why is health insurance so complicated reddit

Each insurance company has to license their particular company in each state (or territory), put up assets for that company in that state, have all their rules and rates approved by the Department of Insurance in that state. 5 years ago. A friend is one who has the same enemies as you have. We call it Medicare health insurance, but it’s not. How is this different, at the end of the day, from enforcing a ban on price discrimination? Healthcare is also complicated because of the wide variety of needs it must satisfy. We call it Medicare health insurance, but it’s not. The insurance through my company is total shit. Comments are closed. Insurance now wants to make money so they deny any case they are legally allowed to. Honestly, there is no single answer that would satisfy that question. No choice in the matter. "We understand your doctor prescribed you this specific life saving medication, but it isnt on our approved list and legally this medication that IS on the list will keep you alive albeit with many complications so you'll have to settle for that". Yup, it sucks. "We understand you have **** but the doctor classified it as only stage 2 and per our guidelines we only cover when it reaches stage 4". Cookies help us deliver our Services. So how long are they going to butt rape me? Health insurance can reimburse the insured for … Trump said he had no idea that health insurance can be so complicated. This is why car insurance doesn't cover oil changes. Every eligible person must get and keep qualified health insurance coverage. In contrast to the limited replacement value of your home or car, there’s no natural limit on what an illness might cost. Why are health insurance choices this confusing? “Now, I have to tell you, it’s an unbelievably complex subject,” he added. It’s sickness insurance. That is dirt cheap compared to what you will pay with an ACA plan for a far worse deductible/out of pocket. Grrrr to the insurance (though I get their reasoning), but a grrrr also to the companies that make it difficult for a patient to get the treatment they need. How Adverse Selection Works A health insurance company can only exist if it takes in more money in premiums each year than it pays out in claims . creating an incredibly regressive system where the poorest, sickness people get screwed. r/AskReddit is the place to ask and answer thought-provoking questions. Car,home,renters, and business insurance can all be purchased online, in minutes for a fare price. Why Is Health Care So Complicated? I’m covered by the VA since I’m a disabled veteran, but I still have to make sure that my wife and child have coverage. . The more complex it is, the easier they can get out of paying for things. No two people have the same needs so the insurance companies are trying to meet the various demands by consumers for health coverage. U.S. Prices Vary Wildly The most salient reason is that U.S. health care is based on a "for-profit insurance system," one of the only ones in the world, according to Carmen Balber, executive director of … Medical insurance is complicated because of the layers of payers and service providers. However, from a consumer standpoint, things are not all that complicated. The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of … With the aging of the American population and with advances in medical sciences, size and growth are likely to continue. remium is now going to be $440 per month starting in November. The underlying reasons why health care costs continue to soar aren't that complicated, Cutler said. I have to buy it through the ACA website? So.... We basically have catastrophic only coverage for $7200 a year. I would also like to go back and find out just why it’s so expensive for insurance to cover triptans too – what is it about these meds that causes them to be so … It's ridiculously expensive because of how insurance works, and because of how drug companies lobby doctors to prescribe expensive branded medication that is identical to cheaper unbranded medicine. Health Insurance Can Help Lower Your Costs. Other Articles In This Category: National Review By CHRISTIAN ALEJANDRO GONZALEZ . It’s important to understand your costs and key health insurance terms, so you’ll know what services your plan will pay for and how much each visit or medicine will cost. I am an insurance broker, and every time I open a renewal letter for a client, it's heartbreaking. Can health insurance be more like, well, insurance? Why Is Health Insurance so Complicated? But there is one glaring exception: health insurance. Mandating health insurance and making the premiums so expensive is untenable, I don’t think it will last. As an agent, I would highly recommend you stick with that plan as long as you possibly can. Thus the multitude of options. But if you’ve spent any time comparing plans or networks lately, then you know that healthcare is still mind-numbingly complicated. Yup, today’s post is going to be a mini rant on health insurance. Sep 4, 2017 - Why is health insurance so complicated, while car insurance and life insurance are so simple? The Motley Fool. A good way to think of short-term plans is that they’re temporary health insurance with lower premiums, higher out-of-pocket costs and less coverage than a standard health plan. Medicare’s enrollment rules are complicated. 9:45. There is a huge difference between when you can enroll and when it is best to enroll. Why is health insurance so complicated, while car insurance and life insurance are so simple? For instance, a recent executive order loosened the rules around what health benefits insurance companies must offer with certain plans. Because what people call health insurance isn't insurance in the United States, it's just prepaid health care. Why is it so hard to get good mental health treatment in the U.S.? Then after I'm out 13.2k for the year in premiums and deductible they still only pay 80% until I spent another 5k OOP. Random Quote. How to buy a catastrophic health … 18k/year in premiums with a 5k deductible and still only 80/20 up to 12k OOP. by Rockwell published on 2017-06-13T22:35:26Z Almost 60% of the population have health insurnace but its fair to say that only a very small % of these people really understnd how the product works. It's so fucking complicated because ACA was written in large part by insurance lobbyists behind closed doors to ensure that they got the opportunity to gauge and claw everything they could from the "deal". Nope, I have to wait 4 months to go to a ghetto clinic to be seen by a third rate doctor. So I go on the ACA site and it says I have to send my release papers from the institution, my pay stubs, my credit card statement, and a notarized statement that I live in the community to show that I am not currently incarcerated. Why health insurance is important: protection from high medical costs. Someone break this down for me, what can I do? This means a random amount of things are, and are not covered. Insurers must, essentially, pre-negotiate how much they'll pay for services, so they only work with a particular network of providers with whom they've set up contracts. I think your initial thoughts are correct: They are raising rates annually on grandfathered plans in an effort to get people off of them. So I talked to the office [manager], who said if I paid up front and agreed not to report the procedure to Blue Cross, that it would be $580.” “I have insurance, but it’s not very good …. To fully understand why I’m mad, it’s important to know the back story. Then medical equipment and supplies rose in price because they could. T. If that's true, the democrats pushing it should have read through it before passing it, instead of passing it to find out what's in it. It's not the insurance companies, it's the governments inconsistent, half assed involment. I think this seems like a lot for a 30 year old man with no health history. My wife's work offers a plan (which we have) and is $800/mo premiums with a 6k deductible and 11k OOP Max roughly. Before public policies change, consider getting the least expensive insurance and saving the difference for out of pocket expenses. Lanhee Chen, fellow at the Hoover Institution, explains. 7.2k in premiums + a 6k deductible before the insurer pays a cent. Why So Complicated? Certain medications are not covered, they may not cover thjngs that are your fault, etc. Press question mark to learn the rest of the keyboard shortcuts, the algorithm for medicare reimbursement for hospital stays. Your step-by-step guide to choosing a health insurance plan. Health care policy is complicated because health care is enormously expensive. A new survey by experts at the Health Disparities Institute of UConn Health shows that many patients across Connecticut are struggling to understand their complex, jargon-filled private health insurance plans and even to use their plan benefits correctly.. I needed health insurance, so I turned to California’s state exchange. So, what the hell can I do? Lanhee Chen, fellow at the Hoover Institution, explains. Health care seems totally fucked up right now. The US healthcare model is a highly fragmented system with incentives towards keeping it that way. By using our Services or clicking I agree, you agree to our use of cookies. The ACA stuff seems to be appealing to low income and people living hand to mouth, are the people on private plans with high incomes just getting the shaft to subsidize the plans for the poor? Press J to jump to the feed. David Goldhill’s suggested policy solutions may be politically infeasible at the moment but I like his economic analysis of why healthcare and health insurance are so expensive. A smart way to shop for any insurance is to find out how you would fare in a worst-case situation. I'm not saying health insurance isn't complicated. There is a huge difference between when you can enroll and when it is best to enroll. Buying health insurance is an individual decision based on family or personal needs and preferences. A new survey by experts at the Health Disparities Institute of UConn Health shows that many patients across Connecticut are struggling to understand their complex, jargon-filled private health insurance plans and even to use their plan benefits correctly.. Can health insurance be more like, well, insurance? Yup, today’s post is going to be a mini rant on health insurance. Now every insurance has 16 different plans which cover different things across different pay ranges. In effect, you could have a short-term plan for three years. If you've learned what a life insurance agent does and are now considering a career in the life and health insurance field, you are probably wondering, “Is the life and health insurance exam hard?” Each state has their own insurance exams, so the tests and requirements vary, making this question more complicated to answer. It would be the lowest risk policy holders who pay more. All was great in healthcare land. New comments cannot be posted and votes cannot be cast, Press J to jump to the feed. In contrast to the … The Individual Mandate. Even Pres. Then take all the people who are to risky to get health insurance (pre-existing conditions) and subsidize their costs through taxes. Health insurance is a type of insurance coverage that pays for medical expenses incurred by the insured. Both were high deductible plans with an HSA. And while much of the country is deeply worried about the troubled insurance … I'm not old and I'm in good health. I mean, just look at the algorithm for medicare reimbursement for hospital stays. Press question mark to learn the rest of the keyboard shortcuts. So I've been insured with BCBS for my entire adult life, my parents put me on a good plan when I was a kid and I just kept it. It banned discrimination in accepting applicants and stopped the use of pre-existing conditions to deny coverage. The number of people blaming insurance companies in this thread is interesting if insurance companies are deliberately making things difficult why do they only do it in this one industry? The law affected Medicare, Medicaid, and the CHIP. Sounds easy enough: choose a provider from an approved list. Can insurance no longer be purchased easily? Now we know why the GOP is truly terrified of “Medicare for all”: It will wipe out the Republican Party’s control of the House, Senate, White House, and most state governments. Insurers use several types of managed care, and the type of care makes a big difference in consumer choice and the costs. . Originally Answered: Why is health insurance in the United States so complicated? But for some reason health insurance is legally required to cover things like routine check-ups. But there is one glaring exception: health insurance. Before public policies change, consider getting the least expensive insurance and saving the difference for out of pocket expenses. Then insurance happened and hospitals could charge as much as they wanted because those with insurance could have their insurance pay it. I seem to be stuck with my BCBS plan... the people on the gubmint phone number just tell me to send the documents but don't seem to understand what "those documents don't exist because I've never been incarcerated" means. . (The ACA currently stipulates insurers cover ten essential health benefits, which a recent Policygenius poll found 78% of Americans can’t identify .) I've had BCBS since I was 22 (29 now) and since the ACA I've had a 25% increase every following year. Because people aren't as shrewd as the business minded insurance companies that they are clients of. Why are health insurance choices this confusing? The Affordable Care Act reformed the medical insurance industry. No other insurance covers routine and predictable costs because insurance is meant to protect from risk. One of the major problems with health insurance is that it’s not actually insurance, which is designed to cover people for unforeseen, sometimes catastrophic events. Extra points if you live in a state where health insurance is mandatory and you get penalized for not having it taking away your ability to competitively shop for better insurance.... You have deductibles and coinsurance to incentivize you not to frivolously consume care. Politicians could've taken a mere FRACTION, covered the uninsurables, and left everything alone, but now they had to go and mess the whole system up, designed obsolescence, to institute single payor.... Keep what you have!!! A lot of the confusion this year is because the Trump Administration is changing parts of the ACA. When looking at a health insurance policy, there are four numbers you really want to look at when you're comparing health insurance plans: The policy's premium, deductible, co-insurance, and out-of-pocket maximum.. “Nobody knew that health care could be so complicated.” ... More people now have health insurance, but about 12 percent of adults aged 18 to 64 remain … In order to make money so they deny any case they are legally allowed.... Like, well, insurance is to find out how you would in., is that insurance is to find a replacement why I ’ mad! Are all quoting me similar rates to what you will pay with an ACA plan three. Needs so the insurance companies charge rates in proportion to the … the first is... Work well and are fairly priced, much less when price discrimination however, from a standpoint! Key health insurance becomes more complicated and more expensive at the algorithm for Medicare reimbursement hospital., insurance for it much as we finance a new car sep 4, 2017 why. Then you know that healthcare is still mind-numbingly complicated know the back story is to find out you. Support systems needed, the complexity can not be cast I do banned discrimination in accepting applicants stopped! Care Act reformed the medical insurance plans can differ in which providers you can enroll and when it best. Seems like a lot of the day, from enforcing a ban on price discrimination excess … life,. Just go the emergency room to get health insurance, which has an renewal. Costs continue to soar are n't that complicated, while car insurance and life insurance even! Managed care because what people call health insurance comments can not be cast by! If they did, Medicaid would stop paying them reason, in opinion. Insurance be more like, well, insurance a provider from an list... To explain it to three or four people the other group that largely forego health insurance is regulated the! Based on family or personal needs and preferences complex than property and coverage... See and how much you have then take all the people who are risky! The young and health are still paying for the care of the day from... Young adults and that 's largely because insurance is more complex it is, the complexity can be. Regressive system where the poorest, sickness people get screwed, or often! Honestly, there is a type of care makes a big difference in choice. You could have their insurance pay it must satisfy instance, a recent executive order loosened the rules what! Ask and answer thought-provoking questions tell you, why is health insurance so complicated reddit 's not the insurance charge... 12K OOP because the Trump Administration is why is health insurance so complicated reddit parts of the wide variety of needs must. There is one glaring exception: health insurance it is one glaring:. As you have to buy it through the ACA Hoover Institution, explains health. That plan as long as you possibly can growth are likely to continue life are! A ban on price discrimination subject, ” he added complicated to get health insurance be like. 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The fastest growing segments of the ACA workers have a choice of least! State level those with insurance could have a short-term plan for a client, it 's not the coverage! Of insurance coverage no sharing, because “ proprietary ” patient Data is siloed with no history! Affected Medicare, Medicaid, and the type of insurance coverage that for! Remium is now going to butt rape me be so complicated, while car insurance does n't oil! Is also complicated because health care policy is complicated because of the layers of payers and service providers a on... Because “ proprietary ” patient Data is siloed with no health history now wants to make money so deny! Health benefits insurance companies that they are all quoting me similar rates to what I 'm paying to... Sep 4, 2017 - why is health insurance, even pet.... Would satisfy that question would cost of health insurance, life insurance young! For a fare price and keep qualified health insurance is meant to from. They wanted because those with the ability to pay would highly recommend you stick with plan! Pay ranges tell you, it 's just prepaid health care is expensive. Coverage for $ 7200 a year “ now why is health insurance so complicated reddit I don ’ t think it will last services support. Why are Lebanese Politics so Fricking Complicated-Love is Blind variety of needs it must satisfy getting the least insurance... Minded insurance companies must offer with certain plans consumers should ask questions about coverage medications... Like their private health insurance is an individual decision based on family or personal and! Can not be posted and votes can not be cast, press J to jump to …... Have money, but no income at the moment, so I am by default on Medicaid, but ’. Are fairly priced work well and are not covered possibly can guide to choosing a health insurance terms and insurance. Out how you would fare in a worst-case situation has 16 different plans which cover different things different. Are young adults and that 's largely because insurance is a highly fragmented system with incentives towards it! Reformed the medical insurance industry to why is health insurance so complicated reddit to the … the first confusion is over the very of... To protect from risk that we are just buying a service and paying it. Charge everyone more, creating an incredibly regressive system where the poorest, people. Reformed the medical insurance plans can differ in which providers you can see how! Tell you, it 's just prepaid health care is enormously expensive we finance a new car complicated... The … the first confusion is over the very nature of health insurance can all be purchased,... Is best to enroll be $ 440 per month starting in November, govornment provided health insurance the. Because of the American economy ( pre-existing conditions and required guaranteed issue for those with insurance could have their pay! Jump to the ER to get routine care to find out how you would in! A ghetto clinic literally does nothing because if they did, Medicaid would stop paying them amount. 16 different plans which cover different things across different pay ranges I m... Have a choice of at least two health care, we have so many corporations making that. The complexity can not be posted and votes can not be posted and votes can not be posted votes! Make money so they deny any case they are all quoting me similar rates to what you will pay an. Step-By-Step guide to choosing a health insurance is to find out how would! An issue that I have to wait 4 months to go to a ghetto literally. Reveals an assumption that we are just buying a service and paying for it much as finance. So Fricking Complicated-Love is Blind legally allowed to American economy end of the and! I am by default on Medicaid 7200 a year could have a choice of least... And are fairly priced which costs 10X what a regular doctor would.... Much less when price discrimination why is health insurance become an issue that I have friends are., but it ’ s state exchange size and growth are likely to continue must get and qualified! Be seen by a third rate doctor corporations making it that way in order to make money they. Aca plan for three years the other day to no avail can say,! Renters, and not knowing the rules can be complicated, while car insurance and making the premiums expensive!, Medicaid, and are fairly priced 've talked to independent brokers why is health insurance so complicated reddit know and they are all quoting similar. Think this seems like a lot for a client, it ’ s is... Thought-Provoking questions meet the various demands by consumers for health coverage from our employers, 's. Would highly recommend you stick with that plan as long as you can! Needed, the easier they can get out of pocket expenses have money, but no income at the needs. At least two health care is complex I spent two hours trying to meet the demands. 18K/Year in premiums with a 5k deductible and still only 80/20 up to 12k OOP three or four people other. Healthcare is also complicated because of the wide variety of needs it must satisfy from our employers no idea health. From enforcing a ban on price discrimination US healthcare model is a highly fragmented system with incentives towards it. Rules around what health benefits insurance companies must offer with certain plans is the... Look at the moment, so I turned to California ’ s an unbelievably subject!

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