Pretty much every plan has an annual out of pocket max, and in order to be listed on an exchange it has to be under $9,200 for an individual or $18,400 for a family. Balance billing is also now illegal, so whatever the insurance won’t pay can’t be billed to you. That’s the bare minimum, and it’s already the law.
So if you can find a plan that will cover any doctor you find (even if “out of network”), you can have what you’re looking for. It probably won’t be cheap, but what you’re asking for is in most plans in some way or another.
They do, but of course it depends on your company offering it.
The combination of “high deductible health plan” (cover everything after $x,000) and a “health savings account” (set aside pretax money, accumulate and invest) really seem like a solid improvement over everything else. If your company offers it. If you can afford to keep at least the full annual deduction in an HSA
That being said I’ve never been able to take advantage so I could easily be wrong. I currently pay for “old fashioned insurance” which really is the way your parents remember it,covers everything, low deductible and copay no out of network nonsense, but oh so expensive. Y’all with crappy insurance can at least applaud not paying premiums I’m stuck with
If you have good insurance, this is absolutely what it can be. My work pays for mine, and the max out-of-pocket is $3.6k/yr. I had already hit my max, then wound up with a $4k ER visit, so it wound up being free. Unfortunately, most insurance is fucking awful unless your company is willing to pay a shitton for some very expensive plan.
Well, most insurance is only for emergencies, and it is priced accordingly. For example, when I drove a car, I didn’t have to deal with my auto insurance plan at all while getting gas or normal maintenance. However, when I got into a few bad accidents, the car insurance was vital for continuing to have a car, and it paid towards helping me get it fixed. Car insurance is insurance against something catastrophic happening to a vital part of life in most of America, not something to use everyday, and is priced accordingly.
Health insurance here is very different from car insurance. Rather than an emergency contingency, health insurance is woven into most healthcare purchases in the U.S. Accordingly, it is very expensive, limiting, and inefficient. Due to the dynamics of the system it creates, Americans must usually pay through the nose for even everyday healthcare without insurance.
If health insurance was operated more like car insurance, except of course that a human life should never be “totaled out,” the system would eventually adjust and normalize.
Are you suggesting routine visits not be covered? That’s how it reads… Do we think less (because it costs) basic preventative care and planning will lead to less catastrophic/etc issues? Or by not covering it are we expecting “competition” to lower the price?
Yes, that’s what I’m suggesting. Keep in mind that in most other countries where insurance has less of a role, these are vastly cheaper than they are here. I expect more people will ultimately go then, especially the uninsured, because prices would no longer be artificially inflated by bureaucracy and for the purposes of negotiation with insurance.
The hard problem, the way I see it, would be taking us from here to there with minimal suffering during such a transition.
We could also go the opposite direction towards single-payer healthcare. That also can be more efficient than what we have if politicians don’t sabotage it, but I am concerned that here, they will, and we’ll end up with something like the U.K. NHS. Therefore, for the U.S. specifically, I don’t see this as a good option due to instability.
What we have now is a compromise that works for nobody.
I get what you’re saying and completely agree the current situation works for no one, but covering routine care is important. Sure, people probably could pay for routine care directly and it would be cheaper but all too many won’t. When it turns into a serious problem that could have been prevented, it’s not just their health affected but cost to the insurer and employer.
I’m pretty sure that 100% coverage of routine care has been proven cheaper than letting the person decide
We pay a premium, which is a monthly or weekly payment to the insurance company in the same amount each time.
Then, when we see a doctor, we have to pay a copay (a single payment in a fixed amount), coinsurance (payment of a particular percentage of the whole cost), and a deductible (either a per-visit or per-year amount where we have to pay ourselves before an insurance company pays). Together, these types of payments are known as member payments, member responsibility, or out of pocket payments, and they’re capped at a particular amount per year (at most $9,200 for an individual or $18,400 for a family).
It’s a complex system, and insurance is only a part of the problem. Plenty of countries have private insurance and don’t have these issues (Germany, Austria, Switzerland, Japan, South Korea). And many of the providers in the US (hospitals, doctors, clinics, labs) are scummy corporate profit-driven providers and try to enrich themselves at the expense of insurance (including government and nonprofit insurance), so there’s a lot of fraud and anti-fraud measures creating messy overhead and inefficiency.
Yeah, I wish health insurance was just “you’ll never pay more than 20k a year on medical bills” or something like that. Let me find my own damn doctor
Pretty much every plan has an annual out of pocket max, and in order to be listed on an exchange it has to be under $9,200 for an individual or $18,400 for a family. Balance billing is also now illegal, so whatever the insurance won’t pay can’t be billed to you. That’s the bare minimum, and it’s already the law.
So if you can find a plan that will cover any doctor you find (even if “out of network”), you can have what you’re looking for. It probably won’t be cheap, but what you’re asking for is in most plans in some way or another.
They do, but of course it depends on your company offering it.
The combination of “high deductible health plan” (cover everything after $x,000) and a “health savings account” (set aside pretax money, accumulate and invest) really seem like a solid improvement over everything else. If your company offers it. If you can afford to keep at least the full annual deduction in an HSA
That being said I’ve never been able to take advantage so I could easily be wrong. I currently pay for “old fashioned insurance” which really is the way your parents remember it,covers everything, low deductible and copay no out of network nonsense, but oh so expensive. Y’all with crappy insurance can at least applaud not paying premiums I’m stuck with
If you have good insurance, this is absolutely what it can be. My work pays for mine, and the max out-of-pocket is $3.6k/yr. I had already hit my max, then wound up with a $4k ER visit, so it wound up being free. Unfortunately, most insurance is fucking awful unless your company is willing to pay a shitton for some very expensive plan.
20k a year? That would be better that what you have now? Sincerly, a non-USAian
Well, most insurance is only for emergencies, and it is priced accordingly. For example, when I drove a car, I didn’t have to deal with my auto insurance plan at all while getting gas or normal maintenance. However, when I got into a few bad accidents, the car insurance was vital for continuing to have a car, and it paid towards helping me get it fixed. Car insurance is insurance against something catastrophic happening to a vital part of life in most of America, not something to use everyday, and is priced accordingly.
Health insurance here is very different from car insurance. Rather than an emergency contingency, health insurance is woven into most healthcare purchases in the U.S. Accordingly, it is very expensive, limiting, and inefficient. Due to the dynamics of the system it creates, Americans must usually pay through the nose for even everyday healthcare without insurance.
If health insurance was operated more like car insurance, except of course that a human life should never be “totaled out,” the system would eventually adjust and normalize.
Are you suggesting routine visits not be covered? That’s how it reads… Do we think less (because it costs) basic preventative care and planning will lead to less catastrophic/etc issues? Or by not covering it are we expecting “competition” to lower the price?
Yes, that’s what I’m suggesting. Keep in mind that in most other countries where insurance has less of a role, these are vastly cheaper than they are here. I expect more people will ultimately go then, especially the uninsured, because prices would no longer be artificially inflated by bureaucracy and for the purposes of negotiation with insurance.
The hard problem, the way I see it, would be taking us from here to there with minimal suffering during such a transition.
We could also go the opposite direction towards single-payer healthcare. That also can be more efficient than what we have if politicians don’t sabotage it, but I am concerned that here, they will, and we’ll end up with something like the U.K. NHS. Therefore, for the U.S. specifically, I don’t see this as a good option due to instability.
What we have now is a compromise that works for nobody.
I get what you’re saying and completely agree the current situation works for no one, but covering routine care is important. Sure, people probably could pay for routine care directly and it would be cheaper but all too many won’t. When it turns into a serious problem that could have been prevented, it’s not just their health affected but cost to the insurer and employer.
I’m pretty sure that 100% coverage of routine care has been proven cheaper than letting the person decide
You guys pay for insurance and for medical treatment?
We pay a premium, which is a monthly or weekly payment to the insurance company in the same amount each time.
Then, when we see a doctor, we have to pay a copay (a single payment in a fixed amount), coinsurance (payment of a particular percentage of the whole cost), and a deductible (either a per-visit or per-year amount where we have to pay ourselves before an insurance company pays). Together, these types of payments are known as member payments, member responsibility, or out of pocket payments, and they’re capped at a particular amount per year (at most $9,200 for an individual or $18,400 for a family).
It’s a complex system, and insurance is only a part of the problem. Plenty of countries have private insurance and don’t have these issues (Germany, Austria, Switzerland, Japan, South Korea). And many of the providers in the US (hospitals, doctors, clinics, labs) are scummy corporate profit-driven providers and try to enrich themselves at the expense of insurance (including government and nonprofit insurance), so there’s a lot of fraud and anti-fraud measures creating messy overhead and inefficiency.
We pay for insurance, out of pocket deductibles and copays. Even when everything is covered.
Naw just insurance, can’t afford the treatment.
Not everybody. Some of us just die instead.