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$300 is your part of a regular doctor visit? Or the total bill? Do you have one of those high-deductible plans designed to discourage people from seeking any h

$300 is your part of a regular doctor visit? Or the total bill? Do you have one of those high-deductible plans designed to discourage people from seeking any healthcare?

ghaff 2y ago
When I was covered by an employer plan, a lot of people seemed to gravitate towards high deductible plans because they were cheaper so long as you didn't consume a lot of healthcare. (Personally, I never did but a lot of people were adamant that you saved money that way.)
- AlphaSite 2y ago
  You really need to look at how the employer funds it but often those are cheaper no matter what.
  - ghaff 2y ago
    I won't argue. I'd have saved a lot of money over the years with a high deductible plan.
  - dingnuts 2y ago
    not if you have a chronic illness. my wife hits her deductible every year just getting the annual MRI she's required to get.
    - BugsJustFindMe 2y ago
      My high deductible maximum out of pocket is lower than the available other plan's premiums+deductible with equivalent care policies. I save money on a high deductible plan no matter what happens to me medically.
- philwelch 2y ago
  I’ve long been a proponent of high deductible plans. The part you’re missing is that you also get the opportunity to contribute pre-tax money to a Health Savings Account, which is money that you get to keep (and even invest) over the long term. You can spend that HSA money on medical expenses but if you save it, it turns into another tax-advantaged savings account like your IRA and 401(k).
  - ghaff 2y ago
    I agree. I think I just had a very conservative mindset with respect to medical insurance which led me to a traditional plan. HSA would certainly have been a better choice in retrospect given that deductibles were never really an issue.
  - ryandrake 2y ago
    It's kind of silly they tie these together. Why can't I also open an HSA if I'm on a traditional PPO plan? Or if I have no health insurance as all.
    - phil21 2y ago
      Because a healthcare plan isn’t insurance. You used the correct term. If you want a prepaid healthcare plan that’s fine, just stop calling it insurance since it’s not. Totally agree it should be available for cash pay.
      - ghaff 2y ago
        It's insurance in the sense you have annual out-of-pocket maximums--which is really the key feature for a lot of people. I can cover $5K or $10K for a year but not, say, $100K or more.
  - eadmund 2y ago
    HSAs can be wonderful, but you absolutely have to have a good one. Some of them still pay less than 1% interest and charge monthly fees. The ones which can be invested and have no fees are an amazing savings tool.
tbrownaw 2y ago
> high-deductible plans designed to discourage people from seeking any healthcare This is in fact not the purpose of those plans. They try to actually be insurance (ie, in case of unexpected high expenses) rather than a combination of insurance plus pre-payment of typical expenses.
- ryandrake 2y ago
  It may not be the intent of those plans, but if it's the result, then that's what matters.
- alistairSH 2y ago
  But do they actually have that result? Or do they simply put people off of all early care
  - PaulDavisThe1st 2y ago
    as they say on the internet .. por que no los dos? 1. they do (post-ACA) function as effective bankruptcy insurance 2. they likely deter the people enrolled to avoid early/minor/preventive medical visits.
phil21 2y ago
High deductible plans are great. They are designed to allow you to take pretax money out and use it to either invest like an IRA or spend it on healthcare. In other words they are actually insurance. Not a prepaid healthcare plan. No one should be using “insurance” to cover every day expected expenses like random doctor visits for the flu. They are a small fight against the massive principal agent problem which is the sole issue anyone should be focusing on if they care about healthcare costs.
- PaulDavisThe1st 2y ago
  > No one should be using “insurance” to cover every day expected expenses like random doctor visits for the flu. The inhabitants of just about developed industrial/post-industrial society other than the USA seek to differ.
  - ghaff 2y ago
    That's largely how, e.g. dental works. You (outside of certain company insurance) pay for dental on your own which is also sanely priced.
- titanomachy 2y ago
  "No one should be using 'insurance' to cover every day expected expenses like random doctor visits for the flu." If it was like $20, sure, but when a "routine doctor visit" costs $300 I'd rather use insurance than deal with the mental load of deciding if it's worth the money. I wonder how many people develop more serious conditions because their high deductible tips the calculus towards avoiding the doctor.
404mm 2y ago
I was referring to the total bill, in both cases. Sadly, yes, I do have a high deductible plan. The $300+ bill usually gets adjusted to about 50% by the insurance (I’m in network), and then I pay my share, depending on the state of my deductible and out-of-pocket expenses. (So in my case, 90% before deductible is met, then 10%, until I reach my OOP max.) UC bill is processed in a similar fashion, and my actual responsibility tends to be less than from my primary care doctor.

$300 is your part of a regular doctor visit? Or the total bill? Do you have one of those high-deductible plans designed to discourage people from seeking any healthcare?

ghaff 2y ago

When I was covered by an employer plan, a lot of people seemed to gravitate towards high deductible plans because they were cheaper so long as you didn't consume a lot of healthcare. (Personally, I never did but a lot of people were adamant that you saved money that way.)

AlphaSite 2y ago
You really need to look at how the employer funds it but often those are cheaper no matter what.
- ghaff 2y ago
  I won't argue. I'd have saved a lot of money over the years with a high deductible plan.
- dingnuts 2y ago
  not if you have a chronic illness. my wife hits her deductible every year just getting the annual MRI she's required to get.
  - BugsJustFindMe 2y ago
    My high deductible maximum out of pocket is lower than the available other plan's premiums+deductible with equivalent care policies. I save money on a high deductible plan no matter what happens to me medically.
philwelch 2y ago
I’ve long been a proponent of high deductible plans. The part you’re missing is that you also get the opportunity to contribute pre-tax money to a Health Savings Account, which is money that you get to keep (and even invest) over the long term. You can spend that HSA money on medical expenses but if you save it, it turns into another tax-advantaged savings account like your IRA and 401(k).
- ghaff 2y ago
  I agree. I think I just had a very conservative mindset with respect to medical insurance which led me to a traditional plan. HSA would certainly have been a better choice in retrospect given that deductibles were never really an issue.
- ryandrake 2y ago
  It's kind of silly they tie these together. Why can't I also open an HSA if I'm on a traditional PPO plan? Or if I have no health insurance as all.
  - phil21 2y ago
    Because a healthcare plan isn’t insurance. You used the correct term. If you want a prepaid healthcare plan that’s fine, just stop calling it insurance since it’s not. Totally agree it should be available for cash pay.
    - ghaff 2y ago
      It's insurance in the sense you have annual out-of-pocket maximums--which is really the key feature for a lot of people. I can cover $5K or $10K for a year but not, say, $100K or more.
- eadmund 2y ago
  HSAs can be wonderful, but you absolutely have to have a good one. Some of them still pay less than 1% interest and charge monthly fees. The ones which can be invested and have no fees are an amazing savings tool.

tbrownaw 2y ago

> high-deductible plans designed to discourage people from seeking any healthcare This is in fact not the purpose of those plans. They try to actually be insurance (ie, in case of unexpected high expenses) rather than a combination of insurance plus pre-payment of typical expenses.

ryandrake 2y ago
It may not be the intent of those plans, but if it's the result, then that's what matters.
alistairSH 2y ago
But do they actually have that result? Or do they simply put people off of all early care
- PaulDavisThe1st 2y ago
  as they say on the internet .. por que no los dos? 1. they do (post-ACA) function as effective bankruptcy insurance 2. they likely deter the people enrolled to avoid early/minor/preventive medical visits.

phil21 2y ago

High deductible plans are great. They are designed to allow you to take pretax money out and use it to either invest like an IRA or spend it on healthcare. In other words they are actually insurance. Not a prepaid healthcare plan. No one should be using “insurance” to cover every day expected expenses like random doctor visits for the flu. They are a small fight against the massive principal agent problem which is the sole issue anyone should be focusing on if they care about healthcare costs.

PaulDavisThe1st 2y ago
> No one should be using “insurance” to cover every day expected expenses like random doctor visits for the flu. The inhabitants of just about developed industrial/post-industrial society other than the USA seek to differ.
- ghaff 2y ago
  That's largely how, e.g. dental works. You (outside of certain company insurance) pay for dental on your own which is also sanely priced.
titanomachy 2y ago
"No one should be using 'insurance' to cover every day expected expenses like random doctor visits for the flu." If it was like $20, sure, but when a "routine doctor visit" costs $300 I'd rather use insurance than deal with the mental load of deciding if it's worth the money. I wonder how many people develop more serious conditions because their high deductible tips the calculus towards avoiding the doctor.

404mm 2y ago

I was referring to the total bill, in both cases. Sadly, yes, I do have a high deductible plan. The $300+ bill usually gets adjusted to about 50% by the insurance (I’m in network), and then I pay my share, depending on the state of my deductible and out-of-pocket expenses. (So in my case, 90% before deductible is met, then 10%, until I reach my OOP max.) UC bill is processed in a similar fashion, and my actual responsibility tends to be less than from my primary care doctor.