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Taxes, Healthcare and Culture
15 10, 3:35am
That's mostly how it's supposed to work here.
How it really works is this.
You go in to the doctor. The doctor gives you a bill, it's high. You do have a co-pay, determined by your plan, (a down payment that you have to pay out of pocket, regardless. If the treatment is less or equal to the co-pay, you're paying for the entire treatment out of pocket. Same for the diagnosis.)
Your insurance gets it, and starts trying to figure out why they shouldn't have to pay for it. (Maybe you weren't prescribed medicine on the insurance company's "approved" list. Maybe your doctor and your insurance company don't do business.)
If and once it's determined that the diagnosis and treatment are covered by insurance, the company starts negotiating to lower the bill.
Finally, a month later, you get a copy of the bill. The insurance company was able to dicker your bill down from $XXX + co-pay to, ...copay. The amount you paid that the insurance didn't cover.
I've seen this happen with a loved one. I have to assume it's the normal course of events, as it's happened with him repeatedly.
Oh, and most plans are paid for in cooperation with your employer. Most people hop jobs like they're playing a game of musical chairs. You change jobs, you change plans. If you have a pre-existing condition, or a dependent does, you literally Can't Afford to change jobs.
At least that WAS true. Obamacare, for all it raises my ire that it exists, may have actually fixed that last one. I don't know.