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Simone Giertz – Back from brain surgery [video]

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Re: Simone Giertz – Back from brain surgery [video]

#11

Post by RandallBrown »

malaporte wrote: post #5
tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

Maybe the deductible part is a fixed amount and not a % of the total bill? (I have no knowledge of health care in the US - both countries I lived in have free health care)

The deductible is (in my experience) a fixed amount. I have to pay about $5000 out of pocket before everything becomes "free".

Re: Simone Giertz – Back from brain surgery [video]

#12

Post by cptskippy »

tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

Because of the way insurance tends to work in America, care providers tend to throw shit at the wall to see what sticks. In other words the first bill is always an outrageous amount of charges that may or may not be valid. Additionally there's something called a negotiated rate that an insurer has with the care provider, usually the care provider's bill does not show this rate but rater some fiction that not even those without insurance pay. If you look at the claims your insurer pays out to the care provider you will see significantly lower amounts than what's billed.

If anyone knows why care providers high ball the rates on bills when insurers have negotiated rates, I'd love to hear it. Is it something in the insurer's contract that gives insured the illusion that insurance is saving them a lot?

In any case I've received first medical bills in the many thousands of dollars only to have them go through four or five revisions before settling down to hundred dollars. This is because the first bill you receive reflects all of the claims to insurance (e.g. if your insurance covers 80% you're on the hook for 20%) but as the insurer and the care provider negotiate and revise the billing the price falls.

In my opinion it's a horrible experience for the insured and the added stress of the huge bills certainly doesn't help with recovery.

Re: Simone Giertz – Back from brain surgery [video]

#13

Post by justaman »

danesparza wrote: post #3
tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

It really depends. I have an PPO / HSA plan where I have discounts up to a certain set "total annual amount" (currently around $5k) -- then insurance kicks in and I start paying a lot less. That $5k (for me) resets every year.

I recently had a heart thing that put me in the hospital and included a med-flight to the hospital. Total bill was close to $40,000 if i'm not mistaken. I had to cover the $4,000 deductible but after that everything was covered. Additionally, my employer is part of something I don't understand(insurance is too damn confusing), I think its an HSA which covered an additional $2,000 towards my deductible. End of the day I only had to pay $2,000 out of pocket. Not bad.

Re: Simone Giertz – Back from brain surgery [video]

#14

Post by sourceless »

tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

$38k is probably unlikely, she'll have hit her deductible first which will have made several things fully covered and other things probably some% coinsurance, and then later hit the out of pocket limit on the plan and be fully covered from there onwards.

Re: Simone Giertz – Back from brain surgery [video]

#15

Post by viraptor »

tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

I remember someone on HN recommending to send a copy of the bill to some health billing transparency project, but I can't find the right link. Google comes up with https://www.fairhealthconsumer.org/ although I'm pretty sure it's a different service (they don't use the submitted bills from what I understand)

Re: Simone Giertz – Back from brain surgery [video]

#16

Post by bloopernova »

cptskippy wrote: post #12
tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

Because of the way insurance tends to work in America, care providers tend to throw shit at the wall to see what sticks. In other words the first bill is always an outrageous amount of charges that may or may not be valid. Additionally there's something called a negotiated rate that an insurer has with the care provider, usually the care provider's bill does not show this rate but rater some fiction that not even tho…

> added stress of the huge bills

I really wish people would talk about these sorts of soft costs more often.

I grew up in the UK, moved to the USA in my mid 20s. While growing up, my parents divorced and my mother had to take care of me and a sibling. All 3 of us had medical conditions that needed regular care/checkups.

Not once did my mum ever spend hours on the phone chasing down bills or insurance rejections. We never paid out of pocket for prescriptions, doctor visits, A&E (USA translation: ER) visits, etc.

That stress, or lack of, is a huge factor in quality of life for a family.

Unfortunately this sort of discussion is heavily politically charged. I really don't want to start an argument thread comparing how taxes pay for socialized care, etc.

Re: Simone Giertz – Back from brain surgery [video]

#17

Post by bloopernova »

justaman wrote: post #13
danesparza wrote: post #3

Earlier quoted context omitted.

It really depends. I have an PPO / HSA plan where I have discounts up to a certain set "total annual amount" (currently around $5k) -- then insurance kicks in and I start paying a lot less. That $5k (for me) resets every year.

I recently had a heart thing that put me in the hospital and included a med-flight to the hospital. Total bill was close to $40,000 if i'm not mistaken. I had to cover the $4,000 deductible but after that everything was covered. Additionally, my employer is part of something I don't understand(insurance is too damn confusing), I think its an HSA which covered an additional $2,000 towards my deductible. End of the day…

I hope you are doing OK now, and I'm glad your insurance/billing situation was resolved relatively easily.

I really, really wish insurance was less confusing though! So many copays, coinsurances, deductibles, out of pocket maximum, lifetime maximum, different tiers of drug prices, etc etc.

That stuff should be made simple by law.

Re: Simone Giertz – Back from brain surgery [video]

#18

Post by VBprogrammer »

mrrsm wrote: post #4
tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

With most insurance I feel like you will hit your max out of pocket before you would hit that amount. Depending on your insurance plan you could be talking $3,000-$10,000 max you would have to spend.

I mean this in the nicest possible way; the casual way Americans talk about these things makes me wonder if they aren't suffering some form of Stockholm syndrome.

The percentage of the population who don't have anything like that kind of money in savings is huge. And that is after you already pay huge amounts for insurance.

Re: Simone Giertz – Back from brain surgery [video]

#19

Post by bloopernova »

ryanmercer wrote: post #7
mosselman wrote: post #6

Yikes, what a bill. My mother had brain surgery a few years ago and didn’t have to pay for anything besides the insurance she always pay for which amounts to a few hundred euros a year.

>Yikes, what a bill. Yeah, cancer-related bills can add up fast. Worse, they'll send you bills for years after the fact... my father had been dead almost a decade from his cancer and the occasional bill would still come and my mom would have to spend hours arguing with them on the phone "uh yeah, he's dead, he's been dead, this happened a decade ago, get your shit together" and they'd usually be all 'oops our bad' al…

We've encountered double dipping too, in dentist's bills and various healthcare bills.

It's this whole circular firing squad of people charging others as much as possible for every little thing. Individually you may do OK, but the system is made more and more complex and stressful with each extra charge.

Re: Simone Giertz – Back from brain surgery [video]

#20

Post by JshWright »

tonysdg wrote: post #2

So glad to see Simone back on her feet. The sh y robot nation needs its queen! As for that bill -- I'm curious: is there any resource I can look up to see how much of that the average Medicare/Medicaid/private insurance plan pays? I ask because I just had two teeth repaired after a bike accident and it'll cost me ~$100 after insurance covers the other ~$500. By that ratio, she'd be looking at ~$38,000 bill.

Two years ago my wife (25 weeks pregnant with twins) was admitted to the hospital because of some concerning ultrasound findings for one of the twins they wanted to monitor closely. Two months later they were delivered by c-section, both healthy but very small (3 lb 14oz, and 1 lb 13oz). The bigger one spent ~3 weeks in the NICU and the smaller one ~7 weeks.

All told it was ~18 weeks of hospitalization (the only major procedure was the c-section, and obviously the NICU care is a little more intensive than average, but neither of the twins needed super high acuity care). Total bill was a bit over a million dollars. We were out of pocket ~$5k (our annual out of pocket max at the time).

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