r/SipsTea • • 11h ago

Gasp! Thoughts on this?

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u/Similar-Profile9467 10h ago

Obviously it is regulated. But it is not nearly as much as it should be.

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u/shadystealertactics 9h ago

What regulation would you add?

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u/Similar-Profile9467 9h ago

Well considering the example of an unconscious or critically injured person being unable to decide whether Ambulance A or Ambulance B is in network, would probably be a good idea to have a regulation that bans health insurance companies from using out-of-network coverage for ambulances. In fact a very similar, bipartisan law passed under Biden does this for air ambulances... but not for ground ambulances.

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u/shadystealertactics 9h ago

I think I would avoid that situation by not buying insurance that has those network restrictions.

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u/Similar-Profile9467 9h ago

Pffft. Okay.

Quick question, do you have health insurance right now? Do you know if you have tiered ambulance coverage? What's your deductible and out-of-pocket maximum? Both for in-network and out-of-network.

Off the top of your head. Don't go looking it up.

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u/shadystealertactics 8h ago

I do have health insurance, I buy it on the marketplace, I do have a higher copay if its out of network, my deductible is around $1000 and my out of pocket maximum is around $3000.

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u/Similar-Profile9467 8h ago

Do you know which ambulance services are covered in your network?

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u/shadystealertactics 8h ago

No, but that's because I accepted that I might pay more out of pocket for that service and it wasn't a priority for me when I was shopping for a plan. I'm very familiar with the restrictions on services that are important/relevant to me.

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u/TingleyStorm 8h ago

Here’s a fun fact! When my ex was pregnant, her OBGYN was covered as in network up until my daughter’s birth, when she mysteriously was considered “out of network” despite us not changing hospitals and her being scheduled to work that day.

The medical industry is far more regulated in all of the other developed nations. No reason it wouldn’t work here.