Canadian new to the US Healthcare system
Hello all. I moved my family down from Canada to Texas 8 months ago. For the first few months we didn't have health coverage so just self paid for a couple check up's. It was $110 for a doc visit all in. After I started paying for our company coverage I went for a appt. And "copaid" $25 then the insurer paid $107. Total hospital received now was $132. However the insurance company was even nice enough to inform me how I saved an additional $350 dollars because they negotiated a discount with the hospital. Ok??? fraud is completely legal when it comes to Healthcare apparently. And I wouldn't care in some ways if this deductible wasn't a thing here.
We sent our son for a specialist to remove an ingrown toenail. As insurance was supposed to pay 80% I wasn't too worried. Not so fast. Turns out they call their negotiated discount as part of the 80%. So instead of paying for thier share they pitched in $14 on a $700 bill….. of which if I paid cash without them involved have been only $150.
Upon asking insurer if I can just pay cash then have the insurance company reimburse me they said it was fine if its in network. So I end up paying $25 and insurance reimburses $125
Can it be this easy to subvert the collusion between the insurance companies and health providers? Just find an ethical health provider. Pay cash then submit receipts? Am I missing something here?
The health care negotiated pricing thing seems to be the largest reason that makes an otherwise world class health care system a complete mess.
submitted by /u/Recent_Performer_116
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