Quote:
Originally Posted by XutvJet
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.
|
In regards to your parents, those were considered catastrophic and urgent and they had Medicare. We have rarely seen issues with catastrophic care with Medicare. We HAVE seen some issues with commercial, but still low for catastrophic.
In regards to your personal experiences, those are considered urgent and non-elective. Again, we see fewer issues there.
It seems that OP has some CHRONIC issues, which are not catastrophic or "urgent" (insurance company definitions...I think all suffering is urgent). It is in the chronic disease space that we see tremendous problems and issues. With cheaper quality policies and Obamacare or exchange policies, we see massive issues with coverage. By coverage, I mean what the insurance actually pays for vs. what is patient responsibility, as well as what insurance calls medically unnecessary and experimental, even though the service is "covered", necessary, and hardly experimental. THAT is what I am referring to and that is what OP needs to watch out for.
All that said, there may be no way to avoid issues no matter what policy OP has because of possible Chronic issues, but the Obamacare plans are absolute garbage. Only healthy people who have no chronic issues should be getting them simply to fulfill the requirement to have "coverage" (which is good to have for catastrophic).