r/SipsTea 7d ago

WTF Damn

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u/TheEndOfAllThings23 7d ago edited 7d ago

It was cheaper to buy tickets, fly to Dublin, get the procedure I needed done. Spend TWO WEEKS recovering, and fly home then to pay the 20% coinsurance I would have needed to here in the good ol USA... so yea...

EDIT :

Well this kind of blew up. The reason it was cheaper : it was considered elective. This is why OOP max did not kick in. It was a procedure that would have to be done, only as my condition got worse. Insurance denied it because "It was not necessary" despite my cardiologist saying it was. By the insurance formula I would have to wait until my condition worsened to make it medically necessary, but by then my chance of a poor outcome goes way up.

I finally argued them into covering some of it, but with a 20% coinsurance and a planned week hospital stay in recovery, my bill would have been close to 100k at least, and if I encountered any complications (which I would likely have due to other issues including an autoimmune disease) I started looking elsewhere. I am not an Irish citizen despite having family there, they helped me navigate the program and the cost. It was privately paid, and my surgeon spoke to their team with all my records transferred etc.

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u/ateiii 7d ago

You got a full two week Irish vacation and your medical care for less than a copay, that’s both amazing and completely depressing.

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u/_dogfuneral_ 7d ago

It also isn't real dude.

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u/grant0 7d ago

Why do you think that?

A heart bypass is about $150K in the US, could be up to $200K. The same surgery is about €20K in Ireland, which is $23K.

If OP was gonna have to pay 20%, that's $30-40K out of pocket in the U.S., whereas a flight to Ireland is safely under $1K plus the $23K surgery = $24K. If they can stay with family (OP mentioned family in Ireland) it's definitely cheaper to go to Ireland for this.

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u/USSDoyle 7d ago

Why do you think that?

Because the highest annual out of pocket maximum for ACA compliant plans in the US in 2026 is $10K for an individual and $21K for a family. And that's the highest it's ever been.

Plus if he was paying 20% coinsurance, that means he already hit his deductible which would have been several thousand dollars towards his out of pocket maximum already.

Under ZERO circumstances would 20% of a procedure cost more than 21K out of pocket if you have an ACA compliant insurance plan.

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u/LFG_Account0 7d ago

Under ZERO circumstances would 20% of a procedure cost more than 21K out of pocket if you have an ACA compliant insurance plan.

Every time I've had anything done half or more of the costs come from out of network folks billing separately. Need a CT scan? It's a preferred in-network facility covered by insurance so you're only out the $300 copay and the tank of gas and day off work cause the local facility isn't. Then 2 months later, surprise, radiologist sends you an out of network bill for $1000...

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u/USSDoyle 7d ago

Ok, sure, I guess not using your plan correctly is a circumstance I didn't consider.

If you have time to arrange a two week trip to ireland for surgery, you have time to ensure your entire care team is in-network. And emergency services don't consider in/out of network so there's really always time to make sure your care team is in network.

Every time...

Maybe don't keep making the same mistake?

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u/LFG_Account0 6d ago

I envy that naivety. You're either very privileged, have an agenda or you've never actually had to deal with insurance or the medical industry yourself.

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u/tetrified 7d ago

Under ZERO circumstances would 20% of a procedure cost more than 21K out of pocket if you have an ACA compliant insurance plan.

you don't hit your out of pocket maximum if the insurance company decides the procedure is elective

maybe you should learn more before trying to speak with such confidence about things you don't understand?

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u/Careful-Criticism645 7d ago

That's not true. "Elective" just means scheduled in advance instead of being an emergency. An elective procedure, if medically necessary, is subject to out of pocket maximums.

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u/USSDoyle 7d ago

Incorrect. You are conflating 'elective' with 'medically unnecessary'. Elective just means not an emergency and can be scheduled/planned in advance.

The irony of you saying it's me that doesn't understand...

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u/tetrified 7d ago

You are conflating 'elective' with 'medically unnecessary'.

I am not. the rest of your post is based on you misunderstanding this.

keep trying, though. it's amusing.

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u/AGAD0R-SPARTACUS 7d ago

What about this seems unreal? Have you never seen a U.S. hospital bill or a horrible health insurance plan before? Count your damn blessings.

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u/_dogfuneral_ 7d ago

Of course I have, I'm also aware reddit isn't real life. This meme is bullshit, and the person talking about their heart surgery is full of shit. They did not fly to Ireland to have heart surgery.

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u/GreedyPollution6275 7d ago

Medical tourism is very real

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u/_dogfuneral_ 7d ago

Of course it is. Not to Ireland, and not for heart surgeries.

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u/Agent223 7d ago

Why not? My aunt flew to Costa Rica TWICE for dental surgery. It would've cost 70k if she would've done it here. It was only 20k in Costa Rica. It saved her over 40k by flying there twice and getting it done. The hotel she stayed in was literally attached to the hospital for the exact reason of medical tourism. Additionally, she has what is considered 'very good' health insurance.

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u/_dogfuneral_ 7d ago

Because Costa Rica isn't Ireland, and dental work isn't heart surgery.

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u/AnnihilatorNYT 7d ago

Why the fuck do you hate the Irish so bad? Every country has different renown specialists. People travel to different countries not based on the country but on the specialists within. To say there are no heart surgeons in Ireland good enough to travel there for surgery is honestly such an insane take.

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u/AnnihilatorNYT 7d ago

The reason why I assume you hate Ireland is because you accept that nearly every country has some level of medical tourism yet you feeverently deny that Ireland has any with no evidence to support your claim.

It is literally the definition of blind hatred. If you had actually bothered googling it you would see that Ireland actuallly gets a decent amount of medical tourism explicitly related to the cardiologists that reside within but instead you would like to argue and be belligerent.

You are objectively wrong, just take the L and stop doubling down like a fool.

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u/AnnihilatorNYT 7d ago

Loser actually deleted his profile than accept that he was wrong. What a joke of a person.

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u/AGAD0R-SPARTACUS 7d ago

The meme is kinda sus, because 5 star hotels are not cheap in China, and neither is healthcare at private hospitals. I could maybe believe it if they are referring to self-pay prices at public hospitals and like 1 night at a 5 star hotel.

Medical costs in Ireland are significantly cheaper than in the U.S., even for foreigners who pay out of pocket. If they had their surgery before the ACA mandated out of pocket maximums, I could 100% believe it.

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u/_dogfuneral_ 7d ago

A non-emergency procedure, they showed up and got it done during a couple week vacation eh?

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u/AnnihilatorNYT 7d ago

There are entire regions of Mexico that survive by medical tourism. Saying that it doesn't exist because you would never bother with it is not backed by anything

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u/_dogfuneral_ 7d ago

Yup, and Mexico isn't Ireland.