4 ms·
This is a far cry from the gravity of the post, but here's my personal anecdote about trying to navigate health care and insurance. A month or two ago, I was t
by recursive 2mo ago
This is a far cry from the gravity of the post, but here's my personal anecdote about trying to navigate health care and insurance.
A month or two ago, I was trying to set up a pediatric dentist visit for my son. Not a medical emergency, but a matter of some urgency. I spent about three hours on a total of a dozen phone calls or so. Some to the insurer, and some to various dentist offices in the region to inquire about scheduling and logistics. I learned that I needed to switch my son's primary office before he would be eligible to receive care. This could only be done once per month. Fortunately, by luck, this would take effect at the close of business on that very day. Next I needed to find a covered provider. Of course, the insurer could not tell me which ones would have openings at short notice, so I had to call several. Then I learned that in order for a pediatric visit to be covered, it needed a referral from a general dentist. The pediatric office helped me find a dentist who could fill out this paperwork, which felt lucky. I verified that my policy worked with this dentist office. Several hours on the phone, but I had a sense of accomplishment for sorting it all out.
The day of the appointment came. The visit went smoothly. Then I found out that it wouldn't be covered because the insurance will not cover pediatric dentistry above the age of 6, but my son is 7.
I think I'm going to opt out of dental insurance altogether in the next enrollment. All the individual people seemed to be doing their best to help me, but the end result is a system that is impossible for me to use.
- all2 2mo agoI've seriously considered opting out of health insurance altogether and stuffing away the obscenely priced monthly expense into an interest yielding account. Insurance is nightmarish, and I don't really want to deal with it much anymore. I know this might appear foolish, but fighting with a corporation whose incentives are adverse to my own (both on the medical side and the insurance side) makes me a little sick to my stomach.
- mothballed 2mo agoI did that for much of my 20s and very glad I did. You are basically used parasitically by the Obamacare system as it caps the differential between young and elderly to the point it's well into the expected negative value, and you're young enough that the off chance of the bet going bad only results in declaring bankruptcy on a few years of professional salary.
- EvanAnderson 2mo agoIf you have enough money for that gamble to pay off over the long haul the cost of health insurance would be immaterial to you anyway. You might get away with it in your youth, or you might have a catastrophic loss and have your finances wrecked. You're often able to negotiate discounts for cash payment from providers, but back when I had insurance that excluded a pre-existing condition I ran into providers who steadfastly demanded the full list price (under threat of collections). It only takes one of those standing pat on a high 5 or low 6-figure bill to cause you to lose on your "bet".
- JohnFen 2mo ago> you might have a catastrophic loss and have your finances wrecked. If you have health insurance (in the US) and you have a catastrophic event, your finances are going to be totally wrecked anyway. You're likely to have to declare bankruptcy unless you are pretty wealthy. At least, that's how it's gone with every friend and family member of mine that had to navigate such an event. That's on top of the painful nightmare that is dealing with insurance company claims (which, to add insult to injury, you have to do when you're injured or sick). The premiums are also so high that I'm very far from convinced that holding an actual health insurance policy is a better option than putting that premium money into an emergency fund.
- hobonation 2mo agoDepends. I got $300,000 in coverage for a catastrophic event and wound up paying $ 3,100. But I did have good insurance with United Healthcare.
- myrmidon 2mo agoQuick numbers that I found suggest lifetime healthcare costs of >$300k even if you're 65 already (with current yearly spending trending more towards $600k-ish). So even with a (single) catastrophic event just paying yourself might save you money still (which seems insane to me).
- rayiner 2mo ago
- mzs 2mo agoSimilar story for our youngest - excuse after excuse. We just bought two round-trip tickets to Warsaw and paid privately. It was a little more but my wife and son got to spend time with friends and family for that extra. The effort we had spent in US we never got back. I hope it worked-out okay for your family as well.
- usern20260720 2mo ago[flagged]
- tracker1 2mo agoFortunately, out of pocket for relatively normal dental care isn't too bad... probably because Dental insurance doesn't really help much and often easier to just pay out of pocket.. though do shop around if you do so.
- starkparker 2mo agoInsurance refused to cover imaging to identify my spouse's squamous cell carcinoma on an ovary because initial bloodwork didn't come back positive for ovarian cancer (squamous cell required different bloodwork, at least at the time). It took a doctor offering to misdiagnose it as a dermoid cyst to get the imaging and hysterectomy ordered and approved, and that still took 2 months. By the time it happened, the cancer had metastasized. The imaging would've cost a few thousand dollars. The hysterectomy would've cost about $20k-40k. Chemo was unsuccessful, and she died 9 months and about $2 million in medical bills later.
- OutOfHere 2mo agoWhich insurance firm was this? Fwiw, if one has a passport and some funds, one can travel abroad for cheaper surgery abroad. It won't guarantee an outcome, but it ought to be better than delaying it. Of course this in no way excuses the insurance firm.
- vkou 2mo ago> Which insurance firm was this? Any of them. They all behave in this exact same fucking way. Every single one has horror stories like this. Sometimes you get lucky, and they don't fuck your particular case over, sometimes you don't.
- illliillll 2mo agoOr get the international plan from Cigna and they will happily pay for just about anything from any non-US provider. So far over $5M into complex cancer care at the fanciest clinics in the world and never been questioned on a single claim.
- BrandoElFollito 2mo agoIn France, land of free helthcare, the problem is ultimately the same but for different reasons. We do not have enough doctors (they lobbied a law to set quotas) and finding a specialist is a near miracle. Then the doctors complain that they are overworked because of what their seniors put in place. The problem is never the money, though.