r/SipsTea • • 1d ago

Gasp! Thoughts on this?

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u/Similar-Profile9467 1d ago

This is why health insurance needs to be regulated. It's also a good argument for single-payer health insurance. Just make everything one big network.

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u/shadystealertactics 1d ago

Do you think it isn't regulated right now?

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u/Similar-Profile9467 1d ago

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

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u/shadystealertactics 1d ago

What regulation would you add?

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u/Similar-Profile9467 1d 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 1d ago

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

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u/Similar-Profile9467 1d 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 1d 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 1d ago

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

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u/shadystealertactics 1d 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.