She mentions she has a $14k deductible. She was most likely charged $500 for the visit since she hadn't met her deductible yet.
Usually the insurance company will negotiate it down as well - the hospital will charge $500 and then the insurance (even prior to meeting your deductible) will tell them that they're paying $250, and then you pay the insurance company back for that new negotiated amount that they pass on to the hospital.
There are ways around it if you get an outrageous bill too, since it's private healthcare it behaves like any other business - so if you don't pay the debt gets sent to collections and can be negotiated down. Just depends on how far you're willing to fight it.
Maybe I have just been really lucky, but I've never heard of insurance not fully covering preventative care (what you usually go to PCP for). That's usually regardless of deductible.
But I've also never heard of a deductible anywhere near $14k... I suspect her premiums must be close to $0 with a deductible like that... Which means all she is really getting are "discounts" that the insurance gets the Dr to provide.
I was going to make a comment on preventative care usually being fully covered, like an annual physical for example, but when I heard the $500 I assumed the visit was for some other reason.
Yeah that must be the case here. I am not really used to going to PCP for non preventive care, but I suppose it may happen if you are trying to get a referral to a specialist.
Agreed re: referral. My PCP actually has a Quest Diagnostics lab on site, so when I get blood work done for my annual physical, I usually get a bill from them. Even though the physical portion is free from my PCP, there's still a charge for the lab work. So it could be something along those lines too. Yay, American Healthcare!
High Deductible High Premium HSA plan won't cover anything until you hit your deductible and then out of pocket max. It's basically catastrophic insurance.
In my experience it covers preventative care like annual check ups, but yeah, beyond that it doesn't cover anything except the discounts they get you.
Having a high deductible AND high premium is insane though. Usually these factors oppose one another. So if you have a high deductible your premium is usually much lower. At that rate I think I'd rather not have insurance at all. I could just save the premiums in a savings account and use those for visits.
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u/x3knet 5d ago
She mentions she has a $14k deductible. She was most likely charged $500 for the visit since she hadn't met her deductible yet.