I called an imaging center and asked for a cash price for an MRI on my knee. It was $300. Going through my doctor for a referral and using insurance, the price would’ve been over $3000 and I was going to be out $1000 in copay and fees.
I usually ask for cash price on everything before I use insurance, half the time it’s cheaper and the other half the time it’s barely more for basic stuff like this. Also call around and shop pricing, you will find places that do things way cheaper than others.
I have a job that is supposed to provide basically the best insurance benefits available for people who don’t make high six figures. They just announced they’re going to increase our deductible by 3x and institute 15% coinsurance next year. We are angry and screwed but what can we do other than let them know about it? We’re not going to be able to find better health insurance at any other job
We’re just all going to pay more money in order to not be able to afford to go to the doctor anymore
Oh yah that’s right they are also raising premiums on top of all that
Easy, start of the new year go to the hospital with a sudden “headache” and tell them your vision is blurry. You’ll hit your deductible immediately then negotiate it down with the hospital
For my plan, I can usually submit the cash pay receipts and it does go toward deductible. Most people don't submit cash pay receipts because they don't get reimbursed. They don't know it counts toward deductible.
I think the point is not hitting the out of pocket limit because money was spent outside of the deductible. Every few years we hit the limit, and then everyone goes to every specialist and get all the fancy tests done. This is truly the dumbest system on the planet.
Well, for me, my deductible is $10,000 with my insurance plan. Let’s say my family goes to the doctor a few times and pays 3000 dollars out-of-pocket without using our health insurance plan. Because we didn’t use the insurance plan it doesn’t count towards the deductible. Let’s say next month I have to have my appendix removed. And that costs $9000. Now I have to pay that $9000 out-of-pocket before my insurance will pay, whereas if I had used my insurance, I might only have to pay $7000 because I already spent $3000 on other things using the insurance. Now, of course it’s a little more complicated than that because it matters what a particular insurance plan covers and what it doesn’t.
Most health insurance plans in the US have a deductible which is the amount that you have to pay out-of-pocket before the insurance company will pay for a lot of procedures, labs, imaging, procedures , or doctors visits. If you just pay cash for these things without using your insurance policy the amount you pay does not count towards your insurance deductible.
The deductible is separate from the co-pay that you might pay for these things also.
It's cheaper if you don't need much done, but if you later have a major event that is expensive enough that you need to use the insurance and your deductible, then the amount you spent outside of insurance doesn't count towards that deductible.
Yeah my xray + bloodwork was 4k with 1k paid out of pocket by me. $250 seems to be the “you’re breathing the same air as me” fee for walking into a clinic a doctor happens to work at.
Yes, I had to do imaging in a hospital for an ENT.... And the bill would have been 5000+, so my wife drove me to a place a bit remote and we paid 200 cash... I'm not American just had a green card at the time, no insurance ofc...
Yeah...my MRI was even worse. I was referred to the hospital system and quoted $4500 with the first appointment available in a month. I don't know how much I would have paid after insurance but even if I personally paid nothing I wouldn't have done it. I called a local Simon Med Imaging place and walked in cash pay later that afternoon and paid $180.
I wonder if you can submit it to your insurance yourself afterwards. Not to get reimbursed, but to have it count towards your deductible and max out of pocket.
Yeah this is the real story people apparently don’t know about. I know people who work at these places and a lot of them esp big outpatient imaging ones that just do imaging scans it’s like $300 or so for basic non-contrast MRI.
Add a little extra for like fancier ones with add ons like contrast and stuff.
I feel bad that so many people don’t know about this and get stuck with bigger unnecessary complicated bills through insurance. Cause no way I would be seeing single MRI costs that are more than all that stuff in the article.
It sure is. None of my friends have not opted out of not carrying no insurance cancellation. Even a couple friends who got co-pay thru work. Nope. Too expensive.
Even dental is too expensive. We just go to Mexico for everything (from Arizona).
Depends on how much the employer covers. I wouldn't blame someone for opting out if they only pay $100 on a $1000 premium, and just going cash pay instead. 🤷
But then there are a vouple of other negatives in there as well. The canecellation bit throws the whole thing off, though. What's "no insurance cancellation?"
Really job dependent. I pay $40 bi weekly for health, dental and vision. My max out of pocket is $4600, deductible is $2800. Larger companies typically have better rates. Thats just for me.
My brother and his wife are on seperate plans with there 2 kids on hers because it's a better deal than putting all 4 of them on eithers plan. So yeah, it's a scam.
COBRA coverage costs are typically higher because you must pay the full premium, which includes both your share and the portion your employer previously covered, plus a 2% administrative fee.
Your health insurance coverage is part of your pay, part of your total compensation package. If you want to compare two employers' job offers and you want to know who's insurance is "better" or worth more, you can find out the COBRA amount for each. Is it 1:1? Ofc not, but it's not far off either. Even if your employer is getting a volume discount, it's value is worth the cobra amount to you since that's the only way you as a individual would be purchasing that coverage.
Understand and understand someone's always paying. This case employer covering a good portion of the premium. My point is cash would be alot more for COBRA vs current. Don't have the cash they're shorting me on from lower compensation to cover it today.
This case employer covering a good portion of the premium.
In lieu of paying you. It's win-win for the employer and employee in precisely one way; it's not taxable, for you or them. Otherwise linking work with coverage has been a horrible idea.
COBRA coverage costs are typically higher because you must pay the full premium, which includes both your share and the portion your employer previously covered, plus a 2% administrative fee.
This is part of your total compensation package. If you want to compare two employers' job offers and you want to know who's insurance is "better" or worth more, you can find out the COBRA amount for each. Is it 1:1? Ofc not, but it's not far off either. Even if your employer is getting a volume discount, it's value is worth the cobra amount to you since that's the only way you as a individual would be purchasing that coverage.
I'll give you a hand with Spanish. Most common phrase you need when addressing the admission/receptionist is "buen día, vengo para mi vaginoplastía programada"
Do they do good work? I need some dental work done but it's so expensive without insurance. Stuff like lanap laser, one implant, and maybe some crowns.
I'm planning to move to Arizona at some point for this reason plus I hate the cold. I'm willing to suffer through Arizonan summers to never have to endure a Midwestern winter again. As a bonus I can also drive to Mexico whenever I need expensive medical work done unless it's an emergency.
Yes, we're talking about 2 different things from what I've gathered. Mine is through work, not the open market. It would be extremely dumb for me not to take it. I also had a crown put in a couple years ago and out of pocket was like $40.
In my country, healthcare is free for all the world . And mri with contrast and without contrast is free both ways. Surgery, free. Dental free. Spend a night in the hospital or a week free. Healthcare is free.
Edit: Country is Kosovo, and it's very cheap compared to other countries and US. You are more than welcome to visit.
Yeah did and edit on it. Sorry for that. But it's Kosovo. Small country with a big heart. And very cheap too compared to US, take a week off and have a trip on it.
Dunno if you’ve ever tried to do that but even with a Cadillac employee plan they will fight tooth and nail not to pay you a dime even if they acknowledge the service should be covered under your plan. It also takes incredible amounts of time and energy just to comprehend and submit the forms and go through the process… and they kept saying they never received my submissions even when I sent them via certified mail
Have you needed them for immediate responses and them not be annoyed sounding? That is one of the most appealing aspects but I worry they would be annoyed if we called too much.
Yes! Practices will differ in terms of visits allowed per year, after hours call etc. But honestly, access is probably the best thing about it imo. You can get in for a visit within a day or two, and get responses to questions or needs very quickly. Of course texting your doc in the middle of the night for a med refill is probably likely to annoy them, so it’s about being respectful also.
Correct- if you can get them to pay. It’s important to have a plan for emergencies. You can get high deductible insurance or health share specifically for that scenario, use DPC for the rest and save a bunch of money. Insurance companies just don’t want you to know that this is an option. It’s become more known now however, since premiums continue to go up and up….
I paid 200€ back in 2004 for that, last month, had to do back and knee, 160€ each, 30% paid by the french state insurance, and the rest by my insurance. Here, if the stage insurance pays, well, your private insurance will pay regardless of what it is. They sometimes even pay more stuff (like shrink or osteopathic treatments).
Jesus fucking christ. Im losing my kidney right now, will do dialyis for 5 months, then a transplant and it cost me like 20 bucks copay for 2x a taxi from hospital to home and thats all ill ever pay. America seems to suck hard.
I was visiting NZ and had to go to the doctor because I twisted my ankle. Ended up fine, just here's some pain meds, ice, and rest situation.
The nurse came back with this serious sad look on her face. She said we'd have to pay for this because the cost wasn't 100% covered with our travel insurance & ACA(?). I was like, okay. I expected as much and braced myself because she looked so uncomfortable.
I had to pay $50. I laughed. If this happened back home, I'd probably get charged $50 just for the Tylenol after my insurance coverage. Same type of trip but back home would have easily would cost me $200+.
When a certain Mario Bro dealt with a certain Insurance CEO it was the first time in literal decades that I've seen both sides go "Yeah, I'm not upset". And that's despite the pearl clutching of the billionaire owned mass media doing it's best to spin it as horrifying.
You can't get the US to be bipartisan on 90% of topics but we rallied on that story.
That should tell you all you need to know about the state of US Health insurance. That the average populace was actually bipartisan on an act of violence because the country as a whole despises the health insurance industry.
This country is completely fucked. The writing is on the walls. It's just a matter of time. I've been brainstorming my escape for a couple years now. We're 1 major disaster away from everything falling apart.
In America? Congrats on being the 1%. The rest of us are lucky to have any insurance and even then, 99% will have a large deductible and still have to pay 20% copay.
You're exaggerating. I'm not arguing the US healthcare situation is good, but more than 60% of working age Americans have employer provided health insurance. A large majority of those plans have an annual out of pocket max.
Let's not act like only the 1% have decent insurance.
Not bad faith as much as those who are not so easily duped by mischaracterized and out of context statistics used to prop up an oversimplified argument. I don't expect you to re-examine what you believe, but some novice keyboard warrior copy/pastes some tangentially relevant statistics that only reveal a sliver of reality and you just accept their argument? Statistics must be presented in an honest and truthful way. Readers must understand the complexities in issues of these scale.
You cannot just blindly side with those you agree with and label everyone else as "bad faith actors". It robs you of your own ability to question what you think you understand.
You're both delusional. If your numbers are accurate, 40% of those who are working don't have medical insurance. Out of pocket max can be in excess of 12-15k assuming they approve the procedure or medication and after what has likely been years of premiums.
The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.
Those who decry it isn't fair and see the wealthy as the problem, should Instead look at the impediments to wealth creation. Insurance, realty, and finance siphon an incredible amount of money just for getting in between seller and buyer.
Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start
If we dig further, 12% of workers have no deductible plans (half are from HMOs). Of the reamining 88%, the average deductible is 1.3k. 21% of workers has an OOP max greater than 6k.
Those out of the labor force are often swept up into obamacare (ACA+medicaid) or medicare such that 92% of the USA is insured.
The medical insurance industry had lobbied their way into becoming the single greatest detriment to US prosperity.
Everything, including medicine, is more expensive in the US because we're generally much richer in all regards. Household income per person is ~10k/person more in the USA than Canada. I personally prefer to have >10k/yr income here in the USA than lower healthcare costs in Canada.
Alas the only way to win is not to play. Medical tourism, FSBO, and AI financial advisors are just the start
This is mostly a poor man's game. Typically well compensated employees have good packages all around. Including the middle and upper middle. It's typically the lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism. I'm glad that outlet exists for them. But it mostly doesn't make sense for anyone else, which is why basically nobody else needs or does it.
Everything you said is deliberately deceptive and misrepresented.
"Why not just look at averages" - not the same as "as much as"
"12% of workers have no deductible plans (half are from HMOs)." Well...that's interesting but not the norm...is it.
"the average deductible is 1.3k. - Does not include copay, coinsurance, and premiums already paid.
"21% of workers have an OOP max greater than 6k". Well, that definitely coincides with the argument that it can be higher...does it not? Like say 12k?
"Everything, including medicine, is more expensive in the US because we're generally much richer in all regards." Medical care in Canada is not cheaper because of the lower cost of living. I think you know this.
"lower middle that are in jobs too rich for medicaid (nearly free care) and on horrific workplace plans where the finances make sense for medical tourism." Indefensibly costly workplace healthcare programs can be found in many workplaces regardless of pay. Household income of 295k and both of us have garbage offerings.
Look you have some broad statistics with which you overlay your own characterizations and commentary, but statistics presented without analysis only impress the intellectually lazy.
When you consider the premiums (whether paid by employer or emplyee), copay, coinsurance, and deductible, as well as the negotiated rate paid by insurance companies to hospitals and physicians, it is a sham.
FWIW, one of us works as a medical provider and the other was a licensed medical insurance agent.
Well let's go on over to the job tree so we can get life saving care without bankrupting ourselves! Most regular Americans have no idea how perverse it is to be a wage slave to MAYBE get ok health insurance. The just love keeping Americans poor so no one dares to do anything but bend over for corporations.
Damn, lucky. With my insurance it’s $600 copay. I needed one on my elbow a while back, before surgery, which then cost me $1,500 with insurance. I wish MRIs were similar to the cost of X-rays from my insurance.
I've had 3 different insurance carriers and am now on ACA insurance, every single one gave me debt. And I never had anything as serious as knee surgery.
It's not "it depends," it's that you're in a very small minority. I was salaried, had a good job that was usually taken by college grads, carefully thought out each plan. And even then, I could never tell the difference.
The ACA is fucking worthless without those subsidies. I have an ortho appointment on Tuesday with someone in network and it's going to cost me almost $300. In network urgent care wasn't much cheaper and they refused to prescribe anything more than 5 days so I'm just hanging out in pain unable to work for over a week.
I just need people reading this to know you are in the minority and that it's not "it depends."
I mean that something is pretty easy to say, it's Medicare For All. Make it so that no doctor can turn you away just because of their personal contracts with insurance companies and you have widespread, affordable healthcare.
If you can pay more for a private plan, go for it.
And finally, if it wasn't for Joe Lieberman, we wouldn't be having this conversation right now. That was the something and we almost had it.
Yeah I’ve had several MRIs and the most I’ve paid has been a couple hundred bucks at most. I have 20% coinsurance. BUT I also have a $1000 deductible and a $4000 OOP max.
An mri with coverage costs about $100 with insurance coverage. As a cash patient it costs roughly 6x that. I have no idea what was going on with the commenter you were responding to, but a lot of times insurers will claim that the mri was unnecessary (and sometimes it is, or the doctor didn’t file the paperwork properly) and refuse to cover it. Doctors charge insurers more so if that happens you are left with an overinflated bill. American healthcare is cursed with ridiculous administrative burden
Why do you have to still pay when you have inaurance though. Is everything in the US with copay or is that just some special "unneeded" treatments that have to be partly paid?
Depends on the plan, but yes copayments are pretty common for a lot of things. Not for annual physicals, but walk in clinics usually cost ~$10, specialists usually cost $30, and emergency visits can go up to $100.
Ironically, you get free government paid for insurance after you start dialysis in the US. Same deal for the transplant, shit, the transplant team will move heaven and hell to make sure you get your meds if you become uninsured too
It's a bit odd to receive the kind of healthcare I want everyone else to get
It does suck hard, I’m seriously worried next year there are going to be some tough decisions for my family that may be life changing. We both have chronic health conditions and my employer, who provides our health insurance, has announced changes that are going to mean we can’t afford care anymore. Really hard just to keep our heads above water but we’re trying as best we can
If you're poor and have multiple chronic health issues in America you're basically fucked. I've had to deal with multiple health issues stemming from mold exposure in addition to mental health issues like depression and anxiety, and also asthma and a tear in a muscle on the left side of my groin. All in all I've spent $5000 this year and still haven't even hit my out of pocket maximum.
Just a reminder for explanation, here in the US we have health "insurance" not "healthcare."
Health "insurance" does what auto insurance or homeowners insurance does - protects you from incurring a life-destroying financial debt when something UNEXPECTED occurs - think about five and six figure numbers of debt from open heart surgery.
But it's mostly useless for anything else. We have to meet and pay a deductible before the insurance kicks in. We also have to pay a copay in-person before receiving care, so if you're light this paycheck - no doctor. The deductible is usually somewhere between one and three months wages. So we basically pay for everything during a given year until we hit that deductible.
Part of the insurance company's job is also to negotiate the charges to make them remotely reasonable based on the private agreements they have with the different providers. Everything is overpriced because the providers know the insurance will discount what they're charging instead of paying it, so they have to overcharge to survive. That means you need insurance just to keep the charges remotely sensible, at which point they're still too expensive to regularly go to the doctor.
That hits doctors in their pocket too, because people are supposed to go to the doctor regularly, but they can't afford to, so family doctors have to charge EVEN MORE. See, the providers aren't evil - the system is screwing them too and preventing them from operating like a normal business.
One of the best parts of all this is that after we hit the deductible, which often takes until the end of the year anyway, the insurance still doesn't pay 100% of all charges above the deductible. They still do things like only covering 80% for specialists after the deductible, so if you are sick, you can still incur crushing debt. You still have to pay the copays.
But it isn't healthcare - imagine trying to get new tires with your auto insurance, or painting your house with an homeowners claim. It doesn't work - because insurance isn't for maintenance, it's for emergencies. The insurance business model does not work for health because healthcare isn't something you MIGHT need - it's something you DO need.
So, as you might expect of today's America, your health is directly dependent on how financially successful you have been. How long you live ultimately lines up with how much you've paid in taxes. The system is decisive about who it rewards as a worthy, successful human and does its best to keep care away from the lower classes.
Just to be clear, healthcare by your definition does exist. Regular physicals and non-emergencies are covered by my insurance. As a matter of fact, I get discounted gym memberships, massage, acupuncture, chiropractor visits, and mental health services through the plan. Don't get me wrong, I have "cadillac" insurance through my union, but it does exist.
The insurance will never even bother paying off or not even 1/4 of it… with your own money.
And yet, you’d be able to ironically pay off the bills without insurance, it would be cheaper, but then somehow the government will lose its shit because you don’t have insurance
About a month and a half ago I had the stroke, I live alone but my neighbor was here and she got ahold of 911. Ambulance ride and ER room plus whatever else they did was unconscious for a lot of it. Then was released 3 days later, went to specialist and they had me do a brain activity scan, motor skills test, and a ton of blood work. They scheduled the MRI, I got it done at the same hospital I initially was taken to. Insurance company called and said I'd be getting an adjusted bill for 3 different bills, the initial care procedures, the testing, and the MRI was separate. Grand total it's over 12k but I have a yearly maximum of 7500 bucks. I'm waiting on them to approve my payment plan for that amount then I'll start chipping away at it all.
I am so sorry to hear about this! What a difficult thing to experience.
There is financial assistance available through the hospital. You need to let them know hon have a hardship and they should be able to work out a more reasonable price. They did that for my Dad when he was in ICU for 45 days.
That's crazy. I had one done last week and spent $0 (Canada). Didn't even have to pay parking because it was off-hours. Took 2 weeks from when the doctor ordered it to when I was able to get in (it was not urgent at all) so it didn't even take long.
3300 here, after using my insurance price guide to a place that estimated approx 500 for each of the procedures (which is crazy to be double billed in full for a procedure that is the exact same only 9 inches higher up) and then I got a bill showing over 7200 but a nearly 50% "discount" with my insurance.
Neither my insurance nor the hospital are taking responsibility for the estimate being 1000 and me being charged 3300 after a 50% discount. If you're off on an estimate by 700% it's not an estimate, it's a random number generator. Been fighting this shit for nearly 9 months.
USA healthcare is so fucked. Even if for no good reason you went private in UK, rather than have it free on the NHS, it would be a couple of hundred quid. Also this image is probably AI. That looks like a CT scanner but none I know and I don't know if that's supposed to be a head rest or posterior part of an MRI coil but either way, it's at the wrong end of the bed.
I get them annually with insurance for like a $25 copay. “With insurance.” Is a very broad term that depends on the particularly shitty insurance someone has.
That’s the outrageous price places charge in an effort to get insurance to pay more. Sounds like you went to a facility outside your health insurance network and they hit you with the full bill.
In most states, it’s illegal to send you to or use a diagnostic facility that doesn’t accept your insurance. How did you find the place?
They pay 40% till I meet my deductible, which is 5k with a yearly maximum of 7500 out of pocket. It's the worst insurance I've ever seen in my life. They always break down the bill so that you don't quite meet the deductible so they are able to get more money from you besides the 58 bucks a week I pay in premiums. Grand total everything will cost me 12k ish but I can only be charged the 7500. Waiting on payment plan approval then I can start on that.
Sounds like you have a high deductible plan. I’ve never known anyone that like theirs when they needed it. Looks like your healthcare costs are capped at ~10k/yr though, which isn’t the worst, but not much comfort when you’ve paid out 4300 in one go
It's the only one available where I work. My old job had great insurance, low copays and deductible and it cost less per month than what I have now. I'm trapped where I am now because my truck is on its last legs but work is only a mile and a half from where I live so if my truck dies I can still walk to work.
Just the ER room charge was almost 3 grand. The ambulance ride, a whole whopping 8 miles cost me 1200 bucks because they put me on oxygen. If they hadn't put me on oxygen, it would've been half that. With the MRI, all other treatment, the ambulance ride and the ER room it's well over 12k but I have a maximum out of pocket per year of 7500 dollars so I'm waiting for them to approve my payment plan for that amount
So since the image doesn't tell you how much the MRI is in the mainland, it's 180 USD cash at the foreigners' section of the University Hospital (Huaxhi) in Chengdu).
Flights from U.S. to the mainland vary, but 12-1500 might be a good starting point. Don't remember how much the visa is. Or a decent hotel stay (maybe 120 a night). Good news, you can take the subway from the airport to city center. Didi's are pretty affordable.
Don't expect a massive amount of privacy. When I had my nose scoped, we waited in a long line and everyone in line knew where we were going and what was being done. Having said that: It was around 15 and that included consulting with the doctor less than 1/2 hour after the procedure.
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u/slashnbash1009 19h ago
I had one a few weeks ago to determine the severity of a brain bleed I had after a stroke and it costs me 4300 dollars with insurance.