I’m undergoing chemotherapy. I hit my out of pocket max in about two weeks in January. It took them until two weeks ago to put in the system that I don’t pay for medical care. Every walk into my PET scans went like this:
“Hi I have that owe $500 for a copay.”
“No I don’t. I am at my OOP max.”
“Ok I’ll have to call and verify.”
Twenty minutes pass.
“You’re right. No copay today.”
Finally last week the receptionist asked them to put that on my account and they fixed it.
The problem I have is with delays in claims oftentimes have to pay multiple providers my deductible at the beginning of the year, then fight months later to get the money back once the insurance claims finally process and show I overpaid.
Exactly. I waited more than a month to get a refund because they did not apply my prepayment to my account. I actually had them billing me the actual (much lower) patient responsibility amount and threatening collections in the meantime!
That’s the most frustrating part. Then when it’s time to be repaid, they say to allow for a month before they cut the check. But I can’t threaten to send them to collections, can I?
They need their money today but I need to wait a month plus mail delivery time.
Yep this just happened to me. Had surgery in February, prepaid, delays in claims, hit deductible before the surgery claim went through, then they ended up owning me $1500 and didn’t get it back to me until June.
Contact the patient advocate if you haven't yet. Billing department was giving the runaround for over a month over some BS with their "back-end team." I called the patient advocate and the refund hit my card in less than a week.
Just had to deal with this. Surgery back in May along with tons of office visits, imaging charges, etc. Hospital made us prepay for the surgery then dragged their feet on submitting the claim, and when they finally did we had hit our OOP max from all the follow-ups who had been sending claims right away. Ended up having over $2k owed back to us from the surgery, which we only JUST got after a month and at least 5 calls fighting the billing department. They even tried to offer us a "store credit" for future procedures instead of an actual refund. After a call to the patient advocate suddenly the mysterious "back-end team" got their shit together and our refund was processed that week.
My hospital asked me to prepay an estimated $5k for a procedure that according to my insurance was fully covered. I ended up paying about $230 after the fact instead for anesthesia
Excellent question. I have yet to get a straight answer beyond that particular group isn’t fully covered, despite the hospital being covered . How anyone is supposed to be able to discover this is beyond me.
It seems anesthesia is always "out-of-network" to the point that it's surprising when insurance will actually cover it. You can't even really know how much a surgery will cost until it's over since it's not one claim. You have the surgeon cost, then the facility cost, then the anesthesiologist cost and they're all billed separately. Medical care is one of the few things you buy where you won't know the entire cost upfront. I feel like regular people who don't support some kind of public option or universal healthcare just haven't used the medical system enough to know how fucked up it is.
There are different levels of anesthesia. That would be local anesthesia, but it would still require an anesthesiologist to monitor vitals and monitor sedation because of how serious of a surgery that is.
When I got wisdom teeth surgery, I had twilight sedation without an anesthesiologist, but I did also wake up during the procedure so maybe it would have been better if I did have an anesthesiologist since I had to pay out of network for that anyway.
Definitely always been a thing but it sucks bigly that it’s increasing.
The number of people who pay a doctor or provider in advance and then owe less when the claim processes but then call the insurance for a refund is larger than it should be. I had to take more than a few health insurance customer calls in my time and it was usually a pain to explain to those people they needed a refund from the people they’d paid.
And part of the reason healthcare is so expensive is because we have to pay people whose job is exclusively to figure out this convoluted bullshit and bill people.
Health insurance can help if the provider is being nonresponsive or resistant to giving a refund or if they billed you incorrectly. Patients should contact the medical provider first, but when that doesn't work, having insurance contact them to get them to act right is one of the reasons you pay for insurance.
Uh, no. You obviously have no idea how little teachers make. I live in Mississippi and decided to manage a GameStop instead of using my teaching degree; the GameStop gig paid more.
The whole year based out of pocket maximums is also bs. Insurance companies can lag decision latter half of year so it spreads to the new year and the out of pocket is never hit.
We need to disconnect this from workplaces now. The whole reason it is like this is the customer is not the target customer, instead the insurer targets the company meanwhile the medical providers and people needing the service are the last on the list.
Not many things have completely removed the service provider and the customer quite like our borked medical system. It is wild if you think about how off it is when it comes to just basic market principles.
this is apparently how my dental insurance works. I pay out of pocket for everything and they reimburse me if/when they feel like it. I'm sure the dentist prefers it as they get to shrug and say it has nothing to do with them knowing they've already been paid in full. The insurance company probably loves it to, big win for everyone but me really
the swiss healthcare system has this option to pay out of pocket and then get reimbursed, but the reimbursement happens really fast, like, at most in a month. it's just that we have standard procedures that everyone knows about and the treating agencies (hospitals, workers etc.) get a flat rate for a specific treatment that is agreed on annually or for a couple of years. it's just usa that is being stupidly complicated on purpose, because the sheepish customer is the one eating the difference of the bill and solving the problems the companies and the system has put in place
american idiot was always one of my favorite songs and i still fail to see how people don't stand up against this broken system
For every American who says "Canadians have to wait in line for their government healthcare!", I point out that Canadians vacationing in Florida regularly schedule emergency medical flights back to Canada since it's still cheaper than being admitted to an American hospital
They say that like Americans dont have to wait too. I went to set up an appointment at a dermatologist for a rash and they told me it’d be three fucking weeks
Only oral surgeon dentist who accepts Medicaid in my city has no appointments, so the wait time to get dental appointment at this place can be 3 months plus
Yeah, but that’s different. It’s because Medicaid pays essentially nothing. Doctors that accept it are Christlike.
This comment chain is about the Canadians having to wait to get their free healthcare, then somebody else said that the Americans also have to wait in the same lines, but pay more. No if you actually pay, you can get seen very quickly.
I support Medicare for all but personally I see doctors very fast, sometimes same day. One time I pooped crazy and decided to call a few gastros. I got a same day appointment and had my colonoscopy within 3 days because I didn’t want to do the prep that day. Turned out to be a polyp that they removed, and not cancer. I want that experience for everyone, the speed of service I mean.
There was already a predicted shortage of PCPs before the pandemic and the pandemic made it worse. Primary care just doesn't pay as much as specialties anyway so there needs to be more done to attract people into the field.
Yeah as usual Americans want the best of everything yet don’t want to pay for it. It’s a culture thing, everyone sees themselves as bill gates yet they resent him for actually being bill gates
Hilariously enough that's what I say to a lot of foreigners visiting the US. I remember reading the German embassy gave a similar warning to its citizens.
Yeah, I've seen foreigners from medical systems that we would consider inferior, but they trust their own countries medicine more than the US. I guess for some people there's no place like home.
My personal favorite are mexican dental vacations where people getting a bridge go to Mexico for the procedure and a 2 week vacation for less than what it costs to get it done here. This whole system is a bad joke
It's cheaper for Americans to fly to Spain got I running of the bulls break their hip their, stay their for a year in physical therapy in Madrid, not learn their lesson and go to it again break their hip against, and another year, the. fly back to the US then to just get a hip replacement in the US.
> schedule emergency medical flights back to Canada
That is probably because they bought travel insurance and the travel insurance is eating the huge med evac bill. It isn't that it is "cheaper", it is that someone else is paying the bill.
Also, foreign visitors that don't have travel insurance routinely skip out on US hospital ER bills
This doesn't protect you from surprise bills, they are just estimating what you owe. But they have no idea what the real amount it till they bill. See all the posts about people asking what the total will be and hospitals are unable to ballpark the total.
How about when you go to an in network hospital, ask literally every single person you come into contact with if the doctors you’re seeing are in network, get told by everyone asked that they are, all during a medical emergency, mind you, then get the bill because the dr wasn’t in network?
Or when the hospital is in network and the doctor is in network, but then they send your samples out to a lab and it turns out that you find out later on that the LAB wasn't in network 🙄.
Agreed always try to stick with in-network, but what I hate is when I go to my regular doctor visits and they are in-network but require payment up front and do a crappy job estimating what my insurance will cover. Then waiting months for them to bill insurance and see how what I paid up front compares to the EOB is an absolutely infuriating process.
Yeah, but what about their radiologists, lab techs, and the list goes on…
I’ve gotten plenty of out-of-network bills from ER visits, and even more frustratingly, labor and delivery + NICU.
You have rights now. If you are in an ER that is in network, they are not legally allowed to balance bill you and you can fight it. some hospitals which are jerks will give you a paper to waive your rights so that they can balance bill you but in that case, just don't sign it.
Lately, all the things they give you to sign are just on a pin pad with an electronic pen. You don't actually see what you're signing. There isn't a screen facing towards you just a little black strip on the desk with a magnetic pen.
They say "OK next you're gonna give me two signatures on the PIN pad. The first one allows us to treat you, and the second one here allows us to bill your insurance etc."
You are misunderstanding the scenario; this scenario is not limited to visits to out of network hospitals. Patients treated at hospitals that are in network with their plan are being asked to pay their estimated patient responsibility/cost sharing amount in advance of treatment vs. receiving the bill after the claim has been submitted to and processed by the carrier.
Yep. I've been asked to prepay for various things when going to exclusively in-network hospitals. So far I've been able to get away with telling them I'm only paying something like $5 before they render services.
It’s insane. At the very least, out-of-network charges should be limited to average in-network charge plus 10% or something, as a starter.
The “list price” is often so comically inflated. I have one hour of therapy every so often and I just looked at my EOBs. The “list price” is $1,044 and the in-network price is something like $150. There’s no therapist worth $1,044/hr.
I've been in the business for decades, and deposits are nothing new. I remember a hospital I was going to work for in the 80's being put out of business because they weren't returning overpayments to patients.
I prepaid for my recent endoscopic ultrasound because they gave a discount to prepay. They claimed they ran it through my insurance first and this was what it should cost me. Still pending for a final bill and the procedure was completed in mid-June.
I was told to see a neurologist by my primary physician. I call to make an appointment and I am leaning that just having a chat with him about my issue is $1000 out of pocket already. I guess I am not going to see a neurologist.
Was vacationing in Iceland (from the States). While hiking at a remote lava field near Grendavik, wife slipped and (triple) fractured ankle. She got buddy walked a mile back to road to meet the paramedics. Ambulance took her to Keflavík. Like a taxi, on arrival she had to pay: $500. Wheeled into ER and immediately examined by attending doctor, medicated and X-rayed. He then jacked her up with morphine, reset dislocated ankle and applied cast. After three hours, wife was handed a bag of prescription meds and wheeled to the checkout desk where payment, in full, was required before leaving. The bill for all services rendered: $800. Not the co-pay, the total charges. For added price context, the crutches from a local pharmacy were $100. The taxi ride back to our hotel in Reykjavik was $200. So, yeah, Socialized Medicine bad, amirite?
I deal with this daily. I just tell them I don’t like giving out my information over the phone or the internet and I’ll just settle in person after the appointment or procedure. Hasn’t been an issue yet.
This is the new gimmick to con patients out of more money. They agree to take the negotiated pay from health insurance companies and then they turn around and charge us more. Now they've come up with this scheme to sit on your money, so now you can negotiate prying your money back from them. This is why the problem isn't only with the health insurers, it's also the healthcare providers. My wife paid $40 for an exam, I went for the same procedure, different provider, they wanted an $800 deposit. I'm not going to participate with this. I will go visit another country before I give our crooks anything like this.
No one else has been in the emergency room waiting room where a billing person yells out your name and tells the whole lobby you owe a 700 dollar co pay ( true story)?
The ER isn’t allowed to ask for insurance information until you have had a medical screening exam by a MD/NP, by law.
They can ask after you’ve been examined. They can not discharge you until you are medically stable. They can not refuse service to anyone who needs care.
Please remember what an ER should be used for. Emergencies are bleeding badly, breathing problems, chest pain & neurological problems. Most things can be treated by walk-in clinics, PCP visit, or urgent care. I know having a regular doc is a privilege a lot don’t have. Another failure in our system.
The insurance industry in the US is completely messed up and needs a complete overhaul. I have no idea how this will ever happen but it is going to come to a head and I am worried it won’t be pretty.
I had a surgery center call me up the day before my surgery and demand $2,000 payment or they would cancel my surgery immediately. I paid it but I told him I'm coming for you I'm going to get that money back. Long story short it took nearly a year I got most of that money back and in the end my cost was about $700 I never forgotten this and I never will forget how they treated me how much stress and pressure they put on me when I was already extremely anxious and stressed about having the surgery they didn't care about my health or my well-being they only cared about my money.
Honestly this is what we want, someone to give you a price up front. I am for it honestly and would rather them say "your insurance is gonna pay x and you owe y" instead of getting 5 different bills over the course of 6 months and arguing with my insurance over them
Yes except somehow they don’t know the actual cost, no one knows, you pay them the estimate and then have to see what happens and track down a refund if owed. I agree with you that upfront pricing is one of the biggest missing pieces in our terrible system.
you not knowing the cost starts with the imaginary pricing in the us-american stores not applying state tax and vat on the price directly.
nobody, and i mean nobody, likes this and it makes absolutely zero sense unless you WANT to make people not know the price to not compare with the competition.
medical treatments are standardized, so the pricing should also be, at least statewide, standardized.
My healthcare system tried to do this and it was more trouble than it was worth. They were calculating the payment on the full rate for the procedure. They always ended up owing me money after the insurance paid their part. Now when you check in it says I own this $ amt, but I can be billed later.
Yeah, those with high deductibles aren’t paying their bills and therefore these hospitals and physicians are losing money. I have a small deductible and I’m typically not asked to pay up front. This title is misleading because being insured doesn’t mean you won’t owe anything.
From a academic point of view i would be very curious to see what the market would do if we banned health insurance....i dont mean replace it with some government system i mean just outright ban it and only have a cash only system.
My general assumption is the massive subsidies and market reaction to insurance would be we'd see cash prices drop to the center of the earth but also see a drop in a labor compensation....probably would see massive pushes to streamline processes.....you think the government is run inefficient as shit then you've never seen a hospital.
They already do that here in GA. Recently relocated from the east coast and went to the hospital. Prior to my procedure/stay they told me my amount due. Before seen by MD, before triaged by nursing. I literally walked in gave my insurance card and ID and she came back saying for this stay you owe 1900 would that be cash or card.. I thought she was messing with me.. because never in my life have I been given a bill prior to the service
So they do know what my appointment is gonna cost before I go there? And all this time they just weren't letting me know my 20 minute appointment was going to cost $800 out of pocket until afterwards.
I had knee surgery a few months ago and I had to pay for my part before the surgery. I ended up using Care Credit. The good thing about this I suppose is that you won't get a surprise bill later (I had some scans done at the beginning of a year, got quotes $992 and ended up with a $1750 bill after).
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jetsonian | 17 hours ago
I’m undergoing chemotherapy. I hit my out of pocket max in about two weeks in January. It took them until two weeks ago to put in the system that I don’t pay for medical care. Every walk into my PET scans went like this:
“Hi I have that owe $500 for a copay.”
“No I don’t. I am at my OOP max.”
“Ok I’ll have to call and verify.”
Twenty minutes pass.
“You’re right. No copay today.”
Finally last week the receptionist asked them to put that on my account and they fixed it.
courtofthepatriarchs | 14 hours ago
Best of luck to you and sending you strength
voxpopuli42 | 4 hours ago
God bless admin
topsecret440 | 18 hours ago
The problem I have is with delays in claims oftentimes have to pay multiple providers my deductible at the beginning of the year, then fight months later to get the money back once the insurance claims finally process and show I overpaid.
Logical_Procedure_24 | 17 hours ago
Exactly. I waited more than a month to get a refund because they did not apply my prepayment to my account. I actually had them billing me the actual (much lower) patient responsibility amount and threatening collections in the meantime!
SargeUnited | 14 hours ago
That’s the most frustrating part. Then when it’s time to be repaid, they say to allow for a month before they cut the check. But I can’t threaten to send them to collections, can I?
They need their money today but I need to wait a month plus mail delivery time.
Ok_Antelope_3584 | 9 hours ago
Yep this just happened to me. Had surgery in February, prepaid, delays in claims, hit deductible before the surgery claim went through, then they ended up owning me $1500 and didn’t get it back to me until June.
This should not be legal
youngishgeezer | 6 hours ago
I’m going through this right now. This thread has been a good reminder to call them again to fix their shit.
AlphaKlams | an hour ago
Contact the patient advocate if you haven't yet. Billing department was giving the runaround for over a month over some BS with their "back-end team." I called the patient advocate and the refund hit my card in less than a week.
AlphaKlams | an hour ago
Just had to deal with this. Surgery back in May along with tons of office visits, imaging charges, etc. Hospital made us prepay for the surgery then dragged their feet on submitting the claim, and when they finally did we had hit our OOP max from all the follow-ups who had been sending claims right away. Ended up having over $2k owed back to us from the surgery, which we only JUST got after a month and at least 5 calls fighting the billing department. They even tried to offer us a "store credit" for future procedures instead of an actual refund. After a call to the patient advocate suddenly the mysterious "back-end team" got their shit together and our refund was processed that week.
formal_mumu | 18 hours ago
My hospital asked me to prepay an estimated $5k for a procedure that according to my insurance was fully covered. I ended up paying about $230 after the fact instead for anesthesia
Churchbushonk | 16 hours ago
And why should you pay for anesthesia?
formal_mumu | 16 hours ago
Excellent question. I have yet to get a straight answer beyond that particular group isn’t fully covered, despite the hospital being covered . How anyone is supposed to be able to discover this is beyond me.
dreamsofaninsomniac | 9 hours ago
It seems anesthesia is always "out-of-network" to the point that it's surprising when insurance will actually cover it. You can't even really know how much a surgery will cost until it's over since it's not one claim. You have the surgeon cost, then the facility cost, then the anesthesiologist cost and they're all billed separately. Medical care is one of the few things you buy where you won't know the entire cost upfront. I feel like regular people who don't support some kind of public option or universal healthcare just haven't used the medical system enough to know how fucked up it is.
GuyWithLag | 8 hours ago
Technically anesthesia is optional, so....
dreamsofaninsomniac | 7 hours ago
For some surgeries, yes. It would be insane not to have anesthesia if you have heart surgery or brain surgery though.
geriatric_fruitfly | 5 hours ago
They do brain surgery awake to monitor signs of neurological damage while they're removing pieces
dreamsofaninsomniac | 5 hours ago
There are different levels of anesthesia. That would be local anesthesia, but it would still require an anesthesiologist to monitor vitals and monitor sedation because of how serious of a surgery that is.
When I got wisdom teeth surgery, I had twilight sedation without an anesthesiologist, but I did also wake up during the procedure so maybe it would have been better if I did have an anesthesiologist since I had to pay out of network for that anyway.
Spyro11221 | 15 hours ago
There is no way actually
SargeUnited | 14 hours ago
There is a way. Few more Luigis and they’ll wise up
Cut_Lanky | 8 hours ago
Heard about a town meeting about Flock cameras, where residents showed up with a giant guillotine, and the CEOs left, said they didn't feel safe.
Just saying.
callmesnake13 | 7 hours ago
We really do need to shame the fuck out of anyone who works in these fields everywhere they go.
itsacalamity | 4 hours ago
i'm doing my part!
OddlyFactual1512 | 9 hours ago
Does your state have a surprise billing law?
AlphaKlams | an hour ago
Isn't this the exact kind of situation covered under the No Surprised Act?
Cut_Lanky | 8 hours ago
Insurance never wants to cover anesthesia. It's criminal.
Suspicious_Place1270 | 9 hours ago
because a stick and scrap textile in your mouth is cheaper /$$$
theStaircaseProject | 20 hours ago
Definitely always been a thing but it sucks bigly that it’s increasing.
The number of people who pay a doctor or provider in advance and then owe less when the claim processes but then call the insurance for a refund is larger than it should be. I had to take more than a few health insurance customer calls in my time and it was usually a pain to explain to those people they needed a refund from the people they’d paid.
SghettiAndButter | 19 hours ago
I mean can you blame them? We have a system so complicated its starting to become comically funny
MikeyTheGuy | 18 hours ago
And part of the reason healthcare is so expensive is because we have to pay people whose job is exclusively to figure out this convoluted bullshit and bill people.
LuminescentToad | 17 hours ago
We’re also paying the people whose job it is to create the convoluted bullshit in the first place.
dust4ngel | 17 hours ago
we also have to pay people to lobby to make it illegal for the convoluted bullshit to be simplified.
ThePensiveE | 15 hours ago
Well yeah and since we spent all that money that's why we can't have universal healthcare!
solomons-mom | 17 hours ago
Yep, and in 116 years, we have built up quite the convoluted pile. Seriously, the Flexner Report, 1910.
MarkIsARedditAddict | 5 hours ago
Don't forget we're also paying for the people (insurance) whose job it is to make it excessively complicated!
Suspicious_Place1270 | 9 hours ago
assuming it's in the USA, there is a south park episode about just that
dreamsofaninsomniac | 8 hours ago
Health insurance can help if the provider is being nonresponsive or resistant to giving a refund or if they billed you incorrectly. Patients should contact the medical provider first, but when that doesn't work, having insurance contact them to get them to act right is one of the reasons you pay for insurance.
ShadyG | 15 hours ago
The best kind of funny
itsacalamity | 4 hours ago
i literally write actual scripts for people to read as part of my job. Fucking insane.
WeirdSysAdmin | 19 hours ago
We should do single payer and force doctors to take equal pay to teachers.
YourMothersDouchebag | 19 hours ago
Uh, no. You obviously have no idea how little teachers make. I live in Mississippi and decided to manage a GameStop instead of using my teaching degree; the GameStop gig paid more.
WeirdSysAdmin | 19 hours ago
No I know exactly how little teachers get paid. Make life fair for everyone and bring salaries down to the bottom.
SghettiAndButter | 19 hours ago
Why to the bottom?
Fuck_Mark_Robinson | 18 hours ago
Because they think they’re making a point.
thewimsey | 15 hours ago
Because they thought East Germany was a good idea.
dust4ngel | 17 hours ago
> force doctors to take equal pay to teachers
fuck yeah, let's raise teacher salaries - they do essential work.
Cakeman826 | 19 hours ago
This is how you get rid of doctors instead of fixing the prices of healthcare.
WeirdSysAdmin | 19 hours ago
Sounds like a good plan, won’t need doctors soon anyways because no one can afford it.
SghettiAndButter | 19 hours ago
So the teachers would get massive raises?
giraloco | 16 hours ago
In my case they asked for money the day of my surgery. They overcharged and I had to do a charge back on the credit card. Disgusting.
drawkbox | 15 hours ago
The whole year based out of pocket maximums is also bs. Insurance companies can lag decision latter half of year so it spreads to the new year and the out of pocket is never hit.
We need to disconnect this from workplaces now. The whole reason it is like this is the customer is not the target customer, instead the insurer targets the company meanwhile the medical providers and people needing the service are the last on the list.
Not many things have completely removed the service provider and the customer quite like our borked medical system. It is wild if you think about how off it is when it comes to just basic market principles.
zeugma_ | 9 hours ago
The decision timeline shouldn't matter. Annual thresholds apply to the date of service.
drawkbox | 6 hours ago
Approvals for pre-approved or ongoing service and medication can be delayed
Ok-Jackfruit-6873 | 15 hours ago
this is apparently how my dental insurance works. I pay out of pocket for everything and they reimburse me if/when they feel like it. I'm sure the dentist prefers it as they get to shrug and say it has nothing to do with them knowing they've already been paid in full. The insurance company probably loves it to, big win for everyone but me really
Suspicious_Place1270 | 9 hours ago
the swiss healthcare system has this option to pay out of pocket and then get reimbursed, but the reimbursement happens really fast, like, at most in a month. it's just that we have standard procedures that everyone knows about and the treating agencies (hospitals, workers etc.) get a flat rate for a specific treatment that is agreed on annually or for a couple of years. it's just usa that is being stupidly complicated on purpose, because the sheepish customer is the one eating the difference of the bill and solving the problems the companies and the system has put in place
american idiot was always one of my favorite songs and i still fail to see how people don't stand up against this broken system
KindAstronaut8499 | 8 hours ago
yeah had a dentist do this it is a scam.
EyesOfAzula | 19 hours ago
It stinks, but I think it's better to avoid going to hospitals that are not in network unless you have no other choice.
There's all sorts of nasty financial surprises that can happen if you go to a hospital that is out of network.
[OP] FireProStan | 19 hours ago
For every American who says "Canadians have to wait in line for their government healthcare!", I point out that Canadians vacationing in Florida regularly schedule emergency medical flights back to Canada since it's still cheaper than being admitted to an American hospital
anewbys83 | 19 hours ago
Americans also wait in line for care. We just pay more to do so.
dust4ngel | 17 hours ago
but it's a capitalist line, so it's more free-er
dakta | 15 hours ago
You can choose which line to wait in: the long one that costs a lot of money, or the longer one that costs even more money. Isn't choice great!
dust4ngel | 14 hours ago
i like the american one because you have no idea what it’s going to cost - it’s like playing the lottery but backwards
Suspicious_Place1270 | 9 hours ago
or us-americans just straight up don't go to emergency because they can't afford it.
Savannah-Actual | 19 hours ago
They say that like Americans dont have to wait too. I went to set up an appointment at a dermatologist for a rash and they told me it’d be three fucking weeks
KiKiPAWG | 17 hours ago
Only oral surgeon dentist who accepts Medicaid in my city has no appointments, so the wait time to get dental appointment at this place can be 3 months plus
SargeUnited | 14 hours ago
Yeah, but that’s different. It’s because Medicaid pays essentially nothing. Doctors that accept it are Christlike.
This comment chain is about the Canadians having to wait to get their free healthcare, then somebody else said that the Americans also have to wait in the same lines, but pay more. No if you actually pay, you can get seen very quickly.
I support Medicare for all but personally I see doctors very fast, sometimes same day. One time I pooped crazy and decided to call a few gastros. I got a same day appointment and had my colonoscopy within 3 days because I didn’t want to do the prep that day. Turned out to be a polyp that they removed, and not cancer. I want that experience for everyone, the speed of service I mean.
Albort | 18 hours ago
that’s not bad. my endocrinologist next available appointment is in 10 months… :-/
Octavya360 | 16 hours ago
Endos are sooooo hard to get into, even if you’re a regular patient. It’s a complex field, I guess there just aren’t enough of them out there.
Drokstab | 19 hours ago
I was referred to a psychiatrist and the soonest appointment was 7 months.
lifeat24fps | 18 hours ago
My eye doctor is regularly book 4 months out. For an annual eye exam, nothing special.
nmay-dev | 17 hours ago
Have you tried to find a pcp recently? It is comical. Our healthcare is dogshit. Free Luigi.
ForcefulBookdealer | 15 hours ago
I had to wait 11 days for a sick visit a few years ago.
I went to urgent care and picked up something else there, so I kept my appointment!
dreamsofaninsomniac | 8 hours ago
There was already a predicted shortage of PCPs before the pandemic and the pandemic made it worse. Primary care just doesn't pay as much as specialties anyway so there needs to be more done to attract people into the field.
dtr96 | 15 hours ago
I don't know I live in a major city and there's no waits for specialists. Max maybe 2 weeks.
SargeUnited | 14 hours ago
A lot of these people complaining about wait times probably live someplace like Mississippi or Tennessee or small towns.
ConsiderationDry9084 | 16 hours ago
That tracks. I schedule my skin cancer screenings 3 months out and even then the good slots are hard to get.
wwwheatgrass | 12 hours ago
I had to wait over a year for a dermatologist in Canada. When I lived in the states, I was seen in two weeks for the same issue.
itsacalamity | 4 hours ago
i have some bad news about just how lucky and short a wait you had for a dermo.... mine is a minimum 3 months, usually more
neatomosquito2020 | 4 hours ago
I was referred to gastroenterologist in April 2025 and the first appointment available was Feb 2026. In the US.
thewimsey | 15 hours ago
You have no idea how long people have to wait in other countries.
SargeUnited | 14 hours ago
Yeah as usual Americans want the best of everything yet don’t want to pay for it. It’s a culture thing, everyone sees themselves as bill gates yet they resent him for actually being bill gates
Pretend-Marsupial258 | 12 hours ago
America has the most expensive healthcare on the planet and lower life expectancy than other rich countries.
EyesOfAzula | 19 hours ago
Hilariously enough that's what I say to a lot of foreigners visiting the US. I remember reading the German embassy gave a similar warning to its citizens.
sleeplessinreno | 19 hours ago
Interestingly, I had a classmate leave Canada to get medical treatment in his home country (Not USA).
EyesOfAzula | 19 hours ago
Yeah, I've seen foreigners from medical systems that we would consider inferior, but they trust their own countries medicine more than the US. I guess for some people there's no place like home.
CautiousOptimism09 | 19 hours ago
My personal favorite are mexican dental vacations where people getting a bridge go to Mexico for the procedure and a 2 week vacation for less than what it costs to get it done here. This whole system is a bad joke
jqman69 | 19 hours ago
I mean it's cheaper for Americans to fly out to Mexico to get procedures done than to get them in the States.
Sufficient_Language7 | 17 hours ago
It's cheaper for Americans to fly to Spain got I running of the bulls break their hip their, stay their for a year in physical therapy in Madrid, not learn their lesson and go to it again break their hip against, and another year, the. fly back to the US then to just get a hip replacement in the US.
ripndipp | 17 hours ago
Yeah wtf is this nonsense
morbie5 | 18 hours ago
> schedule emergency medical flights back to Canada
That is probably because they bought travel insurance and the travel insurance is eating the huge med evac bill. It isn't that it is "cheaper", it is that someone else is paying the bill.
Also, foreign visitors that don't have travel insurance routinely skip out on US hospital ER bills
Sufficient_Language7 | 17 hours ago
This doesn't protect you from surprise bills, they are just estimating what you owe. But they have no idea what the real amount it till they bill. See all the posts about people asking what the total will be and hospitals are unable to ballpark the total.
EyesOfAzula | 17 hours ago
Yeah it sucks. I'm very fortunate that my hospital bills are rarely a surprise.
Every year I obsessively review my insurance benefits and cost of covered services, network providers. etc, so I'm almost never caught off guard.
But still for a lot of people it's not fun living in a country where you have to do that just to avoid surprises at every turn
vroomvroom450 | 15 hours ago
How about when you go to an in network hospital, ask literally every single person you come into contact with if the doctors you’re seeing are in network, get told by everyone asked that they are, all during a medical emergency, mind you, then get the bill because the dr wasn’t in network?
5thtimesthecharmer | 13 hours ago
Yeah there’s no way I’m paying the bill in that scenario
Pretend-Marsupial258 | 12 hours ago
Have fun in collections, then!
vroomvroom450 | 2 hours ago
Oh, there were hours spent in the phone about it. HOURS.
Eaterofkeys | 6 hours ago
There is a newer law that fixed this
vroomvroom450 | 2 hours ago
This may have happened right before the law. It was about 6-8 years ago.
The_Dutchess-D | 3 hours ago
Or when the hospital is in network and the doctor is in network, but then they send your samples out to a lab and it turns out that you find out later on that the LAB wasn't in network 🙄.
vroomvroom450 | 2 hours ago
Right?? Anyone who thinks you just have to simply make sure it’s all in-network has never had to use their insurance.
EyesOfAzula | 5 hours ago
you have rights now if you don't sign them away.
https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/avoid-surprise-healthcare-expenses
PurrfectlyNerdy | 17 hours ago
Agreed always try to stick with in-network, but what I hate is when I go to my regular doctor visits and they are in-network but require payment up front and do a crappy job estimating what my insurance will cover. Then waiting months for them to bill insurance and see how what I paid up front compares to the EOB is an absolutely infuriating process.
ForcefulBookdealer | 15 hours ago
Yeah, but what about their radiologists, lab techs, and the list goes on…
I’ve gotten plenty of out-of-network bills from ER visits, and even more frustratingly, labor and delivery + NICU.
EyesOfAzula | 7 hours ago
You have rights now. If you are in an ER that is in network, they are not legally allowed to balance bill you and you can fight it. some hospitals which are jerks will give you a paper to waive your rights so that they can balance bill you but in that case, just don't sign it.
https://www.cms.gov/files/document/nsa-keyprotections.pdf
https://www.cms.gov/nosurprises/ending-surprise-medical-bills
The_Dutchess-D | 3 hours ago
Lately, all the things they give you to sign are just on a pin pad with an electronic pen. You don't actually see what you're signing. There isn't a screen facing towards you just a little black strip on the desk with a magnetic pen.
They say "OK next you're gonna give me two signatures on the PIN pad. The first one allows us to treat you, and the second one here allows us to bill your insurance etc."
Logical_Procedure_24 | 17 hours ago
You are misunderstanding the scenario; this scenario is not limited to visits to out of network hospitals. Patients treated at hospitals that are in network with their plan are being asked to pay their estimated patient responsibility/cost sharing amount in advance of treatment vs. receiving the bill after the claim has been submitted to and processed by the carrier.
mndtrp | 8 hours ago
Yep. I've been asked to prepay for various things when going to exclusively in-network hospitals. So far I've been able to get away with telling them I'm only paying something like $5 before they render services.
Churchbushonk | 16 hours ago
No hospital should be allowed to be “out of network”. Our insurance should include every single hospital in the country.
NewYork_NewJersey440 | 13 hours ago
It’s insane. At the very least, out-of-network charges should be limited to average in-network charge plus 10% or something, as a starter.
The “list price” is often so comically inflated. I have one hour of therapy every so often and I just looked at my EOBs. The “list price” is $1,044 and the in-network price is something like $150. There’s no therapist worth $1,044/hr.
Few-Artichoke-2531 | 19 hours ago
I've been in the business for decades, and deposits are nothing new. I remember a hospital I was going to work for in the 80's being put out of business because they weren't returning overpayments to patients.
Rhianna83 | 17 hours ago
I prepaid for my recent endoscopic ultrasound because they gave a discount to prepay. They claimed they ran it through my insurance first and this was what it should cost me. Still pending for a final bill and the procedure was completed in mid-June.
TheManWhoClicks | 11 hours ago
I was told to see a neurologist by my primary physician. I call to make an appointment and I am leaning that just having a chat with him about my issue is $1000 out of pocket already. I guess I am not going to see a neurologist.
Tremolat | 16 hours ago
Was vacationing in Iceland (from the States). While hiking at a remote lava field near Grendavik, wife slipped and (triple) fractured ankle. She got buddy walked a mile back to road to meet the paramedics. Ambulance took her to Keflavík. Like a taxi, on arrival she had to pay: $500. Wheeled into ER and immediately examined by attending doctor, medicated and X-rayed. He then jacked her up with morphine, reset dislocated ankle and applied cast. After three hours, wife was handed a bag of prescription meds and wheeled to the checkout desk where payment, in full, was required before leaving. The bill for all services rendered: $800. Not the co-pay, the total charges. For added price context, the crutches from a local pharmacy were $100. The taxi ride back to our hotel in Reykjavik was $200. So, yeah, Socialized Medicine bad, amirite?
aReelProblem | 17 hours ago
I deal with this daily. I just tell them I don’t like giving out my information over the phone or the internet and I’ll just settle in person after the appointment or procedure. Hasn’t been an issue yet.
EriclcirE | 11 hours ago
Please Jesus Christ, let this dogshit farce of a 'healthcare' system absolutely implode. And all of late stage capitalism and all quarterly profits.
No_Succotash2155 | 14 hours ago
This is the new gimmick to con patients out of more money. They agree to take the negotiated pay from health insurance companies and then they turn around and charge us more. Now they've come up with this scheme to sit on your money, so now you can negotiate prying your money back from them. This is why the problem isn't only with the health insurers, it's also the healthcare providers. My wife paid $40 for an exam, I went for the same procedure, different provider, they wanted an $800 deposit. I'm not going to participate with this. I will go visit another country before I give our crooks anything like this.
inyourface317 | 12 hours ago
No one else has been in the emergency room waiting room where a billing person yells out your name and tells the whole lobby you owe a 700 dollar co pay ( true story)?
I thought it was the norm.
Psychological-Pay236 | 2 hours ago
The ER isn’t allowed to ask for insurance information until you have had a medical screening exam by a MD/NP, by law.
They can ask after you’ve been examined. They can not discharge you until you are medically stable. They can not refuse service to anyone who needs care.
Please remember what an ER should be used for. Emergencies are bleeding badly, breathing problems, chest pain & neurological problems. Most things can be treated by walk-in clinics, PCP visit, or urgent care. I know having a regular doc is a privilege a lot don’t have. Another failure in our system.
false_goats_beard | 2 hours ago
The insurance industry in the US is completely messed up and needs a complete overhaul. I have no idea how this will ever happen but it is going to come to a head and I am worried it won’t be pretty.
Subject-Ad-8055 | an hour ago
I had a surgery center call me up the day before my surgery and demand $2,000 payment or they would cancel my surgery immediately. I paid it but I told him I'm coming for you I'm going to get that money back. Long story short it took nearly a year I got most of that money back and in the end my cost was about $700 I never forgotten this and I never will forget how they treated me how much stress and pressure they put on me when I was already extremely anxious and stressed about having the surgery they didn't care about my health or my well-being they only cared about my money.
zeke780 | 17 hours ago
Honestly this is what we want, someone to give you a price up front. I am for it honestly and would rather them say "your insurance is gonna pay x and you owe y" instead of getting 5 different bills over the course of 6 months and arguing with my insurance over them
wannabesoc | 17 hours ago
Yes except somehow they don’t know the actual cost, no one knows, you pay them the estimate and then have to see what happens and track down a refund if owed. I agree with you that upfront pricing is one of the biggest missing pieces in our terrible system.
Suspicious_Place1270 | 9 hours ago
you not knowing the cost starts with the imaginary pricing in the us-american stores not applying state tax and vat on the price directly.
nobody, and i mean nobody, likes this and it makes absolutely zero sense unless you WANT to make people not know the price to not compare with the competition.
medical treatments are standardized, so the pricing should also be, at least statewide, standardized.
melvadeen | 13 hours ago
My healthcare system tried to do this and it was more trouble than it was worth. They were calculating the payment on the full rate for the procedure. They always ended up owing me money after the insurance paid their part. Now when you check in it says I own this $ amt, but I can be billed later.
Low_Mud_3691 | 5 hours ago
Yeah, those with high deductibles aren’t paying their bills and therefore these hospitals and physicians are losing money. I have a small deductible and I’m typically not asked to pay up front. This title is misleading because being insured doesn’t mean you won’t owe anything.
Willing_Activity_855 | 3 hours ago
From a academic point of view i would be very curious to see what the market would do if we banned health insurance....i dont mean replace it with some government system i mean just outright ban it and only have a cash only system.
My general assumption is the massive subsidies and market reaction to insurance would be we'd see cash prices drop to the center of the earth but also see a drop in a labor compensation....probably would see massive pushes to streamline processes.....you think the government is run inefficient as shit then you've never seen a hospital.
Worldly_nerves | 2 hours ago
They already do that here in GA. Recently relocated from the east coast and went to the hospital. Prior to my procedure/stay they told me my amount due. Before seen by MD, before triaged by nursing. I literally walked in gave my insurance card and ID and she came back saying for this stay you owe 1900 would that be cash or card.. I thought she was messing with me.. because never in my life have I been given a bill prior to the service
Swoly_Deadlift | an hour ago
So they do know what my appointment is gonna cost before I go there? And all this time they just weren't letting me know my 20 minute appointment was going to cost $800 out of pocket until afterwards.
Francl27 | 37 minutes ago
I had knee surgery a few months ago and I had to pay for my part before the surgery. I ended up using Care Credit. The good thing about this I suppose is that you won't get a surprise bill later (I had some scans done at the beginning of a year, got quotes $992 and ended up with a $1750 bill after).
StrangeChef | 12 hours ago
Sure! I'll gladly pay! Do you take a third party post dated check?
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Suspicious_Place1270 | 9 hours ago
looool