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redis_mlc

In the USA, acne and pregnancy are often disqualifying conditions. Services are often "out-of-network."

So it doesn't matter if you pay the pemiums or not - you get massive surprise bills.

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> In the USA, acne and pregnancy are often disqualifying conditions.

This is not true. Premiums and coverage are only allowed to vary by age and location, not preexisting conditions.

you realize this is literally only as of the ACA in 2010? and if the trump administration has its way (there's a supreme court case on the docket to completely kill ACA) we're going back to that?

What’s your point? It’s true now.

that there are literally active efforts working to make it not true

Yes, the past was different than the present.

But what about the future? :)

The Trump administration is neither plaintiff nor defendant in the court case you refer to.

is this a game of gotcha? i didn't say they were plaintiffs. i said they were exerting efforts. here are amicae briefs written by trump's DOJ

https://affordablecareactlitigation.files.wordpress.com/2019...

here are summary articles explaining trump's DOJ's efforts

https://www.brookings.edu/blog/usc-brookings-schaeffer-on-he...

https://www.cbpp.org/research/health/trump-administrations-a...

so what is your point other than to mislead?

If filing a Friend of the Court brief counts as "having its way", then the ACLU "has its way" on a majority of SCOTUS cases.

like I said: what is your point other than to mislead? you still have not made any positive claims

I agree that the US health system is beyond fucked up, but the statements in this comment are dramatization and not accurate on their own without a ton of qualifiers and clarifying statements.

“Out of network” doesn’t mean your health insurance plan doesn’t pay for anything. It usually just changes coinsurance rate. Anyone who has a major expensive hospital event while insured will just hit their maximum annual out of pocket amount and that coinsurance rate won’t matter. That’s not a good thing but it also means that this comment is misleading, implying that being out of network means that the insured person just has to foot the bill and that their insurance company dips out.

The whole point of the insurance network is that your health insurance company is encouraging you to take your routine doctor’s visits and scheduled non-emergency procedures to a place where they negotiate.

And acne and pregnancy aren’t disqualifying. What are you even saying they’re disqualified for? That’s a vast exaggeration.

It seems maximum "maximum out of pocket" is 8200$ [0] I find it strange that it's not tied to salary. For people earning 30k/year 8200 per year is a lot.

https://www.healthcare.gov/glossary/out-of-pocket-maximum-li...

Few things you might not be aware of:

1. Even in the event of Emergency visits to in network hospitals, one is often charged out of network fees if one of the doctors present is out of network. Which one is not notified of and has no say over, regardless. So going to an in nerwork hospital (which is the best one can do to align to their plan) means nothing.

2. When charged out of network, it most certainly does not mean only the coinsurance rate changes, you are also charged 10 to 50× more. So you are charged say 40% of $5000 rather than 20% of $300. Again, at an in network hospital.

3. Out of pocket max differs dramatically in network to out of network, in some plans going away completely in out of network scenario.

What you are saying above is not just a minimization its completely misleading and wrong.

You're misinformed. What I said is correct.

the part about preexisting conditions is completely wrong since the ACA.

the person who replied to you is wrong about out-of-network services though. they seem to be describing a ppo plan. my high deductible plan is quite clear on the fact that out-of-network is not covered at all. doesn't even count towards the out-of-pocket max.

My plan will not even apply my out of pocket payments to the deductible. There are wide swaths of the U.S. where I'm 100% pay out of pocket for emergencies, heck, even inside my own state. Most people are completely unaware of how poorly they are covered when they travel on vacation, within their own country.

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