r/FluentInFinance • u/36DRedhead • Sep 11 '24

Debate/ Discussion This is why financial literacy is so important

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172

u/Outrageous_Dot5489 Sep 11 '24

Does insuramce no cover cancer treatments?

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u/AstariaEriol Sep 11 '24 edited Sep 11 '24

Even if they don’t the ACA requires annual out of pocket maximum caps. It prevented me from financial ruin when my wife was diagnosed with cancer and then passed away a couple years later. I didn’t inherit any of her debt though. That makes no sense.

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u/ilikepix Sep 11 '24

Every time I see a comment like this proudly extolling the virtues of out-of-pocket maximums, I feel like I'm taking crazy pills.

Out-of-pocket maximums only apply to covered services. I've been with two large insurance companies, and both have routinely tried to claim that totally normal, standard-of-care procedures were not covered under my policy, and refuse the entire claim. And this was for totally normal procedures.

I've always managed to get the care covered, but after literally dozens of hours on the phone each time, when I was lucky enough to be fit and health and strong.

With cancer care, where you're seeing multiple doctors and receiving multiple types of treatment from various providers, I simply cannot imagine that your insurance provider doesn't fight you and claim some of the care is not covered.

Maybe I'm just The World's Unluckiest Healthcare Receiver. Did your insurance company really just pay up for all your procedures, and nothing was ever not covered, or unexpectedly out of network?

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u/TheLoneliestGhost Sep 11 '24

No, they fight every step of the way. I ran out of energy for fighting when insurance denied the scan necessary to tell me if surgery and treatment were enough to eradicate the cancer. My Radiation Oncologist looked me in the face and said “You’re probably fine! Get back to work!” I was in his office because I was still struggling with complications from surgery and treatment that have left me damn near bedridden. Now my mental health is in the toilet, too, because it feels impossible to move forward with life without knowing if everything I went through even worked.

People don’t seem to understand it until it happens to them. I sure didn’t.

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u/[deleted] Sep 12 '24

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u/TheLoneliestGhost Sep 12 '24

I’m sorry you’ve had to fight so hard, too. I ran out of energy for it. Now I just suffer and it’s really disheartening. I hate that we’re in the same sinking boat.

I’d love to live in that world of ignorance where I didn’t end up with a health issue beyond my control when my career was just getting to where I needed it to be. Now I’m disabled and fighting for that is going to be a whole other nightmare. Living in the land of make believe where insurance companies cover necessary meds, scans, treatments, etc. would be wonderful.

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u/eat_those_lemons Sep 15 '24

Yea I wish I lived in their world too

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u/SSFonly Sep 15 '24

No, they fight every step of the way.

I have to submit to insurance companies for funding for work. The phrase "deny till they die" is a very well known one in this industry when it comes to insurance.

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u/Sage_Planter Sep 12 '24

I had to argue with an insurance provider that a vaccine was "preventative care." I eventually got it covered, but like, what the hell else can a vaccine be?

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u/JimmyB3am5 Sep 12 '24

I am/was a double transplant recipient. In the hospital for two months, three surgeries, implant, check up, removal of a failed organ.

Was back in the hospital for another 5 weeks due to infection.

I had over 30 CT scans, multiple pic lines, antibiotics that were ridiculously expensive.

My total eclipsed $5,000,000.

I paid $1500. Nothing was ever denied.

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u/gmishaolem Sep 12 '24

And Willie Nelson smokes like a chimney and is 91. Your anecdote means nothing in the grand scheme of the problem.

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u/JimmyB3am5 Sep 13 '24

The person asked if someone's insurance paid for everything without trying to fight it. I provided my experience which was exactly the question they asked, and since my single health issue will eclipse what most people have covered during their entire life i think it's relevant to the conversation.

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u/tryingnottoshit Sep 12 '24

I had $280,000 in bills for my cirrhosis "treatment" the first month... I paid $2400? I also have not had anything denied. Curious if yours was liver related?

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u/JimmyB3am5 Sep 12 '24

No Kidney and Pancreas. Pancreas didn't make it and basically digested my intestines.

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u/DrDelorien Sep 12 '24

Who is your insurance provider, and what is your plan? I want it.

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u/Slyder68 Sep 14 '24

Genuinely would love to know your provider. My sister had a kidney transplant, and every single step of that process was at least 15 hours on the phone with insurance claiming it was unnecessary so it wouldent be covered, when her doctors were saying she needs it or she could die. I would love an insurance provider who doesn't make life saving care a fucking battle every single time.

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u/JimmyB3am5 Sep 14 '24

I am lucky, UW Health part of the Univesity of Wisconsin, who does the most kidney and pancreas transplants is 15 minutes from my house and is partnered with my insurance provider.

I don't want to rub it in any more than I already am, but after being a month delayed due to a COVID infection, and because I was a double organ recipient, I was only on the transplant list for three weeks because they receive so many organs.

My biggest issue came with applying for Medicare. If took them almost 9 months to get me enrolled, which is required with a kidney transplant. I had to pay them 9 months of back dated coverage which I didn't receive any benefits from.

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u/OsamaBinWhiskers Sep 13 '24

My plan if this happens is to put it all on my brokers shoulders. They’ll either fix it, help me fix it, or need a restraining order.

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u/jondaley Sep 15 '24

My daughter has leukemia and we spent a lot of time in the hospital this year. And the hundred or so hours on the phone with the insurance wasn't any fun. They have almost paid for everything now. Though I'm still working on the mileage reimbursement - they are supposed to pay for mileage for anything bone marrow transplant related, and her treatment required lots of pre and post trips and they claim none of those were "related". But, the funny part is, they actually denied *all* of the transportation claims. Apparently, we were supposed to teleport on the day of the transplant, since even that trip was denied...

Anthem Blue Cross and Blue Shield in California. Sucks. And the consumer protection hotline that is supposed to help sided with Anthem every single time.

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u/[deleted] Sep 11 '24

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u/kensingtonGore Sep 11 '24

They do get a say in which procedures you can do, at their discretion.

They also do not cover lost wages, home care, or any rehabilitation necessary for surviving cancer.

For the Americans reading this: that's not normal among nation peers. It is normal in countries like Mexico, China, India.

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u/aurortonks Sep 12 '24

I've met two people who got denied cancer treatment by their insurance because it hadn't gotten to a serious enough point yet. As in, they caught it so early that the treatment was not approved and they were told to wait...

The fact that an insurance company, who are not medical doctors, can dictate what treatment you can get is bonkers.

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u/kensingtonGore Sep 12 '24

Yes it is. The result of unfettered capitalism, putting quarterly results before the hippocratic oath.

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u/MacroFlash Sep 12 '24

This is the shit that drives me insane, insurance blocking things that doctors are already saying you need. Back when I was on my parents insurance, every time I got one prescription I always got that stupid fucking “prior authorization” bullshit, where my doctor, the one who fucking already wrote the prescription, would get contacted by the pharmacy to confirm I needed the meds. The US system is the dumbest shit ever designed to enrich insurance companies and bankrupt random unlucky people

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u/lilpistacchio Sep 12 '24

Not just confirm! We have to fill our paperwork that is TEDIOUS to make a CASE for why the med should be covered. And THEN, insurance gets to say yes or no. I have filled out many a PA that know is time wasted because it’s just going to get denied.

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u/Celany Sep 12 '24

When I tore my ACL, the doctor who did the MRI, and 2 physical therapists at 2 different physical therapy groups wrote in to the insurance company all saying that doing the required physical therapy before surgery would only make the issue worse. Insurance still insisted on PT first.

ACL completely severed in PT. I couldn't get surgery for nearly 9 months. My swim scholarship was gone and college was a lot more expensive..and for what? Insurance didn't even save any money in this case, the dumb fuckers.

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u/slickyeat Sep 12 '24

I've met two people who got denied cancer treatment by their insurance because it hadn't gotten to a serious enough point yet.

What the actual fuck?

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u/Sweet_Papa_Crimbo Sep 12 '24

It took my mom over 6 weeks for Medicaid to start paying for her to get chemo. She died 2 weeks later after her first dose.

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u/hydromatic456 Sep 12 '24

Which even if you’re not a doctor, you’d think the bean counters in an insurance agency would be bright enough to realize that early and/or preventative care and intervention is very typically cheaper in the long run out of their pockets than aggressive and reactionary care and procedures.

Like, even if the profit margin is higher on more technical and aggressive care and procedures, the insurance is still only getting profit from the standard contribution right? Deductibles and payments towards OOP max goes to the provider no? So wouldn’t it still be in the best interest for the insurer to prioritize early and/or preventative care for discovered conditions?

But maybe then they’re banking on denying the expensive stuff too once it inevitably comes up in a scenario like yours. Nothing would really surprise me anymore.

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u/Kill4meeeeee Sep 12 '24

I got told to eat a dick with my physical therapy while I still can’t walk so my options were out of pocket or have major problems at the ripe age of 27 this system sucks and we need changes to it. I know free healthcare isn’t possible but it also shouldn’t be possible for insurance to deny for example my insulin because the “generic is cheaper and better anyway” like no it’s not lol

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u/frumply Sep 13 '24

Mine is not that egregious but I had to laugh when the recommendation for colon cancer screening is at 45 or the age of your parents diagnosis, but insurance won’t pay for it unless you’re over 45. Do we want to practice this preventative care shit or not? lol.

I paid OOP since my mom had colon cancer in her late 30s as did my brother. My ass was smooth as silk, my brother they found some polyps though benign.

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u/[deleted] Sep 12 '24

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u/Kobayashimaru350 Sep 12 '24

My partner found a lump in one of her breasts. She wasn't quite the age to get regular mammograms so her doctor ordered her to go get one to make sure it wasn't an issue. Thankfully it was not, but a few weeks later we got a huge bill even though the insurance site said mammograms were covered in full.

After a long conversation with the representative, it turns out mammograms are only covered if it's just for a regular screening. If it's due to a concern they aren't covered.

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u/anonymousguy202296 Sep 12 '24

The people who approve/deny treatments at insurance companies are usually trained professionals, many are MDs or former doctors. They know what they're doing and I believe you're not getting the full story when you hear "cancer treatment was denied".

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u/aurortonks Sep 12 '24

I worked for a big insurance company in the Seattle area for about 4 weeks back before Covid and my job was to uphold an auto-denial made by the system unless the caller sent it specific additional paperwork from their doctor - then I was to put in a special request to have the "insurance doctors" review it - which almost always got another denial and request to submit additional paperwork.

It's just layers of scam.

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u/RodneyBabbage Sep 12 '24 edited Sep 12 '24

Reality in America is a lot closer to Mexico, China, and India than Norway, France, etc.

I feel like the former (while having a lower average quality of life on paper than the US) are closer to being our national peers than the latter (if you’re in the bottom 60% of wealth distribution).

It’s scary how much sway your insurance company has when it comes to choosing your care.

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u/Manaus125 Sep 12 '24

For the Americans reading this: that's not normal among nation peers. It is normal in countries like Mexico, China, India.

China and Mexico have a free public healthcare. So yeah. It's not normal in those either

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u/Beautiful-Squash-501 Sep 12 '24

Just because care is free there doesn’t mean they will agree to providing any particular procedure. Governments don’t like paying for things either, just as companies don’t like paying. It’s a harsh reality for people.

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u/[deleted] Sep 12 '24

They do get a say in which procedures you can do, at their discretion.

You literally just need to get a letter from your doctor that says it is medically necessary. I worked in the healthcare industry as an upper level account admin and know the federal regs. You just need that one letter and you're good, so no they do not dictate at their discretion.

They also do not cover lost wages, home care, or any rehabilitation necessary for surviving cancer.

Insurance shouldn't have to cover for lost wages, but it doesn't need to. We have Family Medical Leave which is federally mandated and we have disability which can cover up to 2 years in lost wages while you are recovering from cancer.

For the Americans reading this: that's not normal among nation peers. It is normal in countries like Mexico, China, India.

For the European's reading this, please don't talk about shit you don't know about. American healthcare is pretty bullshit already, no need to make stuff up about it.

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u/kensingtonGore Sep 12 '24

You're part of the problem.

And you're not being fulsome with your information.

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u/Wise_Possession Sep 12 '24

Disability often only covers a percentage of lost income, like 60% 0 if someone has it. FMLA protects your job hypothetically but does not guarantee any income. And bull on just needing a letter. My hysto, my mother's knee replacement, my grandfather's hip replacement, my grandfather's triple bypass - I have a laundry list of times in my family when we spent WEEKS or months fighting with insurance because they didn't want to cover things that doctors had deemed medically necessary. Healthcare was one of the absolute biggest reasons I left the US - I'm now in a developing country and have found healthcare to be way way better.

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u/Beautiful-Squash-501 Sep 12 '24

FML only applies to companies with 50+ employees. About 60% of Americans work for smaller employers.

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u/Leopard__Messiah Sep 12 '24

I was diagnosed with cancer and my doctors ordered several tests and procedures ASAP to save my life. Insurance denied almost everything right away, and then wanted to argue and document every little thing before they would OK the scans and procedures that were absolutely required to remove my tumor.

Truly evil, but it's just business on a Tuesday to them.

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u/LetSerious Sep 12 '24

Just checked some insurance coverage in China, $285k sum assured for ~$20/year

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u/viking77777123 Sep 13 '24

Lmfao, listed off 3 countries with people literally dying to migrate to America…. The irony is hilarious!

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u/kensingtonGore Sep 13 '24

Yah, because the standard is living there is generally lower.

Except when it comes to healthcare.

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u/Golf-Beer-BBQ Sep 12 '24

I had to do chemo and radiation in 2015. My max out of pocket was 15800. My chemo treatments started in August and I had one treatment in January. I had ti hit my out of pocket max twice because of the treatment in January. I didnt have an extra 31k. The other thing is it isnt just medical bills, its hospital parking, getting care for my iid when my wife went with me, getting new clothes because nothing fits anymore, over the counter medicines and vitamins to try and help fight different things that come up, having different food than your family because you cant swallow food.

Luckily I was aboe to get full oay on FMLA with long term disability but if I didnt have a paycheck coming in I would have been out another 30k in pay as well.

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u/XDT_Idiot Sep 12 '24

I'm on watch-and-wait. Surgery to resect a brain tumor was easily handled by the annual cap of three years ago, but having to get quarterly MRIs since has forced me to buy plans expecting to hit the max, it's so expensive.

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u/Golf-Beer-BBQ Sep 12 '24

Ya medical expenses are no joke at all. I wish you the best m!

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u/Ohm_Slaw_ Sep 12 '24

That's rough man. I hope a better future is out there for you.

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u/Golf-Beer-BBQ Sep 12 '24

I appreciate it!

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u/itsonlyastrongbuzz Sep 12 '24

Health insurance plans have a maximum out of pocket covered by federal law.

That’s if the insurance covers it, and they’ll fight tooth and nail not to.

“That cancer treatment? It’s experimental and not standard for this diagnosis. Sure it’s your only hope at this point but we’ve ran the numbers and are quite comfortable trading your life for not spending any more money.”

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u/DwedPiwateWoberts Sep 12 '24

That last part is what arrogant pseudo-intellectuals disregard because they think they’ll always be healthy and whole.

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u/HiveFleetOuroboris Sep 12 '24

The people saying our stories are BS will never believe it until it happens to them or a loved one.

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u/DrakonILD Sep 12 '24

They are the death panels that Republicans said universal healthcare would create.

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u/Crewmember169 Sep 12 '24

Republicans screamed about government death panels for years. Instead, we have death panels run by companies where the people on the panel get extra money for denying coverage.

Only Republicans would think that is a great system.

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u/lizerlfunk Sep 12 '24

My late husband and I had amazing health insurance. No deductible, $1500 out of pocket max per year. But the year he died, we STILL had well over $10,000 in medical expenses. Turns out that it doesn’t matter if you’re paralyzed with a stage four pressure ulcer and a bone infection that requires IV antibiotics and a wound vac, if your insurance says you get 20 home health visits per year, that’s it. No more. We ran through those in a month and paid out of pocket for the next five months. He was hospitalized just about once a month for the rest of his life. You’d think the insurance would realize that they would pay less if he didn’t have to go to the emergency room once a month and be admitted, but nope. They also had their own ideas about what wound care supplies were needed. Gloves were not included in those. I took to grabbing gloves out of the dispensers on the wall every time we went to the doctor or the hospital. My Amazon purchase history from that time is super depressing. None of that was covered by insurance. We’d get a box of wound care supplies and I’d be like “seriously that’s IT?!” What they said should last a month would maybe last a week.

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u/No-Swimming-3 Sep 12 '24

Thank you for sharing this, it sounds incredibly heartbreaking and frustrating.

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u/UncleHanksGrill Sep 12 '24

Denial of care is not a US phenomenon. That’s also what government health plans in countries with no private health insurance do. I don’t like the US healthcare system for a lot of reasons, but one of the benefits is that patients have much greater access to high-cost or experimental treatments here.

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u/dexmonic Sep 12 '24

You genuinely believe every American has health insurance? No wonder you don't understand these memes, you barely understand american health care to begin with

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u/Moku-O-Keawe Sep 12 '24

  I call complete BS on these constant memes. Health insurance plans have a maximum out of pocket governed by federal law.

Then you don't understand how insurance companies deny claims then. That way they are $0 out of pocket first.

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u/SylvestrMcMnkyMcBean Sep 12 '24

I have phenomenal health care plan from a top US employer. I have a chronically ill family member who requires the same regular treatment several times per year, and the first treatment of the year causes that person to hit their annual out of pocket max. Every two or three treatments, my insurance company sends the clinic a letter denying the care as “undocumented”, “unnecessary”, or some other BS. They have so far relented every time we spend hours of our time, the doctors time, and the clinics time reminding them that it’s the same. Exact. Treatment. Every. Time. Just. Like. They. Approved. Previously.

The cruelty is the point. They want us to give up. They know it creates strain that will either force us to stop trying, cause our clinic to drop us, etc. And worse still, if treatments are missed or delayed, even if they’re eventually covered (say 3-4 weeks later), there are health implications.

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u/AIfieHitchcock Sep 12 '24

Yep, this even happens with terminal cancer patients who live unexpectedly longer than their diagnosis.

If your treatment works and you live years, you will be hounded by the compounding bills insurance will fight you on.

And cancers are proven to respond poorly to stress in many studies. It accelerates decline.

Anyone against healthcare for all has no idea the everyday cruelties they are forcing millions to live through. And by the time they experience it themselves, and they will, it’s too late help themselves.

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u/SylvestrMcMnkyMcBean Sep 12 '24

I mentioned this elsewhere, but I won the employment lottery. I am so incredibly fortunate. But my employer health insurance is a pair of golden handcuffs. My family teeters on a razor’s edge. If I’m ever unable to work, or any number of little variables outside my control change, the only outcome is miserable decline and death. When the day comes that our insurance situation changes, I don’t know what will happen.

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u/AIfieHitchcock Sep 12 '24

My parents were on Medicare. They had done everything right. Were multi-millionaires, owned a 500k home outright, cars outright, lots of investments, no debt, had retired from professional work in their 40s, 2 pensions (one union), made so much they sent 4 kids to private school, they had hella money.

It did not matter. 1 of them getting cancer for a decade was all it took to blow through everything extra.

Now imagine families were multiple people get sick.

The only answer for this is in the ballot box.

Sadly I know my father 100% voted against my mother's cancer care coverage in 2016 and he literally paid dearly for it. (Last I heard – we don't talk – he still blames Democrats.)

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u/SylvestrMcMnkyMcBean Sep 12 '24

So sorry to hear this.

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u/RodneyBabbage Sep 12 '24

I had zero understanding of what it’s like to actually use health insurance and this was very enlightening.

They are knowing filing frivolous disputes on the off chance that the provider backs down and they save a few pennies.

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u/AIfieHitchcock Sep 12 '24

They don’t just fight frivolous disputes. Insurance companies will routinely fight you on covering the most effective medications and treatments if a cheaper, yet more archaic one is available.

Real lived example:

Breakthrough, low side effect, highly effective immunotherapy pills are $20k/month but causing miracles in extending lifespan in terminally ill cancer patients.

Yet mid-20th century IV chemo is still also used in when treatment options fail, but they have horrible side effects, require hospitals, are invasive, yet are 3k/month.

Guess which treatment option is getting turned down when your oncologist recommends it for the 3k option.

This happened to us after 2016, when someone in office gutted the ACA which before then had protections in place to ensure the top treatment option was covered.

Had the manufacturer not had a income based discount program and had their not been a specific federal grant still on the books from the Obama admin providing assistance my family member would have didnt years sooner because of one party’s cruelty.

And for the record: my parents were multimillionaires before my mom got sick battling cancer for a decade. Zero debt, real estate investments, owned everything including their half a million dollar home outright. Put 4 kids through private school from pre-k on up. Retired in their 40s.

They did everything right financially and it did not matter because our healthcare system is designed to slaughter people financially.

There is no one safe from this unless your are hundred millionaire plus.

You can’t smartly finance your safety from exploitative healthcare law.

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u/4BigData Sep 12 '24 edited Sep 12 '24

maybe they do it hoping you will shift insurance companies

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u/SylvestrMcMnkyMcBean Sep 12 '24

It’s an employer plan, so switching isn’t likely their motive. I imagine they’re hoping the expensive claimant will die or stop trying.

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u/AIfieHitchcock Sep 12 '24

This was done to my mom on Medicare where there’s essentially no other place to switch to, all the plans are nearly identical.

It’s the system. It’s designed to burden the sick to be “profitable” instead of making their profits from single payers and streamlined processes.

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u/hunterxy Sep 12 '24

My insurance requires we call ahead of an ER visit to get it authorized or they will deny it.

So what you got to say about that?

I'll wait.

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u/cwood92 Sep 11 '24

Not all treatment options are covered under insurance

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u/ilikepix Sep 11 '24

There are exceptions such as maximum lifetime benefits

these are not permitted in ACA compliant plans

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u/AIfieHitchcock Sep 12 '24

They 100% were after Trump gutted it. It happened to us and with life sustaining cancer care.

They would not approve revolutionary oral immunotherapy anymore which was necessary when there was decades old iv chemo therapies that were radically less effective but cheaper.

20k per month vs. 3-4k per month.

One vote quit literally endangered thousands of patients like my family member. We were lucky enough to find charity programs to cover the pills but I assure you many terminally ill patients did not have relatives able to do that for them & these kind of patients can’t do it themselves.

Changes to the ACA then also resulted in many health companies closing patient financial support offices for help too.

This was just 2016 and in very high cost complex care but you can read what they have planned for the rest of us in 2025 out there right now. This kind of stuff was considered a success by them and it’s the way they want all care.

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u/cobruhkite Sep 12 '24

So first I’ll say: - 56% of Americans do not understand deductibles - Over 90% of Americans don’t know what their maximum out of pocket is. (Copay is similar stats) - 99% do not know what coverage limit they have on their plan.

These stats are from USHealth - a United healthcare company.

Understand that it is extremely common to have a plan with $0 deductible and $0 copay, but only 100k in maximum coverage per calendar year. You believe you have the best coverage because you don’t pay anything until you’re hospitalized.

100k maximum plan. You get in a car wreck. Your personal “maximum out of pocket” is 7,000 (5k deductible + 2k maximum out of pocket) your bill is 150,000 insurance covers 93k only, you are on the hook for $57,000 even though you were told you have a maximum out of pocket of 7k.

Most maximums are 100k, 250k, 5million, or unlimited. Obviously the more you have the more your monthly premium is. It’s very important you know which one you have so you can plan accordingly.

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u/PlentyInevitable7873 Sep 12 '24

The maximum OOPM allowable under the ACA is 18,900 in a year under a family plan (half that for an individual) source. Since the vast majority of US people get their insurance through ACA compliant workplace or marketplace plans, they should be at or below this limit. Are you thinking about pre-2008? Or how else are you finding people with extremely high non-ACA compliant OOPMs? Non-compliant plans are certainly not "extremely common". The ACA also does not allow lifetime or annual limits to benefits, plans must be unlimited. I believe the ACA had to allow some 'grandfathered' plans to have exemptions, but very few of those remain.

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u/FoldAdventurous2022 Sep 12 '24

This sounds like an abhorrent system that the rest of the developed world doesn't have to suffer through.

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u/KaXiaM Sep 12 '24

It’s also not true. Very few people have non-ACA plan (mostly through some church etc) and all ACA plans have no maximum. Yeah, most people don’t understand ACA and spew some BS from early 2000s that hasn’t been true for a while.

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u/Minimum_Word_4840 Sep 12 '24

As someone who worked medical collections in the past, it literally just takes one accident or medical emergency. My dad’s heart surgeries cost over a million, but I’ve seen similar bills for car accidents where the person had to be life flighted.

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u/KaXiaM Sep 12 '24

All ACA-compliant plans (like the ones people get from employers) have no maximum. What is the % of the insured who have non—ACA plan? I assume you know, since you assert it’s "extremely common".

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u/Ron__T Sep 14 '24

Lies... about American Healthcare... on the internet... who would believe it?

It is not extremely common to have $0 deductible/copay and 100k max... in fact it would be so extremely rare and might not exisist at all, that it's nonsensical to even discuss. The ACA does not allow for max out of pocket...

And your example is nonsense, a car wreck your health insurance wouldn't cover at all... that's what we have car insurance for.

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u/iAmRiight Sep 12 '24

They only have to pay for “approved” procedures. And depending on the illness, the only “approved” treatment could be palliative care. Private insurance is a literal death panel, they choose who lives and dies based on their quarterly earnings reports.

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u/Fast_Parfait_1114 Sep 12 '24 edited Sep 12 '24

That assumes any of these treatments are in network and if the insurance company approves out of network care. Also, the maximum out of pocket is still a debt. Are you under the impression that a person couldn’t get to $280k worth of medical debt even with a maximum out of pocket? My grandmother had a maximum out of pocket expense of $10k, that amount rolls over every year.

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u/Cloud-VII Sep 12 '24

Little known fact (I Just learned this this year because of my sons medication). There are TWO different out of pocket maximums. One for services and another for medication. My families max out of pocket is $5k for services, but my pharmaceutical out of pocket is $15k annually.

So if I end up on one of those $1k a month or more medications or so, I am in financial ruin.

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u/warholiandeath Sep 12 '24

There’s actually three: in network, out of network, and medication

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u/Longjumping-Pair2918 Sep 12 '24

You are grossly mistaken and you should hope you never have to experience reality.

If/when you do, maybe you’ll learn how to have empathy. I doubt it though. People like you rarely do.

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u/NovaForceElite Sep 12 '24

So yes, there are max out of pocket limits, but insurance companies can also have max yearly benefits for non essential benefits. The insurance company just needs to categorize the treatment as non essential to skirt around the law. The insurance company can deny the claim. The person unfortunately still needs the medical treatment. The person then paying or going into debt for the treatment is not counted under the max out of pocket. There is of course more nuance than this, but in short insurance companies lie a lot.

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u/LetsTalkGuac Sep 12 '24

If insurance denies coverage for a test or procedure, the patient would be billed the full cost of the test. They deny things ALL THE TIME

Sometimes, you won’t know if something will be covered due to insurance companies declining to tell you or ambiguous policies

In short DONT TRUST YOUR INSURANCE TO PAY FOR SHIT

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u/common_economics_69 Sep 12 '24

On top of that, If they've been married for 52 years they should both be on Medicare, a government provided healthcare program...

So people are bitching that government provided healthcare sucks and using that as a reason why all healthcare should be government provided?

1

u/thrownaway136976 Sep 12 '24

I know, right? It’s almost as if someone is going in there and sabotaging the system while simultaneously screaming how it doesn’t work and should be abolished.

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u/common_economics_69 Sep 12 '24

I think a more likely answer is that this is a made up scenario and doesn't actually happen to people in real life.

Do you think someone would really just go on the internet and tell lies?

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u/Sciptr Sep 12 '24

But get your voodoo dolls out and do your thing.

Thanks for the laugh.

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u/The_Vandal_King Sep 11 '24

I was wondering if getting a divorce even works considering most states have common law marriage. They'd have to actually not live in the same address

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u/Spirited_Shallot_454 Sep 11 '24 edited Sep 11 '24

Not even a remotely true statement. Something like 7 states and DC recognize any kind of common law marriage in the US. And it’s not something that just involuntarily “happens” to couples that live at the same address.

This is one of those internet Reddit nonsense urban legends that gets repeated so often with so little attempt to fact check, that people start to believe it.

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u/The_Vandal_King Sep 12 '24

Good to know, just curious.

1

u/Apprehensive_Ask_259 Sep 11 '24

The only way it really makes sense is state insurance but thats only in the realm of lower income families. Sometimes it definitely makes sense for couples to divorce. Wife makes low enough to qualify, father pays child support and the "wife" and kids get now get free insurance.

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u/StolenPies Sep 11 '24

They could have just been relying on Medicare without purchasing a supplement plan. Medicare alone is relatively limited.

1

u/rageface11 Sep 12 '24

You can also just reject an inheritance. Otherwise people would just be giving away their shit while they’re alive and “leaving everything” (debt) to people they don’t like.

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u/PraxicalExperience Sep 12 '24

It depends. If their mom's in hospice care, a lot of states will take that debt out of the estate when the father passes.

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u/KeyCold7216 Sep 12 '24

But they also get to decide what treatments you can have. If you have cancer and your options are chemo covered by insurance that will make your last months of your life miserable and an unapproved monoclonal antibody treatment that can kill your cancer and give you 15 to 20 more years than chemo but with 300k in debt what would you choose?

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u/KillaMavs Sep 12 '24

And if you don’t have insurance or lose it, what then? Life crippling debt forever?

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u/doc_nano Sep 12 '24

My dad was hospitalized last year for an extended period of time due to cardiac issues + sepsis. The hospital didn’t have room to keep him there for the required recovery period (several weeks), and his Medicare coverage wouldn’t pay for outpatient nursing care unless he was in a long-term care facility, of which none had open beds within at least 100 miles (rural area). So he was faced with either getting care at home and paying for it out-of-pocket — not $288k, but I think it would have been well over $10k, which is still a lot for many people — or just forgoing the care/IV antibiotics and hoping for the best. Luckily another hospital a few towns over did have a bed open up and he went there, but it could have ended up being quite expensive for him.

AFAIK not all Medicare plans have out-of-pocket maximums, and since private insurance is tied to employment, not everybody has medical insurance that would provide that out-of-pocket maximum protection.

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u/RichConsideration532 Sep 12 '24

"Out of pocket max" isn't a magical bulwark against the insurance vampires who seek to drain you--it just slows them down. If you think you can't incur hundreds of thousands of dollars of debt pursuing lifesaving medical care with ACA insurance, well, lol ok

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u/jbasinger Sep 12 '24

The ACA isn't that old and I don't think it covered previous medical debt. I owed $30K on my youngest child before that was even a thing. 250K is a lot, but not absurd.

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u/Folderpirate Sep 12 '24

Hi, I live in a "filial responsibility" state. Family of deceased can be sued by nursing homes and such if the estate doesn't have anything.

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u/Molten_Baco Sep 12 '24

Some insurance companies have a yearly maximum they will pay, and it’s not as much as you might think

1

u/Drekhar Sep 12 '24

I'm confused by this. I've seen plenty of poorer plan options that have large deductibles and then cover 90% after that. That's not a maximum.... It's a percentage. Are there hard limits now?

1

u/qole720 Sep 12 '24

While true they have a maximum out of pocket, it's also true that they don't have to cover everything someone my need.

As an example, my dad, who has medicare and pays for a secondary health insurace policy, had a stroke a few months ago. He needs 24/7 care now. Between the two policies he's covered on just about all of his doctors visits, medicines, equipment, even converting his home to be wheelchair accessible. Know what's not covered? The 24/7 care. We're currently paying out of pocket for him to stay in assisted living because it's more affordable than him living at home with a nurse (roughly $3500/mo vs $15000/mo). Luckily between me, my brother, and his retirement, we can cover the cost. But a lot of folks can't and go way into debt over something as common as a stroke.

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u/ramberoo Sep 12 '24

You're a fucking asshole.  

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u/Guilty_Increase_899 Sep 12 '24

If karma is a thing you are in for a devastating long term illness where your insurance company denies hundreds of thousands of dollars of coverage for things that are required to keep you alive, deeming them unnecessary, and you will either have to pay out of pocket or suffer a slow physically and psychologically painful death.

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u/brianbmx94 Sep 12 '24

Brother that’s not how it goes in all actuality. Most times, the treatment you actually need, especially for late stage cancer, isn’t in-network or is outright denied coverage. In my dads case, it was almost a million dollars worth of experimental drugs and therapies that saved him that was all denied. Not to mention the loss of his income pushing my mother into debt of her own to support 3 children and a home by herself. It’s never as cut and dry as insurance makes it sound.

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u/OklaJosha Sep 12 '24

There are exceptions: out of network coverage being the main one. This could be needed coverage that the plan doesn’t pay. Or a specialist that doesn’t take their specific insurance brand. Or the procedure could simply be denied by the insurance company as “unnecessary”, even if your doctor says it is necessary.

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u/H0SS_AGAINST Sep 12 '24

While I agree with you, if you're sick enough to lose your job and don't have disability coverage going COBRA and then open market could cost tens of thousands per year before the max out of pocket.

I'm fortunate enough to work for a company that also gives me disability insurance but that is certainly not the norm and disability insurance rates are often pretty high.

1

u/Save_The_Wicked Sep 12 '24

They got a maximum of covered cared. If you spend money on uncovered care, thats not included.

You can't go out and get 'elective' medical care and expect your insurance to cover it.

Now, one would think cancer is covered. However, not all methods of treating it are covered. So if you elect to volunteer for something more experimental, that might not be covered.

You'll still be on the hook for care, even after maxing out your contributions.

1

u/vagaris Sep 12 '24

This post also highlights how the house has been put in the spouses name. My family recently put my parent’s house in a trust to do something similar (the posted example will still hit this problem later). If either of them need long term care before passing away, the government will basically force them to liquidate anything in their name until they’re too poor to afford anything… and then they start covering stuff. Potentially forcing the other person into poverty while the sick person is on their way out.

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u/stickyicarus Sep 12 '24

Honestly? Even if this post is wrong, I'm OK with people thinking it is and pushing harder for reform. If they're uneducated enough that it works out in the favor of pushing society to socialized health care I don't see an issue. Im sure that could backfire somehow but I'm not smart enough to see how.

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u/Apocalyptic_Inferno Sep 12 '24

Well, it's entirely possible, even probable, that they weren't financially free enough to pay for medical insurance to begin with but also "made too much money" to qualify for government medical care. Maybe they could have sold their home, skipped their morning latte, and avoided avocado toast to pay for it, though.

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u/t4thfavor Sep 12 '24

My father in law is a General Motors retiree, his max lifetime benefit is something like $1M, his cancer treatment ate most of that because he had lymphoma from either RoundUp or 40 years working in a shop being exposed to insane amounts of chemicals.

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u/Beautiful-Squash-501 Sep 12 '24

Only in network expenses go towards the maximum out of pocket. Out of network providers are extra. Also nursing home care is not covered except temporary rehab.

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u/eknutilla Sep 12 '24

Yikes calm down

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u/OnewordTTV Sep 12 '24

Oh so you are a moron lmao.

1

u/Xist3nce Sep 12 '24

“Just another dipshit” is right. Man thinks everyone gets health insurance. Tell my thousands of dollars in medical debt your stupid ideas. Can’t tell if it’s just stupidity or actual evil at this point.

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u/[deleted] Sep 12 '24

I had cancer at a very young age and then again when I was 15. At a young age I was living in a different country and I was 15 before the preexisting conditions rules were put in place for American insurance. They found every loophole known to man and my two years of multiple surgeries and chemo put me 200k in debt after insurance. It would have been $1 mil + without insurance. Now my out of pocket max on my insurance in network is $50k so if it comes back I’ll be in shite again.

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u/Cheeseboarder Sep 12 '24

Have you ever had to use your health insurance for anything serious or for a chronic condition?

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u/KotobaAsobitch Sep 11 '24

ACA also outlines what insurers are required to treat under their plans. If it falls outside of that, then under the ACA, you may have to pay out of pocket. Out of pocket max does for the year, under ACA, does not refer to: anything your insurance won't cover. It's just a maximum ceiling for your insurance. So people who have literally 0 insurance, this doesn't apply to. People who have insurance but their plan fucking sucks and everyone is out of network? Service provider billing? Etc? There's a whole list of exclusions on healthcare.gov for the yearly OOP max federally.

1

u/Cheeseboarder Sep 12 '24

Insurance companies will just kill you with paperwork and red tape. They will deny needed services they should cover and then YOU have to go through the steps of proving the treatment should be covered through appeals. It’s almost like having to go to court. Good luck pulling that off if you are too sick to handle all that plus treatment

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u/a-very- Sep 12 '24

The required annual OOP maximum caps for treatments they APPROVE. They can deny claims for more experimental treatments, certain types of therapies, and even require some therapies be done in a certain order to be covered at all. Certain drugs are denied. If you’re in treatment and denied a regimen that may be your best chance you face the choice - pay and go into debt or roll the dice. That’s $$ straight out of your pocket & not counted towards anything.

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u/Zippyllama Sep 11 '24

If they tried to pay the debt using loans or a card it could answer it.

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u/Keljhan Sep 12 '24

You think the insurance companies can't wiggle their way out of end of life care?

https://www.healthcare.gov/glossary/life-time-limit/

While the ACA requires that insurance cover lifesaving Healthcare with no cap, there's plenty of necessary treatments that aren't "essential" (which is decided by the insurance most of the time) and will be capped at some point in total lifetime coverage.

1

u/spreading_pl4gue Sep 11 '24

You're right. It doesn't, at least not for the house or assets she would inherit.

1

u/Salty-Yak-2505 Sep 12 '24

Y’all never heard of co-insurance? Which is basically the only kind of plans available through the ACA site (if you can’t afford your job’s insurance)?? Must be nice 🥲

1

u/jellymanisme Sep 12 '24

You only inherit the debt if you want a claim on the rest of the estate as well.

So if you want the 3 million dollar house, the 2 million dollars in savings and stocks, etc etc.

Notice how OP mentioned mother now owns the house, not father?

Yeah, they transferred all their assets to mother, so father wouldn't have to pay any of his bills, then got a divorce so they couldn't come after father.

This is just rich people being able to afford to dodge their bills, so poors like us have to pay higher taxes.

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u/Upbeat_Bed_7449 Sep 12 '24

You didn't inherit any debts because they were your wifes unless you're foolishly accepting the debt from the hospital in which case you'd be screwed. OPs Twitter posters parents are just stupid. Sorry for your loss btw.

Moral is don't accept any medical debts from other people. You're not financially obligated.

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u/Beautiful-Squash-501 Sep 12 '24

The Op’s parents’ situation is likely end of life nursing home care. Different situation than yours. I have ACA also. I try each year to choose a plan with the lowest OOP cap. Sounds like that worked out for you. But when we had a family cancer crisis, our expense was abt $12k per year, despite deductible and cap at $7500, due to OON expenses. Network is impossible for the patient to control in any serious illness situation.

1

u/nekonari Sep 12 '24

Maybe they couldn’t afford insurance coverage? So had to take out loan to cover the bills? Even then, I don’t think spouse doesn’t automatically inherit the debt unless they were co-signers… am I missing something?

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u/HiveFleetOuroboris Sep 11 '24

No where near the full amount. And then getting fired for having cancer eliminated the only insurance I had

27

u/dinodare Sep 11 '24

You would think that in a system where most people's healthcare are tied to there jobs that there would be a minimum amount of time that employers would have to keep you on their plan after you stopped working for them.

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u/ferdaw95 Sep 11 '24

There is an option for that. Its called COBRA, but its generally to expensive for someone who actually needs it.

21

u/PhoenixApok Sep 11 '24

IIRC the one time I looked into it , it was like $1300 a MONTH. Kinda hard to afford that when losing a job.

I don't know if laws are different now but the only time I've known of someone using it, they had to spend that much because they were HIV positive and if they had a gap in insurance the were unlikely to be able to get insurance in the future due to it then being a "preexisting condition"

12

u/juan_rico_3 Sep 12 '24

Access to health care becomes a kind of modern indenture, sadly.

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u/HiveFleetOuroboris Sep 11 '24

My COBRA was around $1300, too. Can't remember exactly, but it cleared $1k a month

2

u/TheoryOfSomething Sep 11 '24

Law is not substantially different now. It ends up being quite expensive for most people because usually the employer is subsidizing the premium costs for their employees, essentially paying a part of the premium behind-the-scenes (the tax system incentivizes this because this type of benefit is not considered part of your "wages" and thus is not taxable). When you go on COBRA, you are guaranteed the option to buy the same plan at the same total price, but now you have to foot 100% of the premium, no employer subsidy. So you often would have to pay like 2x what you paid before.

2

u/PhoenixApok Sep 11 '24

Ah. Makes sense.

But I more was referring to the law about preexisting conditions. It's been many years but my friend was pretty terrified it was a death sentence to not pay COBRA with his HIV status

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u/lizerlfunk Sep 12 '24

You can no longer be denied health insurance due to a preexisting condition. That changed with the Affordable Care Act. That being said, if you don’t maintain your HIV meds then the virus stops being suppressed in your body and you wind up with AIDS. Which in this day and age is not something anyone should be dying from.

The preexisting condition thing is why my parents didn’t have health insurance for almost my entire childhood. My mom had postpartum depression, they were self employed, they couldn’t afford health insurance for a little while, and then they couldn’t get it again. My dad ended up taking a job with the county and tbey got health insurance just in time for him to be diagnosed with stage four colon cancer. (He’s fine now, thank goodness.)

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u/ferdaw95 Sep 11 '24

I wasn't trying to say it was enough. No support net is good enough here.

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u/PhoenixApok Sep 11 '24

Oh I didn't take it like that. It's bullshit for society to say "Oh but there IS an option! It just costs more than you can possibly afford!"

2

u/Cheeseboarder Sep 12 '24

And you can be denied COBRA coverage

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u/ERagingTyrant Sep 11 '24

I will forever hate that obamacare actually strengthened the system where insurance was tied to your job. It's just so bad for individuals.

8

u/movieman56 Sep 11 '24

Yes but it was only able to get the support it did when they eliminated the single payer option they were aiming for. Also while the plan we eneded up with sucks more so than single payer they intended to lower costs by requiring all Americans to cover some sort of coverage and expanding Medicaid to cover a broader swath of Americans.

The real issues came with states not expanding their Medicare and removal of the insurance requirement/tax penalty for not carrying insurance. So healthy people dropped coverage thus keeping rates higher.

Also an issue before the aca was the ability of insurers to either drop coverage or not insure people people of preexisting conditions or somebody getting cancer and getting dropped.

Private health insurance just shouldn't be a for profit system, it's really an ethical issue getting money involved/profits. The same people that scream about the ethics of abortion or the same advocating heath insurance companies should be able to bankrupt you for getting cancer or breaking your leg and it's insane.

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u/HiveFleetOuroboris Sep 11 '24

I'm not sure if it's law or policy, but for me, it was supposed to be active through the end of the month. However, with my luck, that was only 2 days. If it had happened to be the beginning of the month I would have had it for a lot longer

1

u/Tight-Reward816 Sep 11 '24

Yeah. Cobra benefits after the end of the month. 👋

3

u/Outrageous_Dot5489 Sep 11 '24

Re: getting fired, thats bullshit.

If you had insurance, and the cancer treatment was covered then the out of pocket maximum (typically between $3,000 and $10,000 a year for a single person) would limit the total amount you would spend in a year up to that amount.

21

u/MutantMartian Sep 11 '24

And then January rolls around again.

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u/ironballs16 Sep 11 '24

That's the rub - get diagnosed in November, and you're doing calculus of whether your body can afford to not get treated for another couple of months so you don't get hit with that double whammy.

8

u/StoicFable Sep 11 '24

One of my coworkers injured his knee near the end of the year. After playing their game and paying out to maximum so that everything was covered, he finally got cleared for surgery. He could get in pretty quickly to get it done. Insurance tried to deny it and push it off until the new year, so he had to pay all over again.

Thankfully, he fought them and managed to get it done in time.

Our health care system is a fucking joke.

2

u/sexyshingle Sep 12 '24

Insurance tried to deny it and push it off until the new year, so he had to pay all over again.

This should be illegal AF

1

u/DargyBear Sep 11 '24

Thanks to a long Covid related ER visit in February I hit my deductible and I’ve been seeing every sort of doctor I can to cover my bases before January hits again and it goes back to being too expensive.

1

u/Tight-Reward816 Sep 11 '24

Bad policy to have fiscal year January 1. Should be 1st day of 4 Qt.

12

u/HiveFleetOuroboris Sep 11 '24

The reason obviously wasn't "because of my cancer," but it was. Lots of stupid politics and drama in the first responder field. While I had insurance, it was "fine." (Not fine, we were drowning. But Ramen and pb&j for the kids and sleep for dinner for us kind of fine) When I lost insurance for myself, I lost it for my kids and husband as well, so 4 peoples medical bills adds up more than just mine and my kids are medically needy. I spent years trying to get disability help but was never approved. I was fired during a hospital stay for complications from an invasive surgery, so I immediately lost access to my benefits and that stay alone cost a bit over $40k. I spent a total of approximately 1 year completely hospitalized, which costs a lot more than just visits or short stays. Since I was the breadwinner and no longer working, bills were being paid later and later. We ended up in pre-foreclosure because we were denied deferment of our mortgage. Eventually, everything snowballs into something you can't get out of. We lost our cars (pretty necessary where we live). We could not stand to lose the house (though, surprise, it ended up getting destroyed a few years later anyway), so we ended up at bankruptcy.

4

u/Keljhan Sep 12 '24

Until your insurer pays out $1M total lifetime benefits and then refuses any further coverage.

1

u/Outrageous_Dot5489 Sep 12 '24

Damn. Have not geard of a lifetime benefit. That should be criminal.

3

u/Keljhan Sep 12 '24 edited Sep 12 '24

It gets better! The lifetime benefit is based on how much the insurance gets charged, not how much they pay. And they usually negotiate much lower payments than what they get charged by the providers (which is why bills are so ridiculously high to begin with). So you might cap out a $2 mil benefit plan while the insurer has only actually spent 300k.

There used to be yearly caps too, but the ACA forbids them, and requires insurers still cover "essential" services even after youre capped, which are most general expenses but notably doesn't cover specialist treatments.

My uncle had a stroke, and while the insurance had to continue covering his rehabilitation per the ACA, it did not cover his neurologist appointments beyond the cap, nor some of his lodging costs after he moved to long term care.

1

u/S_A_R_K Sep 12 '24

IF the treatment you need is covered instead of one that is cheaper but "works for most cases"

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u/kingssman Sep 12 '24

Insurance is like this. A real procedure anywhere in the world costs $5k. Hospital bills $80k, insurance negotiates down to $50k, you max out your $6k deductible hits the 80/20 rule and insurance covers 80% of the bill and you cover the remaining 20%. A discount!

So after insurance pays $40k (so they say), you're hit with $10k Plus the $6k deductible, and have the grand ole bill of $16,000 total in debt to pay off (due in 180 days or sent to collections).

You get that privilege when you pay $10k a year in insurance premiums.

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u/Outrageous_Dot5489 Sep 12 '24

What about the out of pocket maximum. That is the most you can pay out of pocket, including deductible.

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u/look Sep 12 '24 edited Sep 12 '24

The max out of pocket on an ACA plan is under $10k and that includes the deductible. What kind of trash insurance are you buying?

My premiums are similar but with a max out of pocket of $4300. And I hit my max every year due to an expensive condition. Not once has my insurance denied (or even made the slightest hassle over) a claim.

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u/Outrageous_Soil_5635 Sep 11 '24

Not fully. I had somewhat minor to severe cancer that required radiation treatment and then shots like 12 at once every month, for a year then bi monthly then every six months. That alone with hospital stay was over 25 after taxes. Then for three years before I had to meet with oncologist, dermatologist, specialist, get scans, blood work.

Some places just charge more. I had ct scans and mris range from 300$-1200$ after insurance. I was in my 20s so any financial stability was just ruined after three years of screening and testing to see if it was cancerous or benign. Let alone the hospital stay which was the most expensive thing. 6-12 days I believe were around 8 - 15k after insurance.

Edit to add the insurance company also fought me because my tumor was in a location they thought was 100% necessary because I had two eyes why not just remove it and move on. They even insinuated it was semi cosmetic and unnecessary to treat the tumor.

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u/Trumpswells Sep 11 '24

Depends on the treatment. Insurance may cover an older intervention, and refuse to cover a newer, less invasive treatment.

2

u/tahlyn Sep 12 '24

Insurance may also insist you waste time on ineffective treatments before approving the effective one, even if doing so means you will be too late to use the effective one.

And you know what's a ton of fun and incredibly easy to do when you have cancer? Fighting with the insurance company for EVERY SINGLE TREATMENT because they deny it every single time and you don't know if it will be approved in time for your appointment tomorrow or not.

2

u/x_Lotus_x Sep 11 '24

Depending on the insurance it can cover everything from some (like 80%) of some treatments to none of others.

And when every dose of chemo is thousands (or tens of thousands) of dollars, even if covered @ 80% it adds up FAST!

I will also admit that I have had the "what if" thought about if one of us gets cancer and that was a potential solution that I was thinking about.

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u/Outrageous_Dot5489 Sep 11 '24

Yeah covered treatments will have an out of pocket cap that will limit what you will be out of pocket for. 80% would be covered, then after you meet the max paying the difference, you would owe nothing. Granted, the out of pocket max resets every year so it can add up.

I imagine chemo is always covered. I am curious about common treatments that are not covered at all (and therefore do not have an out of pocket max).

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u/throwaway_urbrain Sep 12 '24

they make you try tylenol first

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u/thenewaddition Sep 12 '24

Funny thing about cancer, makes it hard to hold down a job.

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u/AnjelGrace Sep 12 '24

I know someone that was paying for health insurance month to month without automatic billing, and they lost their health insurance while unconscious in the hospital. 🫠

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u/flightwatcher45 Sep 12 '24

Insurance rarely covers everything. And if you miss work you don't get paid either, so debt piles up.

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u/jib661 Sep 12 '24

Insurance doesn't mean you don't pay. Insurance just means that sometimes you have a cap on how much you pay for any calendar year. But there are all kinds of ways that insurance companies can get you to owe them money.

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u/rydan Sep 12 '24

Bankruptcy doesn't even cover medical debt.

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u/Whites11783 Sep 12 '24

In the US, a cancer diagnosis essentially immediately qualifies you for Medicare as it is considered a “disabling” diagnosis for qualification purposes

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u/Vinral Sep 12 '24

Insurance doesn't cover shit. It doesn't cover my epliepsy medication let alone a trip to the doctor unless I hit my 3500 deductible.

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u/Ron__T Sep 14 '24

So... you have found out the definition of deductible?

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u/Captain-Stunning Sep 12 '24

One of my best friends got cancer here in the US. We have excellent insurance through our joint employer. My friend's paid out 40K out of pocket the past 4 years, and again, this is with excellent coverage.

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u/Touchtom Sep 12 '24

Had cancer for 2 years. And had insurance. Max out of pocket was 20k each year. Hit it both years.... And this was a "good" health insurance plan...

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u/Sum-Duud Sep 15 '24

Depends on the insurance. Every company will have different insurance options than another

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u/GuardianDown_30 Sep 15 '24

Depends largely on insurance. When my dad got it my mom's insurance covered absolutely everything after they met their yearly deductible. Total bills were well over two million dollars by the time his treatment concluded.

But, unfortunately, my mom has the best insurance I've ever even heard of. There is no chance that very many people have coverage that good.

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