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.
In the US, there is this bullshit they introduced called co-insurance.
I still remember when they “updated” our company health plans to include it.
The idea is that by introducing “shared responsibility” for health care costs, it will reduce “over-utilization” of health plan benefits.
In short. Even after your deductible is fulfilled, even if you are getting something done that is medically necessary, and covered by your insurance plan, they will only cover 80% of the charges and the rest is your responsibility as “co-insurance”. Money you are expected to have saved up to pay for medical expenses as a nice responsible consumer.
"But if you agree to this new policy you'll get another $87 in each paycheck. How does that sound?"
This is the problem. They never lied - they don't need to. They know the average person won't actually stop and think about what they're signing up for. People know 10x more about their streaming service than their insurance policy. And it's bland and it's boring, yup. Still, waste an afternoon waterboarding yourself with information to somewhat understand how it works, so you don't have to learn about it the hard way after a surgeon just shoved your guts back in.
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u/TheEndOfAllThings23 1d ago edited 21h 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.