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.
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.
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 don’t really need a lot of specialist care so it’s a much much better deal for me.
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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.