30 Days of US Healthcare: Co-insurance

Day 3 - Co-insurance

[ConstantlyDamaged]

I hope Jimothy's healthcare covers workplace psych. He's going to need it.

[Snarl_Marx]

The worst part is that the system isn't broken, in fact it's working exactly as intended.

[seanspartan]

They need to play these shorts before Congress the next time they have a hearing on rising Healthcare costs.

[Miatalustrium]

I'm always excited for open enrollment every year! I have a week to parse through tens of pages of new policy changes. The price went down for similarly listed coverage??? No, now my medication is $400 again instead of $30. But visiting my PCP is $20 until I pay $2000 out of pocket, THEN! Co-insurance of 90% covers those costs! Still not medication, though, so for a whopping $170/check or $350/month, I get to still spend far more! 😊 But if I pay $220/check, medication costs go back down to $45, but maximum out of pocket before co-insursnce goes up to $5k 😢 but then they cover 90% again of everything (excluding eyes and teeth and medication and specialists [but I don't need a referral!]) Afterwards until the new calendar year starts.

I also have to call the prescription company to confirm prices will stay the same to *show* HR I made the effort even though I know they will say, "uhhhh, it shouldn't go up, but since the policy changes, I wouldn't know until you have an new account number." (Which means that I am not going to get a solid answer until the policy change is effective, but at that point, I can't change it for another year, so if the cost DOES rise substantially [which, again, my meds cash price is $400+]) AND I take the plan that'd slightly more expensive than I had before, I might pay more for both insurance AND medication! AND IF THATS NOT ENOUGH, I have to get ahold of the nebefits rep for the company whom is impossible to reach because she's got 300 other employees all calling and asking for answers for the same exact questions that change based on the person's age and current situation.

Great fucking system. Solid. Definitely the most competitive and best priced in the world.

[moninebrocco]

Youtube is the only place I can see a Doctor these days

[dabzilla]

Every single one of these goes full circle from being hilarious back to being depressing because it's so on point.

10/10 meme 🎉

[fridayallan]

I’m not gonna lie, the healthcare system and the whole tangle of insurance, co-insurance, deductibles, and everything has been really confusing to me for ages but having someone explain it with all the incredulity it deserves actually helps me understand it better. Like, no, it actually **doesn’t** make sense and **really** sucks, you’re not imagining it.

[dragonmystic]

Greetings from Germany, our Healthcare is somewhat f'd up in its own way (long waiting times, not many doctors in rural areas and overworked staff almost everywhere) but you guys take it to a whole other level

[keyofpop]

Thank you for talking openly about this. A lot of social media doctors either do not or only occasionally mention how effed the insurance system is. I really appreciate that you call attention to the issues that effect people THE MOST when it comes to getting good Healthcare. Cause it really is all about the cost.

[sagesufferswell]

I adore you ❤ As a lifelong patient with rare conditions and complex disabilities, your videos are super relatable and validating.

[Microphonecheckher]

I’M LOVING this new series. US healthcare insurance business practices are insane.

[BagsNBaguettes_]

This is 100% accurate. I work in healthcare operations and my husband is a physician, a cardiologist to be exact. I’ve worked in his office many times and had to call insurance companies. Patients have no idea nor understand the complexity of their plans. For example, after you meet your $5, 000 deductible, you still have 20% coinsurance for all procedures or codes, and the plan will pay 80%. Insurance companies have it all figured out. They never lose.

[marceytidwell]

Recently, my sister had routine lab work. The billed amount was $675.37 which they were trying to charge her because they failed to bill the insurance company. AFTER the insurance bill, they _allowed_ $77.50, of which she was responsible for 10%, or 7.50.

The doctor's office also incorrectly booked her appt for her pap smear, and then had her make a second appt to come back. They tried to code BOTH visits as a wellness visit. The first was paid for (although they really did nothing for her) and the second then got rejected because two wellness visits in a calendar year wouldn't be paid for. This also then caused the pap and HPV test to be rejected. The facilities tried to bill her over $600 for the second visit and labs. I told her to ask the office to recode the first one as a routine visit ($20 copay) which caused the second claim and labs to be covered 100%.

Moral of the story - never write a check until you've been over the bills with a fine tooth comb. Assume something was done wrong. Have a person in your corner who knows the system and the verbiage to use.

[yourpalfred]

So glad to see more and more doctors talking about this openly. ❤

[elizabethwang]

What a great healthcare teaching series. You could just play these when you have to sit down and explain policies and rules to people and workers.

[fungifactory]

I work in a pharmacy and have to explain to people how their insurance works pretty much all day every day. I tell a lot of people that it really is intentionally made to be confusing, so that ultimately their insurance company is able to make more money from them. Every time i tell someone they need a PA and they ask what that is, i always preface it with a "so this is gonna sound pretty stupid but..." and that usually keeps people from getting mad at me directly haha. American healthcare system is a nightmare in every way.

[marthahawkinson-michau]

Thank you, Dr Glaucomflecken for fighting the good fight to raise awareness of the evils of private health insurance.

[MrGomezJr]

Morally reprehensible is right man.

I can't even get my annual screenings because of all the damn loopholes.

[pastyourbedtimeasmr]

I always forward these to my Aussie friends they’re shooketh

[AndreaHernandez-ztcx]

Poor Jimothy. Someday somebody somewhere will appreciate your intelligence, Jimothy.