Well, not really of course. I doubt it could be explained by anyone, let alone me such is the labyrinthine nature of our current system. For example: if you have a car accident and you cause $6000 worth of damage to your vehicle and you have a $1000 deductible, you owe $1000 and the insurance company pays the remaining $5000. Simple math. However, if you have health insurance, the copays become much more convoluted. With the same deductible, you could pay many thousands more because certain things are excepted from the deductible and others are covered at a percentage over the deductible to a fixed cap. So, returning to the car analogy, it would be as though you did the $6000 in damage, but it excluded airbags, the radio, and the transmission, but covered the rest at a fixed percentage up to the $6000 dollars. You could end up covering $3000-$4000 even though you had a $1000 deductible.
To make matters worse, information such as how much procedures cost is a closely guarded secret coded in a way that would make Dan Brown jealous. Lets go back to cars (must be on the brain tonight). When you go to purchase a car, you have a wealth of information available to you in regards to price. You have the MSRP at the dealership, the invoice, the actual costs and can find out even more if you are willing to invest the time. You can read copious reviews as well and also check out other dealerships to see what prices they will offer you. You can, in effect, make an informed decision based on actual information. If only going to get medical treatments operated in a similar manner. Instead, it is like going to buy a car without even knowing how much a car should cost in the first place, have no information on the window sticker to remotely guide you as to the purchase price, knowing nothing about vehicles quality or reliability, and, if given a choice of other places to purchase the car, you are afforded no information as to whether the other vehicle is better or cheaper. To truly drive the point home, you wouldnt even find out how much the car costs until you get a bill a month later telling you what you owe (at which point you are required to pay it regardless of how fair or unfair it may seem).
What does all this even mean..........well, it means I will not be getting my gall bladder out on Friday very likely because: A. We evidently already owe better than $1000 for everything leading up to this point and B. The gall bladder removal may be up to a few thousand more. This, by the way, is with insurance and a $1000 deductible. I would like to have the procedure and move on with my life, but that isnt exactly the kind of money I have lying about at the moment and, all things considered, I am much improved to a point that I don't deem it critically necessary (thankfully considering the cost). Hopefully, down the line my hospital job will offer better health benefits...........or at the very least I will have enough income to cover the procedure. Until then, why does insurance have to be so bloody complex?!?!?
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