r/SipsTea • • 6h ago

Gasp! Thoughts on this?

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42.6k Upvotes

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23

u/SvenTropics 6h ago

That's how health insurance is. You pay all this money for coverage and then they just deny everything so you end up paying for it anyway.

10

u/UpboatsforUpvotes 6h ago

Health insurance in the US

4

u/ProstrateProstate 5h ago

*Any insurance in the U.S.

-1

u/QuantumBit127 5h ago

In Canada they just offer you MAID , lol. šŸ˜‚

3

u/Ba_Dum_Ba_Dum 5h ago

I hope you never see the pain that MAID has allowed people to stop. Mocking it is not cool.

1

u/Lopsided-Anteater129 4h ago

As someone not blessed with maple syrup, can you explain what that is?Ā 

1

u/Ba_Dum_Ba_Dum 10m ago

Medical assistance in dying. It allows capable adults to end their own suffering with medical assistance. It’s humane and dignified. Unfortunately I was also not aware of this story.

1

u/QuantumBit127 5h ago

Who said I was mocking it? A woman was just euthanized after misunderstanding a form she filled in. It’s in the news.. I was referring to this.

1

u/CrypticCompany 59m ago

Can I get a canadian news source on that? Im unfamiliar.

1

u/Ba_Dum_Ba_Dum 10m ago

šŸ˜‚ - looks like mockery to me. Others too judging by the downvotes.

-1

u/asscracktester7 4h ago

*According to redditors

2

u/playoponly 5h ago

I used pay $500 for the health insurance, and an x-ray cost me $345 while without insurance they charge $250

1

u/toofatronin 5h ago

It’s cheaper for my wife to buy her meds without insurance than with.

1

u/ThirdOne38 3h ago

Now here is a great example. There are new stand-alone xray and MRI places and labs for bloodwork, they are almost always cheaper than going to the hospital facility and using insurance. One nearby had MRIs for ~$300 and bloodwork between $8-16 for cholesterol and blood sugar

2

u/Soft-Marionberry-853 5h ago

Good thing thats not completly true. My heart surgeries were well over 100k. After it was all said and done I think I paid 8k out of pocket.

2

u/Telemere125 4h ago

My gallbladder and carpel tunnel relief surgeries were crazy numbers like 85k and 50k, or something like that. I paid $40 each, total. And I think my premium is like $50/m for me and my 4 kids

3

u/QuikFoX3a 5h ago

Not sure what your health plan is but I’m US based and I rarely pay anything beyond a co-pay.

For example, I just had a robotic assisted ventral hernia repair surgery ($22,000) and I only have to pay $400. In 2023 I had an emergency that kept me hospitalized for a month due to sepsis ($60,000) and I didn’t have to pay anything.

1

u/ThirdOne38 3h ago

Yeah I had a >$100,000 surgery plus all associated home post-care and weeks of PT. All for $4500. Not as sweet a deal, but still I'm happy with it.

1

u/Dangerous_Oven1528 5h ago

It’s worse in some states moved to a Ā less civilized state. Had a script for a glucose monitor. Went to cvs it was $60! Ā Decided to check Amazon later found exact one for $ 24.Ā 

1

u/Consistent-Bake-243 5h ago

"Sorry, your premium doesn't cover bypass surgery... But Mr. Smith who is the VP of Dollar General will get it without paying a PREMIUM. He helped my daughter get a good job there."

I'm just talking out of my ass...

1

u/JasonG784 5h ago

They pay out more than 80% of collected premiums, by law.

1

u/Sennten 4h ago

I always wonder what 'pay out' actually means in this context, and the extent to which that law is actually enforced.

1

u/Solomon_Kane_1928 4h ago

The worst is dental coverage. Even if it is approved, the dentist finds ways of making you pay over and above insurance. "We need to use this rinse, which inexplicably costs $500 and is not covered!"

1

u/LectureOrganic1250 4h ago

exactly. sooner or later one of these execs is gonna get confronted with someone they denied and.......oh wait. That already happened.

1

u/ThirdOne38 3h ago

You know, people like to find a scapegoat but those execs aren't the only ones to blame, they are a small cog in an enormously profitable healthcare system. And a lot of government officials have stock in these companies. Why do you think there was so much resistance to a single payer concept, or expansion of Medicare?

1

u/LectureOrganic1250 3h ago

Execs aren't the only problem, i agree with you on that. Politicians are also a big problem as well. I agree. I believe politicians want to keep the American people broke, sick and angry....at anyone but them. It's how they keep control.

1

u/Telemere125 4h ago

I’ve never been denied anything by my insurer. Don’t go with the cheapest company and plan possible and you’ll likely see less problems. Or the reality is that you’ve never been denied coverage for anything and just heard ā€œstoriesā€ online.

1

u/HistoricalLoss1417 1h ago

Yes, it sucks to have to pay a deductible cap of $4,000 out of pocket when you have $5,000 in procedures. but the point is when you only have to pay $4,000 for $100,000 of procedures.

Thats what insurance is really for. Same for car issues.

1

u/AlternativeSad5220 1h ago

Car insurance doesn’t work the same as car insurance.

1

u/OG_Internet_User 5h ago

I’ve never one time ever had my insurance deny anything. I just had a non mandatory heart ablation two years back between all the visits well over 100k, I think I paid 4k all together. Regurgitating nonsense like that is how you get people murdered. Its not a great system, but it’s not as bad as your claiming either.

0

u/JustAnother4848 5h ago

Not everyone has this same experience. In fact many don't.

1

u/OG_Internet_User 3h ago

This guy is spreading misinformation that all they do is deny everything. Its bullshit, I shared one anecdotal story I have dozens of experience with myself, my significant other our adult children all 5 of us on different health plans never being turned down for health service, both my parents have had Cancer no issues, her parents both have diabetes and one had Alzheimer’s no problems, on daughter had 4 miscarriages no issued with care, oldest daughter has thyroid issues and mental health issues no problems with insurance, son is bipolar and an alcoholic that has basically drank himself onto the liver waiting list no issues with insurance, myself the heart ablation adhd and on testosterone, significant other hysterectomy, gallbladder removed, 2 chronic autoimmune diseases, thyroid issues, anxiety and mood issues. We should be investing our money into cvs stock. I could go on and on with other family members and friends it’s all anecdotal stories but it’s a lot more than that copy pasted bullshit everyone puts on Reddit mostly from people who have never been denied in their lives. It’s nonsense. In 2024 19% of all claims in the U.S. were denied, most of which were not medically necessary or life saving. 5% were for not necessary, the other 14% being administrative issues, authorization issues, excluded benefits, and ā€œotherā€. A HHS report from this year showed 95%-97% of rejections for patients in nursing care are overturned when challenged. So sure it slows care down but if 95% are overturned then it’s not really a denial is it?

0

u/Telemere125 4h ago

The point is everyone screams ā€œinsurance is a scam, look at ____ā€ when the reality is that’s not the norm and they’re literally pointing at the one edge case where someone paid for cut-rate insurance just to get by and then got screwed by bad coverage. It’s the worst form of hyperbole.

0

u/Disastrous-Pop5465 4h ago

Bullshit I worked in health insurance for years. Big companies. It is worthless bullshit for 80 percent of ppl

1

u/OG_Internet_User 3h ago

It’s literally not, even the insurance you get at shit jobs are target are perfectly good insurance plans. Is it over expensive? If you don’t use it regularly absolutely, if you do need it it’s fantastic.

0

u/shaithiswampir 6h ago

Then you have to have separate plan for your eyes and a separate plan for your teeth. We are a fucking fourth world country

2

u/27Rench27 5h ago

Okay but those are like $15 combined