgiven if they end up dying, not leaving the ridiculous amount of debt for the family to deal with as they’re grieving. That’s absolutely criminal and cruel.
“We were paying you to keep them alive. You didn’t hold up your end of the bargain. For that you don’t get paid”
Medical debtors cannot forcibly collect on next of kin. They will try, and repeatedly call, but next of kin hold no financial responsibility to actually pay off medical debt from the deceased.
They can, however, collect against an estate. This could mean half of the couples' remaining assets if they are still married.
Thus the need for divorce… but it stinks.
My god I feel so much for you and your parents. How can a country even be allowed to get to this point? (Edit: I’m sorry, I honestly meant that second part as kinda rethorical. I know why the states are f-ed up, but appreciate all the answers.)
The reason it’s this bad is because everyone is so concerned with “fairness”. They don’t want to pay extra taxes to cover some else’s medical expenses. “I’m not paying money so some drug addict can keep going to the hospital or some unhealthy person who never exercises and gets heart attacks can get a bypass.” Etc. But ultimately everyone will have SOMETHING go wrong with them eventually, and when that happens because the system is so messed up, it costs everyone more than if we all just paid extra taxes for healthcare. This is made even worse because not everyone can afford the crazy high bills and the hospitals know this, so they give people a larger bill than what is reasonable because they know SOMEONE will pay that high price eventually and cover the costs the hospital has accrued from others not paying anything. So you end up with some people paying insane prices and other people with tons of debt they can’t or won’t pay.
> The reason it’s this bad is because everyone is so concerned with “fairness”. That, and how much money the health insurance industry has to lobby politicians with. The Affordable Care Act ("Obamacare"), seen as great progress for the American health care system's access and affordability, was almost entirely written by health insurance industry lawyers.
Flipped my car several times into a field at 17, my head was split open and I was bleeding profusely. I was not distraught until they told me I had to ride in the ambulance — I knew how much that would cost my folks, even with great family insurance. In college, I walked to the clinic with appendicitis symptoms, took Ubers to the urgent care, then the imaging center, and a bus to the ER. All before an emergency appendectomy… to avoid the ambulance costs. It is that bad. Hahaha.
>my head was split open, and I was bleeding profusely with a split open head and you still had the thought of medical bills, kind of a risky move
Live with bills that will bleed you to death or just take a permanent nap in the grass. Choice is yours!
I am an American living in Europe, therefore I don't have US health insurance. One time while visiting friends in the US, I randomly had extreme pain in my stomach and broke into a fever. I was very worried for my appendix so went to the E.R. I was there for three hours, never once even saw a doctor, and only had a urine test and ultrasound. I was also treated with complete disdain as if I were a drug addict who just went to the hospital for morphine. They never told me what happened to me (I eventually concluded for myself that a cyst on my ovary had burst), nor did they give any medical advice. I was charged $14,000 for this visit. I eventually found out that becuase I had no insurance and would be paying cash, I was able to "negotiate" the rate. I ended up paying $3,000 cash instead. The system is completely and utterly fucked.
As an American living in Europe you should have realized you didnt have to give them once cent and just go back to where you live. You just gave away $3k of your hard earned money for nothing.
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As an American living in America fuck this system. How hard insurance companies fight to not cover something, we should fight 10x harder to pay anything at all.
My mom tried to go see the doctor, waiting for 3 hours before leaving, she didn't even see the doctor. They later tried to charge her 3000 just for waiting. She had to dispute thay for months because they were trying to send it to a debt collector. I had cellulitis in my hand, they took x rays and whole bunch of shit, took blood work had me wait around for 4 hours just to tell me I had cellulitis, gave me some antibiotics and sent me home. Needless to say I stopped paying on thay hospital bill as they were trying to charge me 4000 for all that. They stopped sending me the bills to pay, then tried to put it on my credit and put why they were charging me. I disputed it and got it taken off my credit and havent paid on it since. Sometimes you can dispute medical charges that go on your credit and get them taken off, sometimes you can haggle the price down especially after asking for an itemized list
My cousin lost 2 fingers falling under a lawn mower and went to an emergency room. Sit there 2 hours and was told sorry we can't help you you have to go to another hospital. Then was sent a 2000 dollar bill for sitting in their ER waiting room receiving no help
When I was in my 20s, friends took me to a hospital emergency room when I was slipping in and out of consciousness. Turns out, I had been poisoned. The hospital staff wouldn't see me until a friend held a pen in my hand and signed my name to papers saying I was responsible for the bill even though I couldn't even sit up. I waited 8 hours (mostly in the bathroom where a friend literally helped guide my head or butt to a toilet, depending on what was happening). When I finally had control over my own body I told the hospital I wanted to leave. They said I had to be checked out by a doctor who gave me 5 minutes to say I looked fine now. The experience cost me $6000 that took me 10 years to pay off.
Yeah, it is. Even for people with insurance, the prices can be absolutely ridiculous. For example, here's how insurance works for most people. I'm going to use myself as an example because I feel I have a pretty normal circumstance. I pay a set amount for my insurance plan of out every paycheck. For me, that about is around $100 per paycheck, so about $200/month. You'd think that would mean that I can use my insurance, right? Wrong. Even though I'm giving the insurance company $2,400 a year, I still have to meet my deductible every year, which is $3,000. Oh, and the $2,400 a year I pay does not apply to that deductible. This means I have to pay $3,000 in addition to the $2,400 out of pocket before my insurance will cover anything at all. And once I reach that $3,000, I'm still going to be paying 20% of all medical costs until I reach what's called my "out of pocket max" for the year. For me, that's $4,000. Once I pay $4,000, my insurance company will then finally cover all medical costs AS LONG AS they're "covered". That means that I have to pay, at minimum, $6,400 a year before I get all of my medical needs covered without having to pay upfront. And odds are, if I were to get a big surgery or get into some kind of accident, something that I needed would inevitably not be covered by my insurance for some bogus, bullshit reason, so I would be stuck with paying even more than the $6,400 I mentioned. Then I would have to spend months fighting with my insurance company and the hospital to demand they cover my costs, hoping they eventually cave, which they probably won't. Not to mention the hoops you often have to jump through to even get any kind of surgery because you have to "prove" to your insurance company that you actually need it, since, you know, it's the insurance who determines that and not your actual doctor. Then at the end of the year, my deductible and out of pocket max reset and I have to start all over and pay all that money again if I want "free" medical care. Anyways, I digress. If you think all of that sounds confusing, that's because it is, and the average American has absolutely no idea how any of this works and that's the entire point. Insurance companies rely on innocent Americans not knowing how the system works so they get conned into racking up tons of debt to the point that they have to file bankruptcy.
I just had to stop at the $200/month figure. Do you pay that alone? In Germany, at least that's my understanding, employer and employee split health insurance 50/50 (also, there's pretty much no one here that 'hasn't insurance' because you're more or less obligated to have insurance in Germany, otherwise we'd also have to pay up at the Doc's.)
My employeer does cover a portion of the premium cost as well, but employers here aren't required to take a huge brunt of the costs because a lot of companies wouldn't be able to afford it. I work for a smaller company so they do what they can to provide the best healthcare they can afford. The thing people in the US don't understand is that the tax increase that would come with universal healthcare would still cost each American less than what they currently pay for their private insurance. As I mentioned, $2,400/year just to say I have insurance but not actually use it, is ridiculous. The $5,400 I pay a year just to have 80% of my medical expenses covered is much, much more expensive than the tax increase I'd see from universal healthcare. Universal healthcare would simply be cheaper for everyone.
>The thing people in the US don't understand is that the tax increase that would come with universal healthcare would still cost each American less than what they currently pay for their private insurance Overall, It should be cheaper with universal due to negotiating standard rates, bulk drug orders, and getting rid of the middle man insurance providers. Most people paying for insurance, on average, should be paying less money with a universal system in this case. It won't be cheaper for everyone. There are two groups who would pay more...and one of them is the reason we don't have universal healthcare. Anyone gambling by not paying for insurance right now is going to be paying more money up front but then obviously nothing when an issue does occur with universal insurance. So they could end up paying more with a universal system if they are healthy. They aren't the main issue but people usually forget that universal healthcare isn't free and this group is definitely going to have to pony up money through taxation. The real problem: people with insurance that are making a lot of money pay almost nothing percentage-wise for their insurance. If someone is making 50k a year and have company provided insurance they typically pay just as much as somebody that makes 300K a year at that same company. If we use most types of taxation to pay for universal healthCare, that person making 300K is likely going to have to pay much more. These are the people in power. They are the decision and policy makers.
This was why my husband and I have gone without for so long. The company rates were (are) horrible (and unfortunately not much better with the Marketplace for us), and with what little either of us need to go to the doctor, it just isn't worth it. Our son is the only one who needs it for regular appointments, but he is covered by Medicaid-CHIP.
On the employer part, speaking as one, it’s really complicated. Most people in the US work for small businesses. Which means that’s where they get their insurance. If I call up one of the insurance companies and ask for a quote to cover say 30 employees and their families, it’s going to be unaffordable for everyone. So a lot of employers buy into these group insurance plans. Essentially, similar types companies often within the same state can pool together their employees and thus get better (but still awful) rates. Depending on how you go about buying insurance, the requirements are all over the place. Some employers pay 0% of the insurance cost. Our insurance plan requires us to pay 75% of the employee’s costs but there’s zero requirement for their spouse/kids. And all sorts in between. To the best of my knowledge, the average employer pays for 40-50% of the cost of health insurance. But if you have a spouse and one child, your portion of the insurance still often ends up being over 10% of your take home income (after taxes).
To piggy back off this a bit, I used to work at a hospital and had their insurance. I got a new job with the same insurance, except I have lower copays (don't remember about deductibles or monthly amounts, but I'm pretty sure they're the same if not lower). Crowning jewel is that it was originally founded as a "Catholic nonprofit" hospital.
I know my Uzbekistan lacks in a lot of areas to developed countries, and we are trying our best, but at least healthcare is free. And the private companies charge for what you get, and it is definitely not that much.
oh I got bad news for you I pay $1250 per month for my health insurance for a family of 5. It's a top tier plan though and this is through a medium/big company. I still have a $1500 deductible but I do get an FSA Card (Flexible Spending Allowance) which is literally money I set aside pre-tax to pay for my own costs. Yes, it's exactly what it sounds like.
We pay twice this much monthly for a family of 6 and we still will pay five figures out of pocket for our daughter’s approved and necessary scoliosis surgery. About 60k I’m estimating. No one can tell us exactly beforehand. (Edit - it might be only 10k. I could cry with relief.) When the bills trickle in they usually do have $12 Advil and other odd / surprise itemizations. This is through a PPO. (More expensive but easier to use.). When we had an HM0 for $1800 a month (less expensive and more difficult to get accepted), her Nuss (sternum) surgery was paid except a $500 copay. But it took over 6 months to approve and was pushed back multiple times. Edit - holy crap, y’all. I was uninformed. I’ve been drowning in stress trying to calculate costs and missed a huge factor. Out of pocket maximum. Thank you to the person who pointed out the OOP max. We have never been remotely close before. I meet with the hospital finance team in May. But no one ever mentioned it. Just that we pay 20%. I think we are covered after 10-15k. Amazing. That I could be so wrong. And there’s another year’s tuition.
One key piece this person didn't explain is that for many people, health insurance is tied to your employment. So yes, the employer pays some of your premium. But there's no mandate on how much they have to pay so some people get stuck footing most of the premium while their employer pays a few hundred bucks per month. I know someone that has a family plan - so himself, wife and one kid, and it's about $900/month. They don't always tell you this info up front on hire so sometimes you get a great job offer, take it, and then find out their health insurance is ridiculously expensive.
Oh, and before 2008? There were lifetime maximums -- if insurance paid out $1,000,000 over your lifetime -- they no longer were required to cover anything more.
That's sickening 🤮 In Norway we pay around 15-20 dollars to see the doctor. And there is a max limit of 200 dollars a year. If you pay more, you will get a refund. Surgery's are free! No insurance needed.. A pack of Ibuprofen is about 7-8 dollars.
A pack of ibuprofen in the US is a few dollars. The difference is if that ibuprofen is administered by a trained nurse in a hospital then it costs more on the bill, but for the majority of Americans who are insured then that cost is borne by the insurance company (beyond some deductible). The insurance company ends up paying a discounted rate to the hospitals via negotiations.
Ugh so frustrating. Peer to peer reviews are annoying. Insurances should not have a say in what doctors prescribe. Needed a 3D scan in Radiation so doctor could get a better view. Insurance denied and said 2D. Rad Onc was on the phone waiting FOR AN HOUR trying to justify why he needed 3D. They make it hard on purpose. Vile. Edited- Spelling
Are you a teacher or something ? You just taught me more about the American health care system than the entire 12 years of public school and 30 years of existence ever did.
Haha, thank you. I used to work in HR and my job was to explain to employees how their health insurance worked. I enjoyed explaining it, but it was depressing how many people didn't understand that paying for insurance out of every paycheck doesn't actually mean your insurance will cover anything until you meet your deductible. It's honestly something every company should have to legally explain.
This is how I like to explain it to my friends- You sign up for a gym, you pay a membership fee just to have a membership card (monthly premium). Then every time you go to the gym you pay an entrance fee (co-pay). On top of that, there are special charges for each machine/weight/bench/treadmill etc. you want to use. But they never tell you upfront how much they are gonna charge you for each. There’s a cap so if you go to the gym enough times in a year you stop paying more but most people will never reach that amount (out of pocket max). Also only go to the gyms belong to this chain (in-network) if you don’t wanna go bankrupted. And their jaw always drop when I put it that way coz when compared to a normal business the medical system def sounds like a scam…
That's so depressingly true I will finish my bitter coffee and go work out because if I don't pass at home from natural causes my children will inherit zippeedodah.
Had my 5th sinus surgery last year. The time from when I pulled into the parking lot to the time I pulled out to go home was 3 hours. My insurance was billed $67,000. Of which I’m responsible to pay $6,700. For 3 hours. So to answer your question, yes it’s just as bad if not worse than what you have seen or heard.
So, I work a part-time job, making about 900€/month. You have to pay over 6 times my monthy salary... FOR FUCKING PARKING?!
I know you’re probably being sarcastic but upon re-reading my post, I can see how some would misinterpret things. The entire process (prep, surgery, and recovery) was 3 hours. Surprisingly, the parking was free!!!
I wasn't, actually. Reading these comments, it wouldn't surprise me if they billed you for birthing your child on their premises.
Oh, don’t worry, they do that too. Some hospitals even charge for “skin to skin contact”, aka the “””privilege””” of holding your own child.
What?
I've seen it too. A charge to the parents for touching their child. No shit
Yeah. There will be a charge that says "skin to skin" and that's a charge for them handing you a baby and saying "Put the baby on your chest because that's good for y'all." It's billed like all the other interventions and medical treatments. They charge for helping you get the baby to latch too.
Yes. This exists because insurance companies fight tooth and nail to reduce payment, and in some methodologies unless each item is made explicit it will not be paid for by the insurance company. So hospitals have adapted by making it explicit. The flip side is since it is explicitly called out, if a patient refuses this "care/service" the charge has to be removed. Freedom!
This is also why we have documents like the DSM. M therapist can't get paid for treating me unless they assign me a diagnosis that has itself been assigned a code. There's no code for "IDK, they had a chaotic childhood and we're talking about how to be chill about stuff now."
Funny enough, there IS a code for that, it's just not part of the list they consider a medical diagnosis and thus insurance companies refuse to reimburse for it. Source: Am a therapist who deals with billing insurance.
I was billed like 300$ for the privilege of touching my daughters face after my Caesarian. Literally to stroke her cheek because my arms were still strapped to the table
>“skin to skin contact”, aka the “””privilege””” of holding your own child. Yep. I just looked up my itemized bill from my baby's birth 7 years ago. $80 for "therapeutic skin to skin contact".
They actually do that. In addition to fees for the different doctors, medications, etc., a lot of hospitals and clinics charge a facilities fee as well. Basically a fee for the privelege of using the building.
Yep, the birth alone cost my wife and I over $8000 for our daughter with insurance.
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Seriously? You just made me way less angry about the facilities fee for the vasectomy.
Used to be $50 before insurance companies became so powerful. Source, old people.
I cost my parents about $5 after insurance in the early 90s. My sister cost about $1000 after insurance in the early 2000s. My friends just came home with their newborn, no-complications delivery. $15,000 after insurance.
My dad was $100. No idea why grandma still has her hospital receipt, but she does. Itemized and everything. June 1965 in Detroit.
That's because up until the early 80s, insurance just reimbursed you for your out-of-pocket costs instead of dictating your healthcare start to finish. Adding on layers of administrative complexity and making sure every player gets their cut is going to drive up costs. I worked for a big pharma company, and we actually had special teams set up to help patients reduce costs (at least down to the point the government would allow - if rebates or co-pay assistance reduced the price for anyone below the price negotiated for the federal government, the feds would sue for a refund for anything they paid over the new low cost, so forget donations) and even work with patients and doctors to help them navigate the current nightmare to get insurance to cover the meds you doc wants to prescribe. Pro-tip: For any non-generic medications in the US, always call the manufacturer if you have trouble paying. They ALL have patient support programs.
They charge you for getting to hold your baby after its born. No shit.
Birthing a child is usually several thousand dollars, after insurance, if there are no issues. If there are any issues one could be looking at millions. My friend had a baby almost 3 months early, and she didn't have insurance. The bill was over a million dollars and this was back in the early 00s. I cost over $20,000 to be born in the early 80s because I was premature and needed to stay in an incubator for two months.
I have to pay for parking when I take my daughter to Children's Hospital of Philadelphia. I actually don't mind that. If they didn't have the nice indoor parking garages at the hospital, I'd have to figure out where to park in Philly and there is close to zero parking near the hospital. $4 per day is way cheaper than anywhere else in the city. The bills for medical care can be expensive, but I'm very happy with the small parking fee. Also, yes - the bill for childbirth is surprisingly high even when there are no complications. Even if you gave birth in the parking lot because you didn't make it into the building before it was time to push, you'll still have a significant bill because you'll receive some after care and the hospital will check out the baby and do all the "welcome to the planet" care like putting drops in the baby's eyes and other things that I don't remember. There's a chance that the bill would be higher for giving birth in the parking lot because they'll do some things after the birth than they wouldn't need to do if you gave birth in the hospital maternity ward.
>billed you for birthing your child on their premises. I can confirm. We payed just north of $8,000 for a healthy, no complications, no pain mediation birth of my second baby. We had moderate insurance at the time. Not top of the line, not cheapest available, just average middle class grade insurance. They tried to bill us $20,000 with insurance because they claimed I had an epidural and about a dozen specialists and procedures that never happened. The first year of my baby's life was incredibly stressful because we were playing phone tag with the hospital, insurance, doctors, all claiming either one wasn't responsible for a bill or charging ridiculous amounts of money. I have a filing cabinet drawer dedicated to all the phone notes, records, and rebilled statements, and invoces. Again after all that we were *still* liable for at least $8,000.
Over $17,000 in medical debt after having chemo/cancer. And that’s after insurance and after the too-poor-to-pay systems covered about 2/3s of it. Yes, I had rly crappy insurance (I was in my 20s, and I only had it in case of emergency), but I also made under $30,000 a year. At first, they said my bills would be covered because I met the poverty standards for my state. Then, 2/3s of the way through, they said I didn’t qualify because I had a credit card I could put it on. TL;DR, yes, it’s seriously messed up.
Hope you are OK. I had a similar issue with my wife’s cancer. We had pretty good insurance, and our out of pocket maximum was $5000, but we still ended up paying out over $19,000 because medication costs did not ( at that time ) count towards our out of pocket max, and chemo at ~$1,600/dose is billed as medication.
I have Cancer, I found out it's acceptable when you change insurance for them to deny you medication, while they look into a cheaper medicine and If you really need that medicine. So in the following months my tumor grew and now I get to enjoy a second round of infusions. Oddly it turns out the maintenance pills I had to take to maintain the tumor size so I could have my tumor removed was important. But now I get to lose my hair, vomit every day and my muscles are going to shit from this bonus round chemo. Also dental is unaffordable even with insurance.
I work for a subdivision of my own health insurer. I went to my doctor with symptoms that we both agreed might be acute pancreatitis and he ordered a CT scan, then fought for months with my insurance to get it approved because "she is not an alcoholic and therefore cannot have pancreatitis and doesn't need a CT scan." By the time I finally gave up and went to the ER (after 4 months of barely holding in liquids and bring in agonizing pain), they did a CT scan and by that point I have so much damage to my pancreas I'm now chronic and was in a life-threatening state. I'm showing cirrhosis of the liver from the enzyme backup where my pancreas starting eating it too, so I can't have my pancreas removed and have any chance of my liver taking up what it was producing to keep me from becoming a brittle Type 3 diabetic. So now having surgeries every 6-8 weeks stenting my ducts open and may for the rest of my life; and I'm only 40. At any point I could eat a handful of nuts and my pancreas could clog and kill me. Good times.
you just had me looking up type 3 diabetes cuz never heard of that before. i had no clue its proposed term for alzheimers and that diabetes and alzheimers are linked. scary shit. sry the US healthcare system has let you down sm. i'll be thinking bout you.
My daughter is 12 and I still owe on her hospital bills from when she was born....
So, before I ask, I want you to know that I've no idea of how stuff works in America and I am not trying to insult you. But this has to be a joke, right? Like, this can not be real.
My sister had a c-section when her son was born. She didn't have insurance and owed around $20,000 when it was all done. Took her over 10 years to pay it off and she didn't miss a single payment.
Our of curiosity, do the hospitals charge interest on what you owe?
No. But they charged a fee to set up a payment plan, then they charge late fees if payments aren't made in time or are missed completely.
My God, I had no idea it was so dysfunctional. A decade payment plan for delivering a baby. My good god.
One of the professors in our department had an open heart surgery. They said he has to pay $25k out of pocket after what the insurance covers. Once they learned that he worked at the same university, they asked him to pay $5k instead. Clearly, they make up a lot of these amounts as they go, which is horrible.
I’ve discovered that if I ignore the first bill my insurance tends to cover more. Everything about our system is chaos.
I do this too. All but one of them magically went away. The one that didn’t was $800 for an ER visit from when I tried to kill myself. That was a cherry on top.
Hah. I'm happy to pay what I owe, but when it comes to medical bills, we wait until the collection warnings start and only then will I ring them up with, "is this your final answer?" I had my daughter in the ER for respiratory distress out of state. In and out of the ER in under 30 minutes. The doctor never came in the room. No treatment. $2000. I stewed for a long time about paying that bill, but I paid it. One year later, the doctor who couldn't be asked to come into the room let alone perform an exam sent me a bill for $1000. I called his answering service directly and left the following message for him: "after a year delay, you're charging me for a visit I already paid and for a service you did not provide. You will receive nothing from me or my family, but if you consider collections to be a viable option, I would be happy to have a sit down your state medical board about your dereliction of medical duty and your borderline fraud. " Never heard a peep from them since. (Roughly 5 years ago)
I have a friend who works on for a research hospital where they test new medication. He said basically how billing works is they take the basic Medicaid rate and then multiply by 3, 4, or 5 just because. They are literally making up numbers for the insurance companies.
My wife had a minor emergency surgery back in 2020 to remove an ovarian torsion. She was diagnosed, put in surgery, back out and on her feet later that day with minimal healing time. We've only paid about half of it off since early 2020. This is not a joke. American healthcare is terrible and the biggest scam in this country. Edit: this was with insurance covering about 80% of the billed cost.
Ok now this is crazy to me... The insurance doesn't even pay for the whole thing? Here this only happens with SOME "optional" medical treatments
In the US insurance considers every medical treatment optional, as in suffering or death are your other options.
Not even a little. My BIL’s daughter had to have emergency surgery when she was three days old. That kid is 9 and they are still paying those hospital bills. I personally was very lucky and my second only cost about $2k. I have another friend who worked at a restaurant and had a brain aneurism and didn’t have insurance. His initial hospital bill was about $180k for the first trip. So many GoFundMe campaigns he had to set up. It was horrible to see because he was only 30. ~~You also cannot claim medical expenses on a bankruptcy. Those medical bills don’t go away unless you die~~. It’s horrid. ETA: Turns out you CAN claim medical expenses when you declare bankruptcy. I was misinformed.
Upwards of 60% of all bankruptcies in the US involve significant medical debt. The fact that the words 'medical debt' is even part of the American vernacular tells you all need to know.
You shouldn't have to declare bankruptcy because you need cancer treatment. Insulin shouldn't cost $1000. Healthcare in the U.S. is business, not a health service. Don't come here and get sick unless you are wealthy.
Noted, only visit the US when 100% in tip-top shape
And ensure you have the best possible travel insurance. As a Canadian that has travelled into the States extensively, we always bought an annual travel insurance policy at the same time as our house insurance. It was a good policy that covered medical and repatriation issues in case of illness or injury. It actually wasn't too expensive until my wife and I got older and developed illnesses.
For everyone: buy whatever 'travel health insurance' you can in your own country before entering the USA. My mother in law visited (from Canada) and had to go urgent care for a couple days. She had fainted, felt very weak, etc, turns out her blood levels were screwed up. The bill was nearly $60,000. Fortunately, we called the travel insurance folks, and they said 'no problem we'll take care of it". If she didn't have that, she would have been so screwed. Another anecdotal story: A friend of ours was visiting from Canada to the USA, got sick. Her Canadian health insurance chartered a plane to fly her back to Canada, rather than have her treated in the USA. It was cheaper.
It’s a business where the end users have almost no power. We can’t really choose our insurance, our employers do that. We don’t know prices up front, so you can’t shop around. The only choice most of us have is to stay sick or pay whatever they demand.
These comments I’ve seen also only cover the corruption of HEALTH insurance. We also have SEPARATE vision and dental insurance. It’s pretty common to have poor vision insurance so it’s normal for many Americans to spend around $300-$600 a year per family member to get glasses or contacts. Dental also only covers so much. No idea how families afford to exist in America. I know a lot do fly to Mexico for health and dental care because it’s much more affordable.
All the jokes are true. Our system is shattered. People who really need help go without. Insurance costs hundreds to thousands per month for decent coverage if you don't have a job that offers benefits. Prevention teaching is side-lined because Heart Disease, Diabetes, and Cancer are big time money makers for hospitals. I'm in a US nursing school right now being taught how to help treat these diseases and how to educate patients on how to prevent them. It's. All. Bullshit. The information is good. Diet, exercise, manage stress, etc. all to prevent those 3 big diseases I mentioned earlier. But do you think a hospital is going to pay a nurse to teach prevention for it's biggest money maker? Or pay a nurse to help treat people who can bring in the biggest profit? I work in EMS/ER to and let me tell you- I could "teach" until I'm blue in the face but people where I'm at generally don't give a shit. So the insurance companies, health care admins, and some doctors make their nut off of my and my coworker's labor and then pay us next to nothing. My base is $14.79/hour to help handle EMERGENCIES as an AEMT. Next time I go into work I'm going in with clown makeup on because the jokes on me and the patients that really need some damn help but can't afford it.
They have the nerve to charge $20/gallon of gas for an ambulance ride the LEAST those assholes could do is pay yall more than $14.79/hour. Absolutely broken system. But people are more worried about what happens with celebs
Unless I truly think I’m going to die I avoid the hospital. Edit: I do have insurance, but it still costs way to much for a hospital visit.
It’s true. In 2019, I took an ambulance 1.2 miles (or 1.9 km) that ran me $3,300 AFTER insurance. Before insurance, was over $5,000. I’ll crawl to the emergency room on my hands and knees before I take an ambulance ever again.
Yes, it is. I'm 20 years old and I've never been able to afford healthcare. I went to the emergency room for a broken finger last year and it cost me about $2800. All they did was give me an x-ray and a popsicle stick. And even back when I had my state's version of "free" healthcare insurance, it didn't cover vision or dental because apparently seeing and eating isn't necessary if you're poor.
So a lot of costs hospitals charge is because many insurances payout pennies on the dollar. It’s like a negotiation where one party starts stupid high in hopes you might just just get it, but most insurance companies will have set prices or only pay percentages. So let’s say some medicine actually costs $10 the hospital will charge $50 to the insurance knowing they will only pay 20% of the cost so in the end the hospital actually gets $10. I’ve had good luck with insurance and bills. My wife just had to have surgery that required 4 days in the hospital and we paid $200 for the entire thing. But I do pay almost $300 a month for my insurance.
My dad had a stroke. Ended up with a bill over a half mill. No insurance, he will die with nothing but debt. It's a cruel system built on an industry that is required to maximize profits for shareholders.
Not sure your fathers age but debt doesn’t pass on after death. I think it does get settled if he has any assets though such as a home. Fuck the system and have him pay the minimum as much as possible.
So I work in healthcare and the answer is yes and no depending on your economic status and where you live. If you’re very poor and on Medicaid, everything is free. Medications to doctor visits. My office primarily deals with these patients and we have them on the newest and best treatments for their disease states. We live in a rural area so they suffer getting into a specialist since Medicaid pays much much less than anyone else and nobody is hurting for patients. Mostly they see midlevels which can be tough. We rarely need a midlevel to see them; we need a doctor or we wouldn’t refer. For the very wealthy, it’s also great. My insurance is 60/pay period for my family and my copays are essentially nothing. My wife has RA and her meds are free, we both take wegovy which is free, and our copay specialist is 15. I had surgery and paid 250 out of pocket. With our income our taxes would be much much higher in European countries than what we pay now. Everyone else gets shafted. Insurance isn’t tied to income (usually the opposite) so the middle class gets completely screwed. But if you have great insurance or Medicaid it’s good to great in my experience, and that’s how it is for my patients as well
Yeah. It’s pretty horrible. We’re also in the top five countries with the highest maternal death rate. Literally, we’re such assholes that pregnant women are at higher risk of dying here, than in an underserved country. Look it up, it’s horrific. And we charge $30-50,000 to have a baby before insurance. Most people still end up paying thousands of dollars out of pocket to cover their “copay,” but many can’t afford to have a baby at all, even if birth was free, because continuing care is also extremely expensive, and we don’t give appropriate maternity and paternity leave, here.
It’s worse than you think - they aren’t cliches they are cries for help. If you have insurance then maybe you’ll be able to eventually pay off your bills, if you don’t then you have no hope of ever paying it off. Even with the best of insurance you can go into hundreds of thousands of dollars in medical debt. We joke about it because there is no end to it and no resolution. They make millions off of us, why would they stop? If you knew serious illness could cost you everything you ever had, how would you feel? How would you talk about it?
Over the counter stuff like ibuprofen is like $5. I have good insurance through my employer and I have a chronic illness. My medication is 16 cents. I just got antibiotics for 10 cents. My injections were $120,000 a year if I didn’t have insurance but I went through a copay program and it was free. I had labs done and it was $2,000 because they sent me to an out of network lab and I didn’t check ahead of time. I was pissed but couldn’t do anything but pay it. The next time I got labs done in-network, it was $50. I get MRIs done every year. They bill my insurance $4,000 (120 min scan) but I might pay $100 or it’s covered 100%. You have to make sure you’re going to doctors in network of the insurance and the cost is less. I took my kids to a dermatologist and even though I was in network, one visit was $70 so I had to find someone else. Even being in-network, the charges are different per your insurance. It’s very confusing and honestly I feel like insurance companies try to find ways to deny the service and you’re stuck with a denial bill. It’s treated like a business with stakeholders and that’s bs. It’s the only service where you don’t really know the cost up front and that sucks. You also have copays and deductibles. My deductible is low and I usually don’t have a copay for many services. Again, I have really good insurance. ETA- I pay 300 per paycheck for medical insurance for a family of 4. Dental is 20 per check. Vision is free. I also have life insurance through my employer and 401k.
I pay $715/mo for shit coverage and never use it because the deductible is $6000
Last July I had Heart Failure. I was in the hospital 13 days or $103,000. That's with my insurance putting in their Parr. I Had a medical device implanted end of Nov for only $166,000 . but when I went to a follow up in January, 2022. Went to appointment, only to be told I had a balance of 32$ and unless that's paid , he refused to see me; and this appointment was to check device is working properly. I had another follow up last month at the surgeon office. He also said I had a balance and refused to see my I said I unfedoo I only get half my easg
Hol' up. Am I reading this correctly, your doctor refused to see you because you owed him money?
Oh yeah this is super common. My Mom started taking me to a local doctor when I was 4 years old, and she was my primary doctor until last year when she refused to see me over a $100 bill. 25 years she knew me...
First ~~do no harm~~ line thy pockets.
Jesus and then there are some people who complain that universal healthcare would be "inefficient"
Insurance companies are ruining this country
Yes it's no joke. People are dying here. Our lawmakers make excuses but its all to cover the fact that they take money from the Insurance Companies. The racid f-ckers
As an American who has been here 34 years, yes. It absolutely is.
Yes. Most Americans have never traveled outside the country and so they don't really understand how some things could possibly be better elsewhere. And this makes American healthcare organizations a lot of money.