It was cheaper to buy tickets, fly to Dublin, get the procedure I needed done. Spend TWO WEEKS recovering, and fly home then to pay the 20% coinsurance I would have needed to here in the good ol USA... so yea...
EDIT :
Well this kind of blew up. The reason it was cheaper : it was considered elective. This is why OOP max did not kick in. It was a procedure that would have to be done, only as my condition got worse. Insurance denied it because "It was not necessary" despite my cardiologist saying it was. By the insurance formula I would have to wait until my condition worsened to make it medically necessary, but by then my chance of a poor outcome goes way up.
I finally argued them into covering some of it, but with a 20% coinsurance and a planned week hospital stay in recovery, my bill would have been close to 100k at least, and if I encountered any complications (which I would likely have due to other issues including an autoimmune disease) I started looking elsewhere. I am not an Irish citizen despite having family there, they helped me navigate the program and the cost. It was privately paid, and my surgeon spoke to their team with all my records transferred etc.
I believe in the UK there is a penis doctor who can grew you a new penis on your forearm and you can pay more for extra length before the transplant surgery.
No, looks like his insurance would cover it but he would have had to pay 20% as his portion of coinsurance and it sounds like 20% of the huge US bill was more than the full cost to travel and get it done in Ireland.
Kind of obvious, but the trick is to mark the cost 5 times higher than it is... for a start.
After a while they started asking themselves what's stopping them from doubling that price. Apparently nothing so over the years whenever they felt like it, they just doubled the already enormously overpriced services and at this point there are no signs of it stopping either. There is going to be a post about how travelling to mars for a surgery is cheaper than in US.
The hospitals... despite being "in network" negotiate huge prices and gouge the insurance companies. The insurance companies just pass the costs off onto their customer. Short outpatient surgery now costs 5-8x more than it did maybe 7-10 years ago. It's ridiculous.
The outrageous total bill price is a placeholder to make sure they don't under bill the contracted allowed amount from the insurance provider. When the provider submits the claims the total billed amount is reduced to the contrac amount then processed through. Also most places will have self pay discounts or you can let the owed amount go to collections who will gladly take a portion of the owed amount and close the collection with a ding on your credit.
The outcome is still ridiculous in both situations, especially with big stuff like OPs situation. Our healthcare system is a total shit show.
Because there is an out of pocket maximum for most insurance, meaning you are not paying any more than that, say $5,000 per year even though 20% of the surgery etc can be much higher.
It also really depends on the plan. My plan has 0 co-pay which is not uncommon for HMO plans. I just looked it up that my out of pocket maximum is $1,500 for individual and $3,000 for family meaning the maximum I pay a year is $3,000.
Are you sure that's not just the deductible? I have around 1,500 deductible where I'm responsible for 100%, and then have another limit, like $10k, where I pay various lower amounts until the $10k is up. After the $10k, it is truly free after this. So like 2 emergency room visits.
No actually. I think you might have a PPO plan. My work gives me the choice between a PPO and a HMO. I used to do PPO which is similar to what you have. It has a high deductible, a co-pay and a co-insurance. But then you can go to any in-network specialist you like. And you can go to them directly without reference.
With the HMO, I can only go to a specialist if I am referred to by my primary care doctor. But the benefit is I have 0 deductible, 0 co-insurance for the most part. Urgently care is a flat copay of $25 and emergency room visits are $50 each time (transportation is separate). At my age I donât really need a lot of specialist care so itâs a much much better deal for me.
Goddamn that's incredible, my individual deductible 5,000 at me 80% insurance 20% then after that's meet it's me 20% them 80% and the starting this year there is no oop max. And it's the best plan they offer where I work
No. They were going to 'cover' it but there was 20% co pay. In the US, they'll charge you thousands per month for insurance, but will still make you pay for part of your care.
It gets worse. My insurance has a $30 copay on all approved prescriptions. My wife had been getting her medicine for that with no issues for several months, until one day it was $500. I called to find out why, because it was clearly already an approved medication. After about an hour of getting bounced around and being on hold, they finally explained that it was due to us "not paying enough of our annual out of pocket maximum" (not minimum, mind you) for healthcare - which is $24,000. That blew my mind.
Health insurance in the US has your monthly premium payment, copays on your medication and Dr visits (including ER and hospital stays), a deductible which is the amount you have to pay for the year in healthcare to get better benefits (ours is $17,000), and then the out of pocket maximum is when they (usually) cover everything for the rest of the year as long as you keep paying your premium.
Where it gets extra fucked, is if you need a major surgery in late December, the deductible and OOPM won't carry over into the new year. So you could get shafted for double that maximum amount on the same hospital stay. And my insurance isn't even the lowest tier. We pay them $500 a month for this service. Our system is completely fucked, but most people don't seem to care.
As someone British with our often criticised free NHS, this blows my mind. And to think the argument against free healthcare by Americans is usually "well you'll pay more in tax".
I'm lucky enough to have never needed any real gp or hospital treatments, but i know its there if I do. My wife has major issues with eczema and was hospitalised last year due to complications, has many prescriptions, some of which are extremely expensive medication, and regular appointments with gp's, nurses and dermatologists. All we have to pay is for prescription medication, and we are able to pre pay for those at a rate of ÂŁ10 per month total. Thats it. And our tax is no higher than any other average western nation.
Crazy. I hope your country comes to its sense sooner rather than later.
I dunno...sounds like (from various news sources) that the UK is thinking about cutting some of that healthcare in some way or other. You guys seem to be electing more & more conservatives that are crying about "entitlements." You are not immune to the right-wing crazy.
I too wish we could come to our senses:(, but have so little hope left in our electorate.
The last election we elected a left wing government -Labour- with the largest majority ever. They have massively increased spending on the NHS. Where are you getting the idea that weâre electing more conservatives to parliament?
Just to add insult to injury the government healthcare spending per capita is higher. Just the government spending.
So if you work you pay more in taxes than other countries, for insurance you can't use becuase it's only for the poor or elderly, and so you have to pay for your private Healthcare.
As a percentage, I pay %0.7 of my salary for health insurance. It covers nothing until Iâve spent like 1500 or 2000 on medical expenses, then I get the âpay 20% of the costâ until I hit $12k or something. Fortunately, I donât usually get to the $1500 in expenses level.
I can also save up to $5k/yr tax free, but the money can only be used for medical expenses. It can however also be invested in the stock market. So maybe Iâll have enough in there over the years to pay for stuff if I really need it, but I think I would rather have a functional healthcare system.
I had to spend Friday and Saturday in hospital, as a kidney stone chose the middle of my workday to make an appearance.
I had a lot of drugs. A lot. From paracetamol, to endone, morphine and even fentanyl. In the first hour. There were also a couple of suppositories, but this little stone beat them all.
They did a CT scan, blood work, an ECG, and checked my blood pressure about a million times. I was given a bed within a couple of hours, then they tried to give me more pain meds, which I had to aggressively push back on. As it was, the next day at 10am I was still woozy from the big Friday cocktail.
When I checked out, they gave me a packet of endone, just in case.
Total for the stay... $0. I don't have private health insurance, and refuse to pay for something twice that my taxes already pay for.
Bro, $500 a month is more than all my tax deductions from my salary! And I have "free" healthcare through the NHS (UK), you guys are paying more even without being sick
And sadly, my monthly premium is considered low. It is well over $1,000 a month premium for "good" insurance for two adults.
But at least I'm allowed to even buy health insurance now. Before the ACA (AKA: Obamacare) passed, if your job didn't offer it you were basically screwed. And even then, they could deny coverage for having any pre-existing conditions.
What the actual âŠ. And here i am getting nervous about my parking running out when at the hospital and getting a ticket as my biggest expense. I could care less about paying taxes that go toward universal healthcare as its benefits everyone. The worst part Americans complains about the wait time in Canada all the while the wait times in america are just as bad and getting worse.
I'm a health insurance broker. Something is very wrong with what you were told about the prescription copay. That isn't AT ALL how that works. I would call back and ask to speak directly to their pharmacy team and find out exactly what happened. They cannot by law just take away a copay like that. I suspect you were fed very bad information by someone who didn't know what the hell they were talking about. Also, the $17000 deductible? Does that represent your family deductible? The maximum allowed by law is $10600 for an individual. You are mostly correct about your thoughts on insurance, it's getting weirder and less consumer friendly by the year. If it helps, we brokers are as upset as everyone else. We're customers too.
Lastly, you don't have to worry about your deductible and out of pocket maximum resetting while you're hospitalized. They don't do that. If you had a heart attack on December 31, needed a stent, then had complications on Jan 1, that would all be considered a single " episode of care". Your deductible and max wouldn't reset until you got out of the hospital.
I got diagnosed with a complex migraine last year. Cause the symptoms mimic some other brain related illnesses, they sent me to the ER. So, it cost me $7,500 out of pocket to find out I am very healthy but maybe shouldnât drive 15 hours straight while dehydrated.
Seems in the middle for GPs and near the top for meetings with specialists. Canada is waaay back there.
It's outcomes that matter though, not wait times. I think people in the USA avoid seeking medical care more than in other countries because of the expense. That and other reasons lead to worse outcomes in USA vs most/all of the developed world.
EDIT: Oh I realize you agree with me. Sorry I was confused by "lower end of wait times", thinking you meant "lower ranking".
This is from your link
"A common misconception in the U.S. is that countries with universal health care have much longer wait times. However, data from nations with universal coverage, coupled with historical data from coverage expansion in the United States, show that patients in other nations often have similar or shorter wait times."
read beyond one sentence and look at the data itself, and of the countries evaluated the US is near the bottom for wait time length for all the metrics evaluated. Certainly not on the higher end of any list.
So a broad claim of the US having generally "higher wait times" is incorrect , no? I mean hell, % waiting over a month for a specialist was 27% for the US and up to 61% in Norway and Canada.
In the US, there is this bullshit they introduced called co-insurance.
I still remember when they âupdatedâ our company health plans to include it.
The idea is that by introducing âshared responsibilityâ for health care costs, it will reduce âover-utilizationâ of health plan benefits.
In short. Even after your deductible is fulfilled, even if you are getting something done that is medically necessary, and covered by your insurance plan, they will only cover 80% of the charges and the rest is your responsibility as âco-insuranceâ. Money you are expected to have saved up to pay for medical expenses as a nice responsible consumer.
"But if you agree to this new policy you'll get another $87 in each paycheck. How does that sound?"
This is the problem. They never lied - they don't need to. They know the average person won't actually stop and think about what they're signing up for. People know 10x more about their streaming service than their insurance policy. And it's bland and it's boring, yup. Still, waste an afternoon waterboarding yourself with information to somewhat understand how it works, so you don't have to learn about it the hard way after a surgeon just shoved your guts back in.
Cousins who live in Ireland. My family came over during the famine and kept close ties to our family who did stay. The hospitals over there are just as good as the USA some even better.
My father in law from Ireland, who is a heart surgeon in America, flew his mother to the states and paid out of pocket for her heart surgery because he didnât trust the hospitals in Ireland to do it.
Eh, depends on the procedure and specialty. The 5th largest hospital in the US is in AL at the University of Alabama Birmingham. Itâs state of the art for organ transplants and nationally ranked for many programs.
I get what you are saying though, generally. If youâd have picked Mississippi it would be an easier sell đ
This is crazy to me. I just had heart surgery that was a "you'll need this at some point" but I was given the option to wait and monitor til intervention is required. I chose to get it 3 months later and hit my out of pocket with the confirmation angiography. Heart surgery totally free and totally not an emergency. Some healthcare providers in this country are dogshit.
I had an extra electric path way in my heart, insurance refused to pay for the surgery to fix it . I had to be rushed to the hospital and almost die before they would cover it.
i had a similar issue when getting stomach surgery due to my esphagous getting scared from stomach acid, which is highly cancerous. Rather have me get cancer and pay for the costs then (or of they are lucky a different insurance company) then solve the issue now.
Recovering from heart surgery isn't a vacation, it's a near death experience where every waking moment is a struggle to breath and stay alive, though it slowly gets better over the course of a couple to several weeks (or even months), seen both my parents go through it.
But my 6y/o is terrified of dentists in Houston. Several attempts to get tooth filling always fails because the dentists gave up once he starts crying. The 3 attempts at different dentists probably cost a total of $1200. Because the last attempt they tried sleeping gas and insurance doesnât think that anesthesia is required so I get to pay for it.
We flew to Indonesia for our visa renewal. Return ticket $1k each, Indonesian dentist who actually talked and communicated with my son and managed to calm him down for the procedure, $180
So, gotta ask, did your surgeon play on the Dubs Gaelic football team? Lol. For those that don't know, the Dublin football team had a few doctors on it, only reason I know is my friend taught them in grade school. Nothing quite like a watching a group fight break out in the middle of a game; the referee is like I didn't see anything. And well there's hurling... one second you're running for the ball and then you get close lined by a wooden stick.
How did you find and arrange for the procedure? I wouldn't really know where to begin outside of Canada, since they kind of market to Americans and it's within driving distance for me.
People do it a lot in Mexico. High end Mexican healthcare is cheaper than regular US medical care plus they have companies that act like travel agencies that make all the arrangements for you, hotel stay, transportation to and from hotel straight to hospital, and English speaking staff with other American patients. The standard of care meets or exceeds what youâd get in the US too, itâs not some back alley street doctor itâs a high end facility with US trained doctors.
Did you price Surgery Center of Oklahoma? This might gave been above and beyond what they do, but they dont take insurance and lots of people do the same there without leaving the country.
Insurance denied it because "It was not necessary" despite my cardiologist saying it was.
Attempted murder, this needs to start being called what it is. If you call the shots for someone's well-being and ignore the doctor, you should be charged. If corporations are people, then they should be put to trial and face the same punishments as one.
Or maybe whoever makes that decision should have their name public with each decision. Maybe if people started to worry for their safety and well-being based on their decisions, they'd care more about other people's safety and well-being.
Im from Ireland and somebody travelling to use our health system is wild to me. The people are fantastic but it really struggles and people can left waiting a long time for procedures. It is however not expensive for these types of surgeries
I had my appendix out, caught the flu. Went into septic shock. My hospital bill to the insurance company was over a million dollars. After a 12 week stay and rehab. I paid 20k of it. Who knows what the insurance actually paid. But I saw the raw bill. It may be slow, and struggle but people are not being bankrupted and being forced to sell their homes if they get cancer either.
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u/TheEndOfAllThings23 Aug 22 '26 edited Aug 22 '26
It was cheaper to buy tickets, fly to Dublin, get the procedure I needed done. Spend TWO WEEKS recovering, and fly home then to pay the 20% coinsurance I would have needed to here in the good ol USA... so yea...
EDIT :
Well this kind of blew up. The reason it was cheaper : it was considered elective. This is why OOP max did not kick in. It was a procedure that would have to be done, only as my condition got worse. Insurance denied it because "It was not necessary" despite my cardiologist saying it was. By the insurance formula I would have to wait until my condition worsened to make it medically necessary, but by then my chance of a poor outcome goes way up.
I finally argued them into covering some of it, but with a 20% coinsurance and a planned week hospital stay in recovery, my bill would have been close to 100k at least, and if I encountered any complications (which I would likely have due to other issues including an autoimmune disease) I started looking elsewhere. I am not an Irish citizen despite having family there, they helped me navigate the program and the cost. It was privately paid, and my surgeon spoke to their team with all my records transferred etc.