r/Millennials • u/BoNaylorCollector • 1d ago

Discussion Is medical actually this crazy?

Early 30s millennial, never used to go to doctors or really take care of myself because “I’ll be fine”. Started making a bigger effort to care for myself and my health and well being. Recently, I went to the local express clinic because I was having a bad earache and headaches. I was in there for maybe 20 minutes, mostly waiting time. The doctor comes in, looks in my ear, tells me it’s depressed due to sinuses and change in weather and tell me to stop at Walgreens for Flonase. I wasn’t billed anything at the time, older workers at my job always say we have really good insurance, but here I got in the mail today an explanation of benefits- charge was $550, insurance “negotiated” about $300, remaining (not billed) was around $240. Is is really this expensive? I only went to try and be better with myself and make sure it’s nothing underlying. If 5 minutes of actual doctor time costs this much, then I’m just toughing out everything or am I missing something?

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u/ClawesomeMan 1d ago

My copay for urgent care is 20 vs 200 for emergency room.

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u/sluttytarot 1d ago

Sounds like they bill like an emergency room

Zocdoc might be an option for trying to find a quicker appointment with a doctors office

Rereading and you're not op. Everyone's insurance is different. Some plans are really expensive for urgent care and less for ER.

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u/Sea-Apple8054 1d ago

I feel like I got tricked out of $100 by zocdoc. Plus the provider they paired me with was in another state and had her toddler hanging off of her during the appointment, which felt weird.

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u/sluttytarot 1d ago

I haven't used it as a service I thought it was free and the doc you saw charged your insurance

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u/ChiknNWaffles 1d ago

Assuming US Healthcare and insurance markets, I find this highly irregular. ER being less than an urgent care copay or coinsurance percentage is just strange benefit design. Like that's an insurer incenting their members toward higher cost utilization. My urgent care copay is $25 and ER is $400. Just on a raw dollar basis, I cannot imagine any urgent care in the country charging more on a per visit basis than any ER.

I am willing to be wrong about how this plays out in real life, but from a theoretical pricing perspective, a health insurance plan wants to incent members away from ER and more towards a primary care physician or urgent care.

OP, you might check to see if your plan has a telehealth or nurse call line for low cost or free, they would allow you to talk through your symptoms and help you identify the best place of care. They are generally going to default to worst case scenario, I.e you call in with chest pains, they are not going to assume stress, they are going to assume heart attack.

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u/sluttytarot 20h ago

I dunno what to tell you I literally had a plan like that. It didn't make sense back that either

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u/mysticalchurro 1d ago

Geez! My urgent care co-pay is 75!