Quote:
Originally Posted by thebmw
What you're describing is a personal experience. What I am describing is how the industry works. That said, you're describing a catastrophic event, which I described previously. Catastrophic events are typically covered. However maintenance and usual conditions have a lot of issues with coverage for procedures and medications.
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I think the US medical insurance system and health care system are a disaster, but I can't say I agree with much of what you've said. My dad had all sorts of health problems the 4 years prior to his death at 70 in 2013. Tons of ER visits, ambulance rides, heart stints, multiple overnight stays, etc. My mom and him carried supplemental insurance in addition to Medicare. Their out of pocket costs only slightly exceeded their expected max out of pocket cost each year. In those 4 years, I believe it was something in the range of $200K. He then in the week prior to his death he had a heart valve replaced which his heart did not take. He was in the ICU for 12 days and then passed away. The surgery and ICU costs were in the range of $550K. My mother paid $7K of that and she met her deductible that year. She had a knee replacement and eye surgery that year. My mother's dealings with insurance in all of these cases has been surprisingly good.
For me and my family, we're very healthy, but we've had our accidents and sports related injuries over the past 5 years. I've had two 5th metatarsal foot surgeries which cost around $20k each and I paid out of pocket around $2500/ea. There were no surprises. I knew exactly what I was obligated to pay as my doctor's office disclosed everything I'd be billed for and when to expect the bills and from whom.
I don't enjoy spending the close to $500/mo for my family healthcare (high deductible HSA plan), vision, dental, etc., but I see the value in it, especially when your health hits the fan.