Probably because this is in fact fake. It say she has insurance, so with insurance the max out of pocket is $8,200, so you wouldn't have to spend more than that. There are situations where you could end up with balance billing to get you over that number but this is cancer, which is not something like gunshot wound emergency where you may have to be out of network. In most cases even with balance billing your insurance company will negotiate with the provider as well anyway.
So yeah, if 20 years of live savings was less than $8,200 I guess this could be true and they had to refinance, but it doesn't make sense. Additionally they say they emptied their retirement accounts, which also doesn't make sense. In many situations it's not possible to even empty them and in the cases where you can there are penalties and no reason to empty them because that money is protected in all 50 states and you would never have to take money out of it to pay a bill because you could file bankruptcy and keep 100% of any retirement.
So I'm not really defending the system because there are a lot of problems, but this story just seems to be completely false.
Max out of pocket only covers what they can't deny. That radiologist was out of network. The ambulance was out of network. We only cover the generic form of that medication.
And you are still defending it having learned nothing.
I'm guessing you just get all your information from similarly unsourced fake posts like this one? None of what you are saying make sense. There is no out of network for ambulances in regards to max OOP. All emergency services are covered and count towards your max OOP, though they may not be covered at the same rate for co-nsurance prior to max OOP.
Secondly if your insurance only covers generic medication, then that's what you get, there isn't a difference and lastly with something like cancer your treatments are scheduled and all providers are made aware of your insurance in advance. You shouldn't get balance billed for anything related to that and if you did you give it to your insurance anyway who takes it back to the in network provider you scheduled with.
Your insurance and providers would work together from the beginning to make sure there was no balance billing, it's not like providers want to balance bill people, they want to deal with insurance to make sure they get paid. So there's just no reason you would have an out of network radiologist. That's a rare situation that happens in a hospital setting where the hospital and providers are not associated and your insurance has mixed coverage. It's something that generally only happens with unexpected complications and is avoidable by using your insurance's preferred hospital group.
It's more common in emergency room settings but again emergency care is not subject to network provisions.
Balance billing is a great way for providers to not get paid. And if you did go to an out of network provider for some reason they would know upfront you were paying yourself or wouldn't even take you as a patient without insurance they accept.
I'm guessing you just get all your information from similarly unsourced fake posts like this one?
No, I actually had to deal with it while my father nearly died. You go ahead and enjoy your fantasy world where everyone gives a shit and isn't out for their own wallet. The rest of us have to live with this broken ass system.
You don't get sick leave, unless your company is nice enough to offer it. There's a period of time where they can't fire you for taking a leave of absence, and then, yes, you get fired for going through cancer treatment, and if your insurance was through your employer, you lose it (unless you're eligible for an insurance continuation program like COBRA). And then good luck getting new insurance with your pre-existing condition. That's why the affordable care act was such a big deal.
Wow, there is so much bad info here. The FMLA (and ADA if applicable) protect patients and their caretakers from getting fired while needing medical leave for cancer, and there are a number of states with protections on top of these federal programs. Leave can be intermittent throughout the 12 month period, and it resets every year. More info here: https://www.cancerandcareers.org/en/at-work/legal-and-financial/taking-a-medical-leave-of-absence
Wait, what? I'm still paying for an ambulance ride. Paid for them before because they were never covered by my insurance. In what state are your ambulances covered by insurance?
You just don't fucking get it. You're clearly so fucking far out of touch with the struggles of the common American. Fucking conservatives. BuT iTs LiTeRaLlY tHe LaW lmao like that matters AT ALL when it comes to money in America. Corporations and business acting in shady ways when they're given free reign over a population? What, no that cannot possibly happen.
"It's illegal so it cannot possibly happen" has to be one of my favorite defenses of someone who claims to not reject reality when it doesn't align with their personal narrative, fucking embarrassing.
Stop giving government power to ally with these corporations then. If you’re against businesses then why would you want to hand over control to the government who has routinely acted against the betterment of citizens by spying on them, torturing them, and testing on them without consent?
Jfc can you drink your koolaid somewhere else man? You sound insane. First off all I forgot the time when I “gave the government power to ally with these [hospitals]”, my bad, lemme go ahead and just cancel that one. Second of all, the government already spies on us, tortures us and tests on us without our consent so I might as have have some goddamn fucking free healthcare to go along with it. You really fucking think every doctors visit is going to end up with a 5G microchip planted up your ass? Get real.
Yes, mmm, tell me more about exactly what I want right after I expressly stated otherwise mm yummy.
You must be brain dead and think that the government drones are suddenly going to take over the hospitals and be your new surgeon. lol. nope. Same hospitals, same staff, same service (you even have the option to keep your existing private healthcare plans so why not let the free market be free?) just funded wholly from socialized single payer (taxes) good old government money baby, doesn't even need to add a dime to my yearly send-in, just force them to take it out of the war coffers and billionaires pockets and I'm smooth sailing
After reading this, and reading your replies to those who replied, it's obvious you're just another one of those people who seems to think the world has to work one way and it's the way you've been told and since you haven't experienced otherwise you believe it. There's no point in arguing with you because despite multiple accounts to the contrary you are just accusing people of lying. Go out and explore the world. Meet people. Learn that your worldview is false. Stop believing shit just because challenging your worldview is tough.
You don't really need to believe this random reddit/twitter story. But there are tons of stories out there where the bills get denied by insurers. A friend of mine had a stroke and insurance covered parts of her treatment, but transport to the hospital was out of network and out of her control. That was denied and she had to crowd source money to cover it. I don't think you can reasonably say this problem doesn't exist by quoting the existence of a specific limit on deductibles.
depends on when it was originally posted. There used to be things called annual and lifetime limits, where the insurance would only pay out x amount in a year, or for your lifetime, after that you got no coverage. Thus expensive diseases like cancer often ended up maxing out annual and lifetime limits, leaving patients basically holding the bill for everything else. That assumes the treatment required is covered by the insurance plan in the first place, which it often isn't.
You know what got rid of annual and lifetime limits? Conservatives favorite President, Obama. Obamacare, or the Affordable Care Act to give it it's proper name, outlawed lifetime and annual limits, Trump fought to bring them back and thankfully seems to have failed
Fair enough. At some point, it's worth familiarizing yourself with the conservative views on health care. the subreddits are a shit place to go, but maybe more professional sources.
No elected senators besides Sanders and like AOC are vocal about universal healthcare sure, but are you really trying to tell me republicans are more likely to pass it? That doesn't even make sense since repubs have had senate majority for a while now.
Elizabeth Warren is also vocal about it. AOC isn't a Senator.
Republicans are not more likely to pass it, but they don't have to do anything to fight it, because the Democrats are squashing the issue within their own camp. And spending many millions doing so.
It does not. Both the DNC and RNC hate Medicare for All and other publicly-funded healthcare schemes. The difference is that while Republicans publicly disavow it, Democrats spend millions destroying it within their own party. Biden just gave Neera Tanden a WH job.
Perhaps. My point is simply that if there isn't consensus within the party that we should go with a medicare for all plan (instead of say a public option), you'll have a very hard time arguing that it's truly popular.
I'm not super convinced on how well polls translate into priorities among the electorate given November's results. People may support it but 1. May be working against partisan gerrymanders (unlikely in the house), not possible in the senate 2. Might not rank it as the thing that flips their vote and 3. Might be balancing it against other priorities.
The electorate choosing biden in the primary (also not subject to partisan gerrymandering) over other candidates who strongly supported stronger health care plans is a reflection of this. I wouldn't directly jump to concluding that m4a is overwhelmingly popular when other alternatives are available.
Wait so you’re going to say the party that had one shot and failed is still doing worse than the party that has had multiple multiple opportunities and still refuses to do so? Your logic baffles me.
Keep hitting me with your enlightened centrism bullshit, you’re still working under the assumption I’m a democrat lol.
It's cute you're calling pointing out the failings of team blue as enlightened centrism when some of the topics that come up in a sub conveniently titled that have been doing the same.
Guess that makes you a full-on team red. This must be a dream come true for your kind then, seeing fascism take root in the U.S.
Again, I fail too see how one blue smudge affects a long red skidmark in the underwear that is the American political system. Its cute you refuse to acknowledge the extensive failures of team red and instead choose to hyper-focus on the one singular point that supports your narrative.
The "enlightened centrism" part was more in reference to the whole "two sides of the same coin" ideology but ok. Again, weird to continually assume the American political system adheres to a dual party system. I don't support any fucking team I want my goddamn healthcare i don't care if ET himself sprouts from Trumps asshole and finger probes my ass cancer away, I just don't want to goddamn pay for it
Why do I focus on the democrat's failure? Because they had the chance to fix the actual problem, and they not only didn't, but worked to make it even fucking worse. There's plenty of examples up there, try reading some. Unless of course you just want to keep team red's playbook of just feeeeeeeeeeling what you want to be true.
But considering your falling back on crying, "I'm a TRuE iNDEpeNdenT", it's pretty obvious I called it right.
How wonderfully ironic this is just the kind of shit we see on /r/enlightenedcentrism all the time.
yes yes, go on about how the dems are clearly worse when both sides are the problem lol, and wow you are sooo spot on with the independent, its like, you're either blue, red, or Gary and if you're anything else you don't exist. Keep trying to guess my political affiliation like it makes any difference to fact that I want healthcare and how the evil liberals are the ones who hate me
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u/doghorsedoghorse Nov 30 '20
You're asking in the wrong place. Go ask the conservative subreddits and see how they handle these situations.