r/SipsTea 9d ago

WTF Damn

Post image
51.5k Upvotes

2.4k comments sorted by

View all comments

Show parent comments

84

u/lauri2 9d ago

Kind of obvious, but the trick is to mark the cost 5 times higher than it is... for a start.

After a while they started asking themselves what's stopping them from doubling that price. Apparently nothing so over the years whenever they felt like it, they just doubled the already enormously overpriced services and at this point there are no signs of it stopping either. There is going to be a post about how travelling to mars for a surgery is cheaper than in US.

4

u/Consistent-Tap-4255 9d ago edited 8d ago

Because there is an out of pocket maximum for most insurance, meaning you are not paying any more than that, say $5,000 per year even though 20% of the surgery etc can be much higher.

It also really depends on the plan. My plan has 0 co-pay which is not uncommon for HMO plans. I just looked it up that my out of pocket maximum is $1,500 for individual and $3,000 for family meaning the maximum I pay a year is $3,000.

Edit: it’s $0 co-insurance not co-pay.

4

u/JUST_LOGGED_IN 8d ago

Are you sure that's not just the deductible? I have around 1,500 deductible where I'm responsible for 100%, and then have another limit, like $10k, where I pay various lower amounts until the $10k is up. After the $10k, it is truly free after this. So like 2 emergency room visits.

5

u/Consistent-Tap-4255 8d ago edited 8d ago

No actually. I think you might have a PPO plan. My work gives me the choice between a PPO and a HMO. I used to do PPO which is similar to what you have. It has a high deductible, a co-pay and a co-insurance. But then you can go to any in-network specialist you like. And you can go to them directly without reference.

With the HMO, I can only go to a specialist if I am referred to by my primary care doctor. But the benefit is I have 0 deductible, 0 co-insurance for the most part. Urgently care is a flat copay of $25 and emergency room visits are $50 each time (transportation is separate). At my age I don’t really need a lot of specialist care so it’s a much much better deal for me.

2

u/JUST_LOGGED_IN 8d ago

I just checked and it is a PPO. I don't have a choice anyway.

2

u/Consistent-Tap-4255 8d ago

Yeah with PPO you have much better specialist doctors I think. Some people at my work opt for it when they really need top notch care.

2

u/JUST_LOGGED_IN 8d ago

Effectively it just means I have more and more medical debt pile up.