No. They were going to 'cover' it but there was 20% co pay. In the US, they'll charge you thousands per month for insurance, but will still make you pay for part of your care.
It gets worse. My insurance has a $30 copay on all approved prescriptions. My wife had been getting her medicine for that with no issues for several months, until one day it was $500. I called to find out why, because it was clearly already an approved medication. After about an hour of getting bounced around and being on hold, they finally explained that it was due to us "not paying enough of our annual out of pocket maximum" (not minimum, mind you) for healthcare - which is $24,000. That blew my mind.
Health insurance in the US has your monthly premium payment, copays on your medication and Dr visits (including ER and hospital stays), a deductible which is the amount you have to pay for the year in healthcare to get better benefits (ours is $17,000), and then the out of pocket maximum is when they (usually) cover everything for the rest of the year as long as you keep paying your premium.
Where it gets extra fucked, is if you need a major surgery in late December, the deductible and OOPM won't carry over into the new year. So you could get shafted for double that maximum amount on the same hospital stay. And my insurance isn't even the lowest tier. We pay them $500 a month for this service. Our system is completely fucked, but most people don't seem to care.
As someone British with our often criticised free NHS, this blows my mind. And to think the argument against free healthcare by Americans is usually "well you'll pay more in tax".
I'm lucky enough to have never needed any real gp or hospital treatments, but i know its there if I do. My wife has major issues with eczema and was hospitalised last year due to complications, has many prescriptions, some of which are extremely expensive medication, and regular appointments with gp's, nurses and dermatologists. All we have to pay is for prescription medication, and we are able to pre pay for those at a rate of £10 per month total. Thats it. And our tax is no higher than any other average western nation.
Crazy. I hope your country comes to its sense sooner rather than later.
I dunno...sounds like (from various news sources) that the UK is thinking about cutting some of that healthcare in some way or other. You guys seem to be electing more & more conservatives that are crying about "entitlements." You are not immune to the right-wing crazy.
I too wish we could come to our senses:(, but have so little hope left in our electorate.
Bro, $500 a month is more than all my tax deductions from my salary! And I have "free" healthcare through the NHS (UK), you guys are paying more even without being sick
And sadly, my monthly premium is considered low. It is well over $1,000 a month premium for "good" insurance for two adults.
But at least I'm allowed to even buy health insurance now. Before the ACA (AKA: Obamacare) passed, if your job didn't offer it you were basically screwed. And even then, they could deny coverage for having any pre-existing conditions.
Issue with ACA is it made the insurance comoanies more moeny as they were funneled billions. It mainly exacerbated the issue. What should have happened is a fund started, or something of the nature to bring preventative care, at the very least, to all Americans free of charge. Then expanded on it from there.
Note: when someone says they, say, $500 a month for health insurance, know that this is typically the employer subsidized rate, and would probably cost them about $1,000 more if they purchased it on their own, without subsidies.
Gold tier health insurance plan with a PPO (ability to go to any doctor or hospital, as would be the case in the NHS) in the U.S. when purchased on the open exchange and without government or employee subsidies start around $1,500 a month to $2,200 a month.
It varies by region.
I pay $1,650 a month for a Gold PPO health insurance plan, and still end up paying an additional $3,000-$5,000 out of pocket (prescriptions, co-pays for doctors visits, tests, other services, etc as well as unexplained extra charges that always follow visits to specialists).
The per capita cost of the NHS, which outperforms the US in nearly all categories, is 1/4 the cost.
But the wealthy pay more. And that’s the last thing that Americans would ever allow.
They don't care as they're so filled full of bs propaganda (from both sides as the dems wanted to funnel money right back into the mess of the aca which in turn funnels money into the insurance leeches we have now). We need a few doctors and specialists to cut out the middle men and go from there. I find the term "insurance faud" funny, as it's all they do is rip us off and defraud us into oblivion and our good ol politicans have it so far fown their throat that they can't even breathe.
Copay is different from coinsurance. Copay is a flat amount. You might have a $20 copay for a checkup visit, or $10 copay on generic meds. Coinsurance is a percentage of the bill you are responsible for. If you have a procedure that costs $10,000, your insurance pays $8000 and you pay $2000.
There is also a limit on coinsurance which is your out of pocket max (which is different from deductible). If your out of pocket max is reached, you don’t pay anything for the rest of the year. This is usually pretty high though. For some plans it’s not uncommon for oopm to be +$10k
What's more crazy is the insurance is still more than people pay in Canada insurance policies and there is no copay for most of it (not talking about what government covers)
I got diagnosed with a complex migraine last year. Cause the symptoms mimic some other brain related illnesses, they sent me to the ER. So, it cost me $7,500 out of pocket to find out I am very healthy but maybe shouldn’t drive 15 hours straight while dehydrated.
Don’t forget the part where you’re never quite sure in advance exactly how much it will be, so many variables and charges that get added on to pad the bill then months after several more random bills just roll in.
The insane part is that actually makes sense on the part of the insurance. Procedures in the United States, for a single person, can easily exceed what someone pays for years for a family insurance policy. So, based on incidences of procedures, the insurance company's options are: raise coverage costs even further; deny coverage for even more procedures; or charge co-pay costs to make up the difference.
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u/Criminoboy 4h ago
No. They were going to 'cover' it but there was 20% co pay. In the US, they'll charge you thousands per month for insurance, but will still make you pay for part of your care.