Want to know how easy it could be to reach your $2000 medical deductible?

[pnwmom]

Last edited Wed Apr 2, 2014, 04:10 PM - Edit history (3)

You could need a few stitches in the emergency room.

Have a $6,000 deductible? My daughter's broken finger required a pin and the whole thing cost almost $6,000 before the bills stopped coming in.

I saw someone complaining online that with his $6,000 deductible he'd have to get hit by a Greyhound Bus to ever reach it. I wonder how many others among the people who hate the ACA are as delusional as he is.

Our problems go way beyond the insurance companies. The whole system is messed up, including the for-profit hospitals.

ON EDIT: someone just asked a question that probably worries a lot of people, because some misinformation has been spread about deductibles during the anti-ACA media campaign.

Under normal circumstances, I've never heard of a hospital requiring the whole deductible up front. They're usually willing to work with the insured person on a payment plan, if necessary. Members of my family have ended up in the hospital a number of times, and we've never been asked to pay for the whole deductible up front. As always, your experience may differ, but I wouldn't expect the worst.

Also, for people who buy a silver plan and whose income is below 250% of poverty, assistance is available to help with out-of-pocket costs, too.

http://obamacarefacts.com/obamacare-subsidies.php

ObamaCare and Out-of-Pocket Subsidies (Cost Sharing Reduction)

In order to receive out-of-pocket assistance (AKA cost sharing reduction subsidies), you must buy a Silver plan from the state exchange and an individual or family must have incomes no more than 250 percent of the Federal Poverty Line. This means that families in the lowest income group pay no more than 6 percent of its share of out-of-pocket expenses, while those at the upper level of the group pay up to 27 percent of out-of-pocket expenses. Combining Advance Premium Tax Credits with Out-of-Pocket subsidies creates an average subsidy of about $5,000 for families and individuals. But, low-income families get larger subsidies and those with several children get the most.

Income Level Actuarial Value (the amount of costs a Silver plan will cover due to cost sharing reduction subsidies for % of the Poverty Level).

100-150% FPL 94%

150-200% FPL 87%

200-250% FPL 73%

http://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?action=click&module=Search®ion=searchResults%230&version=&url=http%3A%2F%2Fquery.nytimes.com%2Fsearch%2Fsitesearch%2F%3Faction%3Dclick%26region%3DMasthead%26pgtype%3DHomepage%26module%3DSearchSubmit%26contentCollection%3DHomepage%26t%3Dqry297%23%2Fhospital+costs+stitches+emergency

A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to the International Federation of Health Plans, a global network of health insurance industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures — closing a wound with a needle and thread — typically leads to bills of at least $1,500 and often much more.

At Lenox Hill Hospital in New York City, Daniel Diaz, 29, a public relations executive, was billed $3,355.96 for five stitches on his finger after cutting himself while peeling an avocado. At a hospital in Jacksonville, Fla., Arch Roberts Jr., 56, a former government employee, was charged more than $2,000 for three stitches after being bitten by a dog. At Mercy Hospital in Port Huron, Mich., Chelsea Manning, 22, a student, received bills for close to $3,000 for six stitches after she tripped running up a path. Insurers and patients negotiated lower prices, but those charges were a starting point.


Chelsea Manning in St. Clair, Mich., in November. She tripped and fell in the driveway of her home, and needed six stitches for which she was billed close to $3,000.Joshua Lott for The New York Times

The main reason for high hospital costs in the United States, economists say, is fiscal, not medical: Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market.

Rising costs of drugs, medical equipment and other services, and fees from layers of middlemen, play a significant role in escalating hospital bills, of course. But just as important is that mergers and consolidation have resulted in a couple of hospital chains — like Partners in Boston, or Banner in Phoenix — dominating many parts of the country, allowing them to command high prices from insurers and employers.

[djean111]

1. Basically, you can have insurance and still go deep into debt.

[hunter]

13. Yep.

How I lost my credit rating and learned money is just another pathetic game.

For it is easier for a camel to go through the eye of a needle than for a rich person to enter the Kingdom of God!

[phleshdef]

33. Yea but its way more manageable than without insurance, especially for anything life threatening.

Someone with treatable cancer could rack up hundreds of thousands of dollars in a matter of months. 6000 vs hundreds of thousands... one is most definitely a better situation or the other.

[RandoLoodie]

2. Is it the case that you have to pay the deductible first

out of pocket?

If so, does one pull 2,000 - 6,000 out of their ass to cover it?

I don't know very many people who work for a living that can just access that much money.

[pnwmom]

4. No, hospitals are used to working with people -- as long as they have insurance.

They send you a bill, showing what the costs are -- a very scary bill. Then they send you another bill showing what the insurer "allowed." A somewhat reduced bill. (That's another advantage of having insurance that many people don't think about. People without insurance don't get those reduced bills.) Then they tell you the portion of the reduced bill they're going to pay (after the deductible) -- which will vary depending on what kind of plan you have. For example, they might be paying 70% of the allowed cost, with you paying 30% of the allowed cost.

If you can't pay it all right away, hospitals will make payment plans. They're used to that. As you say, most people don't have thousands of extra dollars lying around.

[Blue Diadem]

7. Our hospital & specialists have payment plans

and it takes some negotiating with the hospital because they always want a higher payment that we can afford.

[Trekologer]

50. In many cases, providers are not allowed to collect more than the copay up front

According to their agreement with the insurance company.

[kestrel91316]

52. No. If you have insurance, you get treated and then the hospital bills you for the part the

insurance doesn't cover.

[Jacoby365]

3. I took my uninsured girlfriend to the ER because of an asthma attack

a couple of years ago. They provided a medicated vapor for her to breath and then took a couple of x-rays. The doctor released her from the ER after about four hours. He said if she had insurance, he would have admitted her to the hospital. Well, the bills came in, and the cost was about $6500! There really is something wrong with that.

[pnwmom]

5. Yup. The article said ER's are hospital "profit centers" -- and there really is

something wrong with that.

[Walk away]

56. But if she had insurance they would have charges a fraction of that.

Insurance companies have deals with the care providers in their network.

[mike_c]

6. remove the for profit health insurance industry and regulate prices...

...via the clout of one single payer. Open quality, low cost public hospitals in every market dominated by for-profit outfits that shakedown the sick and injured. Gee, oddly enough there are models to follow in just about every other developed nation. It's not rocket science.

[leftstreet]

8. +1

[pnwmom]

9. And we have the example of Veteran's hospitals here. n/t

[zeemike]

43. Yes but then you would be competing with them

And that is not allowed in our "free market" system...and what that means is that they are free from competition from the non profit model.

[mike_c]

45. that's exactly the point....

Lot's of countries do it exactly that way-- a free, public health care system that exists side by side with private hospitals and health care associations. Shockingly (or not), many of those private providers have such reasonable costs that Americans retire to those countries and pay out of pocket to join a private provider because it is far less expensive than paying insurance premiums in the U.S. It's shocking what a little competition with not-for-profits can do to bring down the cost of health care!

[kestrel91316]

53. [phone] 000

[thecrow]

10. My uninsured nephew broke his arm badly while snowboarding...

so his brother took him to the ER. Because he had no insurance and was from out of state,
the doctor told him about his compound fracture, wrapped him up in ace bandages and told him to go home for medical attention. He had to fly all the way to the east coast (he was in AZ or Colorado at the time)... So he was in pain, in danger with a movable break and he didn't get the bone set for a few days because of this. The ER is not a magic room where everyone can go for free medical attention and expect to be healed as they say.

[CreekDog]

11. you're misstating how most plans work

while some are high deductible plans that literally force you to pay every penny until you meet the deductible.

many plans, including ACA plans have different co payments and patient share costs where the plan is paying before you ever reach your deductible.

you're confusing the deductibles with maximum out of pocket, and maximum out of pocket per family, etc.

i agree with you about the costs and way this all kind of railroads people, but we have to be honest when we provide examples.

[pnwmom]

14. As I said, most hospitals will work with people on a payment plan. The important thing

is to ask.

[CreekDog]

15. no i wasn't talking about payment plans, i directly addressed your issue and you ignored it

[pnwmom]

17. Because I was talking about whether HOSPITALS require payment of the full deductible

up front -- which is a separate issue.

A person can get care in a hospital without paying his full deductible up front. Then, if he can't pay the amount of his deductible when he's billed, he can arrange for a payment plan of that amount with the hospital over time.

The insurer won't start covering its portion until the deductible has been met, but that doesn't prevent a person from getting care in the hospital.

[Glitterati]

21. I'm sorry, but this is just NOT TRUE

When I tried to set up payment plans at the hospital, their response was "Sure, but we need a one third down payment before we can set up payments."

Your broad bush strokes are just incorrect.

[pnwmom]

23. As I said, your experience may differ. But no one should assume they can't get care

if they can't pay the full deductible up front.

I know a woman who went to the hospital without insurance, got a $5,000 bill, and wrote to them pleading poverty and asking for a payment plan. They waived the whole bill.

It's always worth asking.

[notadmblnd]

26. it happppened with my sister too.

had no insurance and had a diverticulitis (sp?) attack. She was there 2 days, it cost in the neighborhood of nine thousand dollars. She told them she had no job and no money. They not only took care of the bill, they hooked her up with a program that allowed her to get follow up care until the ACA kicked in. During that time, she had to see the hospital's Drs. and had to come up with $15.00 a visit.

I also have a friend who has seizures who has no insurance. Once when she had one while with me she had to be hospitalized. When she came out of the seizure, instead of telling them she couldn't pay, she checked herself out of the hospital. She is still being hounded about the bill.

I don't know why people seem to do things the hard way. If my friend would follow up medically instead of avoiding what needs to be done, she would be entitled to social Security Disability Insurance and would qualify or medicaid and wouldn't have to worry about medical bills.

[Imalittleteapot]

35. Set up your own payment plan.

What are they going to do - turn down your money? Put you in jail? I got a $4000+ emergency room bill and decided to pay in installments that I could afford. Yes, I got the "past due" notices and the phone calls, but continued until the bill was paid.

[kestrel91316]

54. They can and will sue. I hear some of them are doing it if you take more than 30 days to pay.

[truedelphi]

24. I don't know why she won't try and hear you.

For people close to the poverty line (in our case, we make $ 70 a month too much for medicaid) the deductible and co-pays mean that the insurance won't get used.

I admit that technically speaking, pwnmom's statement that the hospitals will work with you is correct. However, that does miss the overall point.

The overall point being that if you have inclusive insurance, such that even doctor's visits and Big Pharma products are covered, let's say you get a bad cold. You can seek medical attention before it becomes a problem like pneumonia or bronchitis. So you end up being healthier.

But if you don't have the money for the doctor's visit (And my local doctor insists on payments up front for his new patients) then what? Hospitals may work with people -why wouldn't they? It costs X amount to see a doctor, and ten to thirty times X to utilize the hospital ER, even though you probably get better care in your doctor's office. (Catastrophic accident injuries being the exception, where ER care would be better.) So it is not hard to see why the Medical Mafia ruling here at California hospitals would be totally willing to "work with you."

That is the big stumbling block, and why those of us who are older, less likely to be employed and have the more "premium" insurance setups (setups an actual working physician like pwnmom receives) - that is why those of us in that boat are so critical. We can see that the ACA means-

One) We have to somewhere somehow find the money for the ACA premiums each month. Those premiums may indeedy be a lot less than before - but if you don't have money, you don't have it. It doesn't matter if it is $ 215 a month or $ 10,0000 a month - if you are broke, where does that $ 215 a month come from? Many older people (I imagine) dig into their retirement savings. We have already lost our retirement savings to the Magical American Medical Kingdom, so we don't have that option.

Two) The ACA forces the lower incomed among us (in California, anyway) to see doctors on the exchange, who are few and far between.

The two that would be available to me, were I utilizing CoveredCa - one is basically a Seventh Adventist Witch Doctor who wants me on psych meds rather than my usual pain meds, as her religious beliefs force her to deny me my pain meds. She actually refers to her religious beliefs in her medical consultations!

The other doctor spends her entire time with patients advocating for their using anti-cholesterol meds. I know this first hand from how she treated me. She ignores massive incapacitating pain. She had no curiosity for what is causing that pain. Her whole goal is getting people in anti-cholesterol meds. With me that is nuts - though I already have problems with a non-responsive muscular situation. This doctor spent six months ignoring what were symptoms of gluten intolerance, due to her wanting me on anti cholesterol meds. (My cholesterol is 160, totally within normal range for a post-menopausal lady.) The doctor I found who finally figured it all out does not want to be on the exchange. Why? He can't be on Kaiser - he is not part of their system. And he feels the other two choices are bogus. I mean, Anthem For Poor People tells patients their claim will be paid only if the doctor's office submits said claim, and then tells the doctor's staff that the patient must submit the claim. So Anthem never pays the claims, for those on the Exchange.

[pnwmom]

32. Did you know that people on the exchange, in addition to getting subsidies on the premiums,

can get tax credits for part of the out-of-pocket costs, too -- and you don't have to wait till the end of the year to get them?

For people who buy a silver plan and whose income is below 250% of poverty, assistance is available to help with out-of-pocket costs -- not just premiums.

http://obamacarefacts.com/obamacare-subsidies.php

ObamaCare and Out-of-Pocket Subsidies (Cost Sharing Reduction)

In order to receive out-of-pocket assistance (AKA cost sharing reduction subsidies), you must buy a Silver plan from the state exchange and an individual or family must have incomes no more than 250 percent of the Federal Poverty Line. This means that families in the lowest income group pay no more than 6 percent of its share of out-of-pocket expenses, while those at the upper level of the group pay up to 27 percent of out-of-pocket expenses. Combining Advance Premium Tax Credits with Out-of-Pocket subsidies creates an average subsidy of about $5,000 for families and individuals. But, low-income families get larger subsidies and those with several children get the most.

Income Level Actuarial Value (the amount of costs a Silver plan will cover due to cost sharing reduction subsidies for % of the Poverty Level).

100-150% FPL 94%

150-200% FPL 87%

200-250% FPL 73%

[truedelphi]

44. It is irrelevant right now as the deadline for applying is up already.

I had several emergencies that had to come up right as the deadline approached. Back in Novemebr or December, I had tried to get CA covered, but I was always kept on hold about 30 minutes.

Also I admit I did not did not have the motivation as all three of the choices I had were crap.

Three and only three choices were mine, and all are pathetic!

Crap choices are crap choices. I mean, for pete's sake, one of my three choices was Kaiser, a medical HMO that does not even have a single clinic here in the County! And that is the HMO that mis-diagnosed my spouse and caused us to lose our retirement!

[pnwmom]

49. I think I read that you could still apply, explaining on the honor system how you had

attempted earlier.

But it sounds as if you've already made up your mind. Still, you should know about the credits for out-of-pocket because it sounds like you might qualify for them.

[truedelphi]

57. I do want to take a moment and thank

You for your encouragement. That is very kind and I appreciate it.

I understand that insurance is how the system works. I understand that cutting my nose off to spite my face won't solve anything.

But I have such a world of hurt having to deal with bureaucrats, which is what it would take to get enrolled right now.

Every time I now have to deal with a bureaucrat, I get so mad that I just explode. And that style of emotional melt down can be a very dangerous thing to do in this day and age. To want to go "F___ you, you goddamn bureaucrat, and may you die a miserable rotten death," and then Homeland Security could be here the next day.

I think it is some type of PTSD.

I now hate bureaucrats. Every time I have to deal with one I remember how quickly our retirement monies were gobbled up, all due to the errors perpetuated by Kaiser, even though they were being paid $ 900 a month out of our bank account at the time.

My altered state is so bad that a few years ago, in the midst of Kaiser screwing us over, I got stopped for speeding. And I said, quite politely to the police man, "Couldn't you just let me off with a warning, as I was only doing 57 in a 55 mph zone."

He replied, "If you get out of the car, I will shoot you," and I thought Good! I'd never have to deal with one of these pains in the butts again!

So I stepped out of the car and luckily, he changed his warning to "Get back in the car or i will arrest you."

So I got back in the car.

Two summers ago it came out that that particular local CHP officer was a pedophile and he is now in jail. But still, up until then, I knew better than to take on that attitude while dealing with authority.

I have been watching Will Pitt from the sidelines and I think he is at the PTSD end of his rope too! Nobody in the world should have to "take on" the insurance industry every damn time you need to get a payment for a procedure or medicine covered, yet we in the USA keep doing it willingly ("Because Obama" !!!) Except if we are put in jail, we get all our medical care for free!

[pnwmom]

58. I am sorry that you and so many others are having to go through so much,

and that even things like the ACA feel like rubbing salt into your wounds.

I hope things start going better for you soon.

[Hoyt]

12. Insurance does several things for you. It gets you in the door. It usually reduces provider's charge

to something much less. It is not uncommon for a doctor or hospital to charge $1,500 for something the insurance company only allows $400. If you are in-network, you are only responsible for the portion of that $400 that the plan does not pay. They have to write off the difference (and, no, they don't get a tax deduction). If you are not covered, the doc or hospital -- unless they are one of those that show some compassion -- will come after you for the $1500.

Further, if you have insurance, a hospital will likely treat you and work out some reasonable payment plan for whatever portion of the deductible or copay you are responsible for. Of course, they may do that if you are uninsured too, since they can't get "blood out of a turnip," so to speak. As discussed above, it doesn't take much to meet the out-of-pocket cap. it's much easier to avoid bankruptcy if your maximum exposure is $5,000 or so, vs. $200,000.

Also, many insurance plans will cover certain things without applying the deductible -- preventive visits and tests, drugs may have a lower deductible, copays may apply to doctor or emergency visits that are much lower than the deductible, etc. You have to read the policy, and it's sometimes difficult to understand -- it's been that way for decades, so don't go calling the President a vile name.

I agree, it shouldn't be this way, but it is. We shouldn't get sick or have accidents, but we do. We should have been born in England or Canada, but we weren't. We shouldn't have right wingers blocking better health care legislation, but we do.

[seveneyes]

16. Failure to prosecute criminal price overcharging

From the hospital, drug companies and others. Again, the administration and the Justice Department could attack these criminals instead of pot users.

[truedelphi]

46. ^^^^^^^^Read This! ^^^^

[HockeyMom]

18. Few years ago I fell off a bus

twisted my ankle and fell on it. Could not stand up on it. Oh, no, ER time. I had insurance and did not go. What would they do? Obviously xrays. What would that have cost? Probably given me pain meds? What would that cost? Ice and wrap it? What would that have cost? I went home took a few Tylenol, iced it for 24 hours on and off, and wrapped it myself. Took out an old crutch (what would that cost?) my husband had in the garage, and walked using that for a couple of days. It cost the hospital and Me nothing.

Another time I was on a night tour when I hit my head on a tree limb. I FELT crack inside my head and blood poured down my face and soaked my hair. Had insurance. Oh, again, ER. No, I got some paper towels and applied compression to my own head. It stopped bleeding after about 15 minutes of pressing on it. I went home but didn't wash my hair for 2 days because I did not want the water to open the wound. What would this have cost in the ER? CAT SCAN? Stitches? Maybe a stay overnight in the hospital? This one too cost the hospital and ME nothing.

People RUN to doctors and ER, when they DO have insurance, because the health care industry has them terrified that without medical care they are going to DIE from every little thing. THIS drives up the costs. Why are doctors and hospitals doing this? To MAKE MORE MONEY.

[pnwmom]

19. I"m glad that worked out for you. But if you ever got a head wound like that again,

another possibility would be to call your doctor the next day and get a prescription of antibiotics, to make sure it didn't get infected.

[HockeyMom]

22. If I had my own doctor,

he would have wanted to see me. He would have wanted me to have a CATSCAN (probably at an ER anyway) anyway to check for internal bleeding in my head, etc. It would have been almost the same process are going directly to the ER at the time.

[notadmblnd]

31. I won't go to the Dr either. I have insurance.

Why? Because it's a racket. You're never cured any more. They put you on a regimen of drugs that they tell you you absolutely need to take for the rest of your life. Then, they have you coming back every other month because they won't renew your prescription for the medicine you need to take for the rest of your life, if you don't come in for an office visit.

I have no interest in taking a handful of pills every day that may or may not work on the particular malady they tell me I'm suffering from. Nor do I care to spend my time or money for the privilege of waiting in their office 30-45 minutes for an appointment that I was 15 minutes early for.

Yes, my knees ache if they're hyper extended in some way for a long length of time. It doesn't mean I need knee surgery. When I don't sit cross legged for a long time or spend an afternoon on the trampoline with the kids, they don't hurt.

Today, the lady I work with was called out by her daughter's school. It seems the school receptionist, who also doubles as the health nurse wanted to notify her that at recess her daughter took an elbow in the nose. It was bleeding and she wanted permission to call EMS. Really?

I don't know how people got started with believing that they should be able to go through life totally pain free or that they needed to get to the Dr with every sneeze, sniffle or fart but many seem to think that way.

[HockeyMom]

34. +1000

You are never cured. You will take that pill for the rest of your life. My husband has been talking meds for high cholesterol for 30 years. Forever? Once you have high cholesterol, you ALWAYS will? Your DIET cannot change that? His doctor keeps saying how LOW it is getting. It will NEVER be normal? Doctor keeps LOWERING the meds. Same with blood pressure. Once high can never be normal without pills every again? Gotta keep taking those meds and coming back to them. Plus, look at all the TV drug advertisng. Ask your doctor if xyz is RIGHT FOR YOU. Don't they sell cars anymore on TV? Doctors and drugs.

I fell on my spine off a driving board as a 10 year old at camp. I couldn't move, except my toes, for 24 hours. Doctors said unless I had surgery, I would be a cripple as an old woman. My parents refused and took I am glad. My back used to bother me with the weather until I had my children. I supposed carrying two chidlren cured it? It never bothered me ever again. I also worked for many years with disabled children and adults, pushing and lifting them in and out of wheelchairs. Never hurt my back doing all that, although that is not how you lift anyway. Anyway, I am not a crippled old woman today like they said I would be.

[truedelphi]

47. My mom was told after a serious whiplash injury that she

Would never walk again. Even though she was in the hospital, and it wouldn't have troubled them to give her therapists, the Admin refused, saying her type of injury was catastrophic and nothing anyone could do would help.

Well, they knew they would have her in there for six weeks and she gave them hell every moment of every day until they relented and got her the re hab therapists.

In three months she could hobble and in six months she could walk. Within five years she was walking perfectly, with t he only way you would ever know something was wrong being if you went to Church with her and saw her genuflect.

[Jesus Malverde]

51. We were at the specialist and they put her on a medication that did not seem to be working,

The medicine seemed to be making her sicker, we wanted to take her off it, as she was doing better before she started on it.

The doctor said something to the effect, if a medication is not working we don't discontinue the medication we add another "therapy".

It was a messed up moment, but one that illustrated the mindset.

Doctors rarely focus on causes like stress, lack of sleep or diet, they focus on prescribing drugs.

Your indigestion might be because your drinking a venti latte in the afternoon, rather than counsel you to not consume them, they will put you on a daily regimen of acid blockers for the rest of your life. Those drugs themselves cause other health problems in the long run.

It used to be when one got sick, they would send you to a convalescent hospital where you could rest and use your own immune system and body mechanics to get better. The notion that a person can heal themselves is ignored in the medical field in spite of the well documented power of placebos, rest, destressing and self healing.

Americans have never been sicker .."mental illness" diagnosis says we're all crazy and drugs are needed for everyone.

[scorpiogirl]

20. It's ridiculous!

Years ago my daughter went to the ER for a cut on her scalp. The doctor in the ER saw her for a whopping ten minutes, put one staple on the cut and sent us on our way. The bill was $1200 for the ER and another $400 for the doctor as we were billed by the doctors service separately. Outrageous.

Our pediatrician told us when we went to her to have the staple removed that it wasn't even necessary for them to do that.

No insurance at the time.

The hospital reduced the bill to under $300 for which they told us "congratulations" as they announced the news. Never paid the doctor bill and never got a bill other than the first one. I have no idea if they wrote it off or what as we were under severe financial hardship at the time. We were also in the process of signing our kids up for medi-cal but they wouldn't cover it by a space of three weeks.

[HockeyMom]

25. What happens when deductible IS met?

They pay 100% of the bill after that? Hell, no. The places I worked had 80/20. One place had a 50/50 plan. One coworker had a newborn with sereve problems who was in the hospital for months to the tune of a few million dollars. In that case the insurance company dropped the coverage for everyone because of just one claim. This woman made $11/hour. How the hell was she supposed to work out a payment plan for half a million dollars? Even if that hospital was nice and decided to cut it down to tens of thousands, she still could not pay it.

What do people do who make very little money, have insurance, and cannot possibly (in their lifetime) pay what the insurance doesn't pay?

[Jgarrick]

36. I hit the $5,000 deductible a couple of years ago and had over $300K in expenses by year's end.

BC/BS paid every penny.

[HockeyMom]

40. This was HIP

Maybe they have different polices. It was a Non-Profit agency and we had very low premiums and deductible ($110 family month premiums, $1,500 deductible). They get you on the other side?

[srican69]

38. all plans have an out of pocket maximum ... usually around 10 or 12000 per year .. Insurance pays

100% after that OOP maximum..

you generally pay 100% till deductible .. split with insurance ( depends on the plan) till you reach OOP max

[kestrel91316]

55. There is always an out-of-pocket per year cap. The information on what this is

is found on your policy. For Exchange plans, the total OOP cap is usually under $7500 IIRC, so if you get hit by a driver who leaves the scene and your medical costs are $1 million, you AREN'T stuck with a $200k bill.

[Mosby]

27. American hospitals should be nationalized

That would be a real start to lowering the cost of health care.

[Thinkingabout]

28. I would much rather have the insurance than not having insurance.

Since the US pays almost twice the amount as other countries for health care per person. It doesn't take much of a problem to be $6000. On the other hand if one had a heart attack $6000 would be a small amount to compared to the total cost. Having insurance is a good thing, I am glad ACA is available.

[progressoid]

29. I'd kill to have a $2k deductible.

My wife and I don't use our insurance for the most part because of the deductible.

[steve2470]

30. might wanna put your link in bit.ly or another link shortener nt

[SoCalDem]

37. Kaiser.. every "new" year

when my husband renews his Rxes for the first time..his first med costs $110.00...the others are just the co-pay.

In my case, I take no meds, so when I needed some eye drops, instead of paying $115.00 at Kaiser, I paid out of p[cket $11.50 at Walgreens.

[HockeyMom]

41. My husband get his meds from Canada

and he takes a lot. I don't take any. The few times I have needed an antibiotic (dental) I go to Publix Supermrkets in Florida which gives free antibiotics.

[CBGLuthier]

39. Health Insurance is responsible for the outrageous prices.

Until the government gets involved (as they do in civilized countries) and stops this obvious over-charging the system will remain broken. ACA is still fucking health insurance and it is still fucking disgusting and uncivilized. But i guess it is as good as a backwards-ass country like the USA can manage.

Fucking shame really.

[HockeyMom]

42. I only have Medicare A & B

I refuse to feed the beast with Medicare Advantage, especially for something I don't use or want.

[JaneyVee]

48. Christ, I cut myself on coral reef snorkeling in

Costa Rica and needed 5 stitches, it cost me $12 total.