I don't understand how health insurance works

[Keego]

I fell on my wrist when it was snowy outside and I went and got an xray. I have full health insurance, yet out of a $141 bill (doctor visit: 86, xray: 49, bandage: 6) they only paid $12 of it. WTF? I thought health insurance was supposed to cover everything except for the copay? I don't have my enrollment stuff with me, but this is making me depressed.

 

[jagec]

Let me explain how health insurance works.

Bend over and drop your pants.

 

[msparish]

Do you have a deductable? Was the doctor/hospital in your network?

 

[Viper GTS]

Let me guess, ER or Urgent Care was involved?

Viper GTS

 

[Nebor]

Wow, I'm glad 100% of my emergency care is covered.

And it's because my SO is a federal employee! Hahahaha, us homos really are sticking it to the rest of you!

 

[GTaudiophile]

It doesn't work.

Edit: I still haven't seen a statement from my October 2005 visit.

 

[jagec]

Originally posted by: Nebor
Wow, I'm glad 100% of my emergency care is covered.

And it's because my SO is a federal employee! Hahahaha, us homos really are sticking it to the rest of you!

Are you referring to bradruth?

 

[Slew Foot]

How much of that did you have to pay?

 

[Keego]

$129

They only asked for $20 at the office so I just got a bill for $109.

I thought that the $20 at the office was the only thing I had to pay
Yes, it was "urgent" care. It was a mild sprain but I had never gotten one before so how the hell was I supposed to know if it was broken. It hurt like fire.

 

[EagleKeeper]

Seems like you have a deductible and co-pay.

The co-pay was probably $20.

Contact the insruance carrier if you need explanation.

 

[0]

Usually there is a deductable, once you reach your out of pocket max, then they cover it as you say. Just another way to screw you.

 

[Keego]

oh ok that makes sense. Thanks

So that $12 that they picked up, will that come back to hurt me later or is it ok?

 

[ElFenix]

Originally posted by: Nebor
Wow, I'm glad 100% of my emergency care is covered.

And it's because my SO is a federal employee! Hahahaha, us homos really are sticking it to the rest of you!

:laugh:







i wish i got the federal health insurance option

 

[vi edit]

Without knowing the particulars of you plan it's hard to say. You may have been "out of network" and charged with a bulk of the costs for that reasons. Your plan may have different coverages for ER/Urgent care. Ect.

Realistically though, for a visit AND an X-Ray...$144 is cheap. Real cheap.

 

[Vic]

Either you have a deductible or crappy insurance. My bet is on deductible. It sounds like you don't see the doctor very often and it's typical to have a $100-$150 deductible each year.

 

[db]

Insurance is another reality. One you don't play in, but others do. You lose. Your only hope is to become as informed as possible in order to understand it and maybe get some benefit out of it.
Welcome to Capitalism, the least worst system in the world. Other people make money off of you, and maybe you will get something.
End of story.

edit: you can't play the game unless you learn the rules

 

[E equals MC2]

Originally posted by: db
Insurance is another reality. One you don't play in, but others do. You lose. Your only hope is to become as informed as possible in order to understand it and maybe get some benefit out of it.
Welcome to Capitalism, the least worst system in the world. Other people make money off of you, and maybe you will get something.
End of story.

edit: you can't play the game unless you learn the rules

I'll stick to that than free health care or communism.

 

[dartworth]

The bill came close to $20K when my wife had our son...

My out of pocket expense...$0

:thumbsup:

 

[NogginBoink]

Think of this as a very inexpensive lesson.

You REALLY need to know what your insurance covers, what it does not, what providers are in-network and are not, and how to seek treatment under your plan.

Imagine what the bill might be like if you had $30K or so worth of emergency medical bills and didn't follow the plan's requirements.

Get out the policy. Read it. Call the plan if you have questions. You're only out a hundred or so dollars this time. Next time it could be a LOT worse.

 

[Rkonster]

Originally posted by: Keego
oh ok that makes sense. Thanks

So that $12 that they picked up, will that come back to hurt me later or is it ok?

It is probably ok. The remainder that you paid probably just went to your deductible.

 

[DrPizza]

Originally posted by: NogginBoink
Think of this as a very inexpensive lesson.

You REALLY need to know what your insurance covers, what it does not, what providers are in-network and are not, and how to seek treatment under your plan.

Imagine what the bill might be like if you had $30K or so worth of emergency medical bills and didn't follow the plan's requirements.

Get out the policy. Read it. Call the plan if you have questions. You're only out a hundred or so dollars this time. Next time it could be a LOT worse.

excellent advice... I was going to type the same thing. Consider yourself lucky!

 

[xSauronx]

Originally posted by: Keego
$129

They only asked for $20 at the office so I just got a bill for $109.

I thought that the $20 at the office was the only thing I had to pay
Yes, it was "urgent" care. It was a mild sprain but I had never gotten one before so how the hell was I supposed to know if it was broken. It hurt like fire.

i dislocated my shoulder when i was 7 and never went to a doctor, get some balls and some icyhot next time!

 

[db]

Originally posted by: E equals MC2

Originally posted by: db
Insurance is another reality. One you don't play in, but others do. You lose. Your only hope is to become as informed as possible in order to understand it and maybe get some benefit out of it.
Welcome to Capitalism, the least worst system in the world. Other people make money off of you, and maybe you will get something.
End of story.

edit: you can't play the game unless you learn the rules

I'll stick to that than free health care or communism.

E equals MC2, In case you missed the point, "least worst system" means it is the best of all alternatives....
But I'm sure Rush would be proud of your response.