Current Events > Just visited a doctor without insurance for the first time. I don't get it..

(+) Yeah! (+)

Backstory: Got a new job and the new insurance doesnt kick in until next month. Had a weird rash on my arm I wanted to check out ASAP (Im fine thankfully)

Anyways I went to a dermatologist I usually visit. When I had insurance they would bill the insurance $300 for my visit and then my insurance would pay $180 and I would pay $120 out of pocket.

This time the dermatologist billed me directly and it was only $70 total lmao wtf? I was paying more with insurance somehow.

Next I was prescribed a cream for my rash that cost $100. The dermatologist told me to use a site called GoodRx and show the pharmacy a discounted price.

The pharmacist initially asked me to pay $100 but I showed how found the exact cream for only $30 on GoodRx and the pharmacist looked at my phone and went oh okay, just pay $30 then. I literally didnt register or sign up or do anything. I spent 20 seconds searching on the site and if I didnt I wouldve been charged $100 instead of $30 lmao

Is the US Healthcare trolling me or whats going on because none of this makes any sense.

tl;dr: Paid less for doctor visit without insurance compared to having insurance somehow. Also found a random coupon online and paid way less for a prescription without even signing up for anything.

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Sounds about right

The insurance thing is not explainable but getting free coupons should not require signing up

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Insurance is a racket.
In other news, water is wet.

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TrevorLawrence posted...

Is the US Healthcare trolling me

US Healthcare bureaucracy has been trolling everyone (while lining their pockets) for about 60 years, now.

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sabrestorm posted...

The insurance thing is not explainable but getting free coupons should not require signing up

I dont have a copay with my insurance so it somehow comes out higher than getting directly billed without insurance

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Insurance companies set rates for what they're willing to pay, so offices will generally just charge whatever the maximum is to an insured person because they know insurance will cover it. They tend to charge lower amounts to people without insurance because if it's too high they'll probably just never get paid so they try and pick a number that's more appropriate.

Edit: so imagine a procedure costs between $50 and $150 depending on where you visit. A large insurance provider will turn around and say okay, we won't pay more than $150. So now every office charges insurance $150 because they can. It's why the US spends significantly more money per person on healthcare compared to much of the rest of the world.

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Insurance involves a third party so it naturally makes whatever you're buying more expensive. That's why we only get insurance for catastrophic events that we'd never be able to pay out of pocket for. You get your house insured for something like fire damage but not minor stuff.

Health care is a weird exception to this where insurance covers not just catastrophic risks but expected expenses as well. There's no reason you shouldn't be able to go in for a routine check-up and pay a small fee out of pocket like you do when getting a hair cut. And there's no reason for hospitals not to advertise prices for services like that. Insurance has made this more expensive.

s0nicfan posted...

Insurance companies set rates for what they're willing to pay, so offices will generally just charge whatever the maximum is to an insured person because they know insurance will cover it. They tend to charge lower amounts to people without insurance because if it's too high they'll probably just never get paid so they try and pick a number that's more appropriate.

Edit: so imagine a procedure costs between $50 and $150 depending on where you visit. A large insurance provider will turn around and say okay, we won't pay more than $150. So now every office charges insurance $150 because they can. It's why the US spends significantly more money per person on healthcare compared to much of the rest of the world.

No offense but that sounds like a bunch of capitalist gobbledygook.

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Shablagoo posted...

No offense but that sounds like a bunch of capitalist gobbledygook.

It's actually closer to socialist gobbledygook.

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candyapplered posted...

It's actually closer to socialist gobbledygook.

The way private insurance companies in the United States of America operate is socialist gobbledygook? Listen to yourself.

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s0nicfan posted...

Insurance companies set rates for what they're willing to pay, so offices will generally just charge whatever the maximum is to an insured person because they know insurance will cover it. They tend to charge lower amounts to people without insurance because if it's too high they'll probably just never get paid so they try and pick a number that's more appropriate.

Edit: so imagine a procedure costs between $50 and $150 depending on where you visit. A large insurance provider will turn around and say okay, we won't pay more than $150. So now every office charges insurance $150 because they can. It's why the US spends significantly more money per person on healthcare compared to much of the rest of the world.

This is pretty much what I figured based on the experience I described in the original post. I learned to not use my insurance for these small office visits and just pay directly. The system is screwed up.

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Broseph_Stalin posted...

Insurance involves a third party so it naturally makes whatever you're buying more expensive. That's why we only get insurance for catastrophic events that we'd never be able to pay out of pocket for. You get your house insured for something like fire damage but not minor stuff.

Health care is a weird exception to this where insurance covers not just catastrophic risks but expected expenses as well. There's no reason you shouldn't be able to go in for a routine check-up and pay a small fee out of pocket like you do when getting a hair cut. And there's no reason for hospitals not to advertise prices for services like that. Insurance has made this more expensive.

Technically I can just say I don't have insurance (for smaller visits) and just ask them what the cost would be I guess. Not sure why this isn't the default set up though as you mentioned. When I asked the dermatologist what the cost was they had to look through 3 different booklets to even let me know what it would be.

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