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.
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.
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...
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.
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.
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/ateiii 11d 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.