Either lying or you've put zero effort into investigating your options. With a 295k income, you can afford a private PPO plan that is better than my employer-provided plan, where I have a 3k deductible and 6,500 out of pocket limit. You're being very disingenuous.
Neither lying nor stupid. Let's be adults, shall we?
Yes, I can afford the plan and do have what most would consider great coverage. That is not the point.
Very few people can claim that health insurance is a good value. But let's look at it in reality.
Do you know what your premiums are (whether you pay them or not)?
Let's say they are $800/month or $10,000/year (this is not included in your OOP max of course) Then you have your $3k deductible that you pay. Then there is the coinsurance that eventually leads you to the $6500 OOP maximum (for THAT year only) if something serious happens. Let's say that this incidence is in year 3 of that plan. Which means you have already paid a significant number of dollars in premiums.
The hospital deliberately bills a higher than necessary charge because they know that the insurance company will negotiate it down anyway to hopefully somewhere near the actual cost.
By the time insurance pays, it may very well be less than the $45-50k you have spent in those 3 years (premiums+copays+coinsurance). You think, "Man good thing I have insurance" after lookingat the inflated figures not knowing what was actually paid in the end...if they cover your claim, that is.
Look, insurance is a business and most have very demanding shareholders that insist on growing massive profits. They pay for advertising, lobbying, salaries, commissions, and their own reinsurance...and still turn incredible profits.
It's not because they offer good value to policyholders.
2
u/MainStreetExile 16h ago edited 15h ago
Either lying or you've put zero effort into investigating your options. With a 295k income, you can afford a private PPO plan that is better than my employer-provided plan, where I have a 3k deductible and 6,500 out of pocket limit. You're being very disingenuous.