US health insurance
#91
Re: US health insurance
The billed amount and what is actually paid are two vastly different amounts. My real life example, I was quoted almost $6,000 for knee surgery going through insurance and a 3 month wait. I asked about private pay and was quoted $2,800 to be performed in the next week which I gladly accepted. The MRI that that I needed was about $2,000 going through insurance and about $1,000 by private pay. There are times when I consider giving up my private insurance since self pay is frequently significantly less cost. I am self pay, but keep it simply to guard against the huge expenses associated with cancer, heart issues or other catastrophic illnesses. With all that said, I think the system over here is superior to the NHS because you have rapid access to most treatments, excellent preventative care, and for the most part it is affordable to most people, because either you qualify for employer plans, or if you are self pay you qualify for subsidies or you have the means to pay for it. It isn’t free, and not inexpensive by any means, but it is priceless if you have an unfortunate prognosis,
#92
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Joined: Mar 2017
Location: Austin, TX
Posts: 455
Re: US health insurance
There's some very good science that gets done in the UK, although of course there are simply more institutions in the US than there are in the UK. Grant funding is an issue too and it will be an increasing problem post-Brexit, although it remains to be seen what the long term impact of that will be.
Of course, based on the relentless TV advertising here in the US, one could get the impression the US companies are churning out non-essential skin rash medication, ED medication, and such - profitable but not exactly medically essential stuff.
#93
Re: US health insurance
Is the roof over your head (a home you own and live in) considered as a 'resource' in this case?
#94
Re: US health insurance
Yes, I continued to work. The health provider was as helpful as possible arranging my treatment usually late in the afternoon. Yes, it has gone but still monitored.
She missed work for several months, taking some time as sick leave, then unpaid leave during which she paid the full insurance cost (i.e. her employer's contribution as well as her own).
In my experience disability insurance is separate from health insurance and you get what you pay for.
She missed work for several months, taking some time as sick leave, then unpaid leave during which she paid the full insurance cost (i.e. her employer's contribution as well as her own).
In my experience disability insurance is separate from health insurance and you get what you pay for.
#95
Re: US health insurance
Yes. It can be liened after your death to recoup what Medicaid paid out for you, but not before your death.
#96
Re: US health insurance
The billed amount and what is actually paid are two vastly different amounts. My real life example, I was quoted almost $6,000 for knee surgery going through insurance and a 3 month wait. I asked about private pay and was quoted $2,800 to be performed in the next week which I gladly accepted.
The MRI that that I needed was about $2,000 going through insurance and about $1,000 by private pay.
So for these procedures, do you simply ask the doctor 'what if I pay cash'? I've had little exposure personally to medical procedures (thankfully!) but when I have tried to have 'cost' discussions, the doctors have no interest in engaging in such matters, and defer to the 'front office' folks. They, in turn, seem clueless. The insurance companies obviously don't want to discuss. So who exactly do you have these 'self-pay' discussions with? I did recently talk to an old doctor about getting an annual physical at a 'cash price' and it was surprisingly cheap - I got a full-blown 'old fashioned' physical for about $280 (my new doctor treats the annual physical as a '10 minute chat'; my old doc spent an hour poking and prodding!).
There are times when I consider giving up my private insurance since self pay is frequently significantly less cost. I am self pay, but keep it simply to guard against the huge expenses associated with cancer, heart issues or other catastrophic illnesses.
EDIT TO ADD: - if you go 'self pay' - does the money you spend even count at all towards your annual deductible?
Last edited by Steerpike; Aug 9th 2021 at 8:37 pm.
#97
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Joined: Jun 2015
Location: Near Lynchburg Tennessee, home of Jack Daniels
Posts: 1,381
Re: US health insurance
so, even if you are retired at , say 65 yo, covered by Medicare, you still could be bankrupted if you don't buy additional insurance?
What's TriCare?
So, people, I suspect get around, what, $1500 on average as their retirement pension and they still need to buy some additional health insurance?
What's TriCare?
So, people, I suspect get around, what, $1500 on average as their retirement pension and they still need to buy some additional health insurance?
Last edited by ddsrph; Aug 9th 2021 at 8:16 pm.
#98
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: US health insurance
Medicare co-pays can be pretty large. $1450+ deductible on a hospital stay, plus up to $371 per day if you spend more than 60 days as an inpatient. Then Nursing Facility stays for rehab are $181.50 per day from says 21-100. You max out your rehab days and don't have supplemental insurance and you'll owe $14,520. Not astronomical by US healthcare standards, but enough to be a considerable strain on most retired peope.
#99
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Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: US health insurance
My daughter’s school friend was diagnosed with a rare, aggressive type of cancer when she was 16. When she died 3 years later her parents were $250,000 in debt. Both parents worked with good healthcare insurance. Debt over healthcare costs is the #1 cause of bankruptcies in the US.
#100
Lost in BE Cyberspace
Joined: Jan 2006
Location: San Francisco
Posts: 12,865
Re: US health insurance
It depends on the specific disability insurance policy and on how you paid for it. My state has mandatory short term disability insurance which lasts up to a year with, I think, a one week waiting period. But that's unusual. Long term policies here kick in after that and 60% is a common replacement percentage. The good news is that if you pay premiums with post-tax dollars the disability income is federally tax-free. Not sure whether it's generally state tax-free as well.
#101
Forum Regular
Thread Starter
Joined: Jul 2021
Posts: 31
Re: US health insurance
I am sure it is far more nuanced than a single article or my opinion can muster, but this could be spun another way - Europe's Healthcare systems ensure significant purchasing power for drugs, pushing down prices while the USA continues to structure like a local drug pusher system.
Here is an interesting article describing the process:
https://lowdownnhs.info/drugs/billio...-does-it-work/
Looks like US Medicare tries to achieve the same
What’s the Latest on Medicare Drug Price Negotiations?
https://www.kff.org/medicare/issue-b...-negotiations/
Last edited by John123456; Aug 10th 2021 at 4:39 am.
#102
Forum Regular
Thread Starter
Joined: Jul 2021
Posts: 31
Re: US health insurance
The billed amount and what is actually paid are two vastly different amounts. My real life example, I was quoted almost $6,000 for knee surgery going through insurance and a 3 month wait. I asked about private pay and was quoted $2,800 to be performed in the next week which I gladly accepted. The MRI that that I needed was about $2,000 going through insurance and about $1,000 by private pay. There are times when I consider giving up my private insurance since self pay is frequently significantly less cost. I am self pay, but keep it simply to guard against the huge expenses associated with cancer, heart issues or other catastrophic illnesses. With all that said, I think the system over here is superior to the NHS because you have rapid access to most treatments, excellent preventative care, and for the most part it is affordable to most people, because either you qualify for employer plans, or if you are self pay you qualify for subsidies or you have the means to pay for it. It isn’t free, and not inexpensive by any means, but it is priceless if you have an unfortunate prognosis,
The other thing I have learned is that it is very difficult or almost impossible to find how things would cost in the US if you didn't have a health insurance and wanted to pay for everything by yourself privately.
There's even a website that lists places where you could go to have something done and how much it would cost, I took a look , but there not many hospitals/clinics that could be available around the country, that could povide their prices for various procedures/treatments.
I remember one is in Oklahoma city, I watch a video once about it, I'll try to find it and post it.
This short video says it all , I guess, but it's not the one I was having on my mind:
That's the clinic I mentioned earlier, that is transparent with their prices, so no surprises when it comes to paying, and prices seem reasonable
Another idea would be to go and have things done in Mexico, Malaysia, Thailand, Philippines, I've heard some insurance companies pay their clients to have things done in France, or in other parts of the world, where you know private healthcare is very good and you could pay less.
Has anyone of you thought about it?
#103
Forum Regular
Thread Starter
Joined: Jul 2021
Posts: 31
Re: US health insurance
Tricare is insurance for the Military. Military dependents can get Tricare for a very reasonable price and when the active duty members retire they also can get on it. I am a retired reservist and my wife and I were both on Tricare. When I turned 65 and on Medicare my standard Tricare became a free Medicare supplement that pays 100% of what Medicare doesn’t pay. Standard Tricare was free for me (after I retired) but recently my wife who isn’t quite Medicare eligible has to pay for her Tricare standard which is a 80/20 policy $150 deductible and $2500 max yearly out of pocket. Free for both of us until last year and now she has to pay an astounding $12 per month. At 65 it will convert to a free Medicare supplement like I now have called “Tricare for life” This insurance could be a good reason for anyone eligible to consider joining reserves.
what are the requirements when joining reserves? haha
#104
Re: US health insurance
I have read soemwhere on here, on some previous thread, someone had some health condition and some problems with her/his health insurance in the US, or maybe it was no health insurance, and she/he then did research and found out that going back to the UK, and doing the same in the UK privately would cost a quater of what it would cost to do the same thing in the US.
The other thing I have learned is that it is very difficult or almost impossible to find how things would cost in the US if you didn't have a health insurance and wanted to pay for everything by yourself privately.
The other thing I have learned is that it is very difficult or almost impossible to find how things would cost in the US if you didn't have a health insurance and wanted to pay for everything by yourself privately.
I can give you an example of "real" cost, although it's always hard to say because doctors and hospitals make deals all the time. It's not called the Health Care Industry for nothing.
We are currently paying through the nose for a decent health plan since I became self-employed last year due to being a Covid layoff. Be that as it may, OH recently had an outpatient procedure in a hospital. We were there for maybe three hours - prep time, procedure time, and recovery time. It involved sedation and a local anesthetic, but not a general, and a very minor amount of cutting/stitching/messing about inside. The "real" bill was about 150,000 USD, all in. We paid our out of pocket max of 3k. We pay A LOT in premiums for the two of us, so don't at all get the idea that the insurance is cheap! It's better if you are on a group plan at work, but still expensive for complete coverage.