Ashmi

A lot of people are dragging this person. The knee jerk reaction of “92% coverage?! That’s amazing! Why are you complaining. Leave the country.” This shows how low the bar has been set for health insurance coverage in the US. Let’s put on our empathy hats for a moment. Imagine paying a ~$1k per month premium for the privilege of having health insurance. It was $750 last year, but the company you work for had a lot of employees use their health insurance in 2023, so Blue Cross decided to hike up the premiums to defray the cost of actually paying for their customer’s healthcare. You’re annoyed but fortunately, are still able to pay the monthly premium. Over the course of the year, you seek preventative medical care like you’re supposed to, paying a $20 co pay for every visit. Maybe you have a few extra visits to your PCP or the emergency room. These bills go entirely to your deductible, which means you pay for 100%. The high deductible plan was all you could afford due to the rising premiums. Again, you’re annoyed but you can manage. Finally you reach your deductible, thinking “great, I won’t have to pay anything the rest of the year.” At least that’s what it sounded like from the intro pamphlet you received from HR at the beginning of the year. It was all pretty confusing. With your deductible met, you finally schedule that procedure your doctor has been nagging you to get that will prevent further health care issues down the road. However, you didn’t realize co-insurance charges still apply until you reach your out of pocket maximum (~$12,000 for the plan you chose. Again, the only plan you could afford). You are frustrated, but fortunately still able to cover the estimated cost. Then, while recovering from major surgery, you receive a bill for $4,457 that you can’t pay. This is more than you were quoted by your doctor’s medical office. Turns out Blue Cross thought some of the medication you received during the procedure was unneccesary, so they refused to pay for it. You’re angry. You have done everything right. You paid your premiums, you did everything your doctors suggested to keep yourself as healthy as possible, and yet, you still end up with a bill that will take months, if not years, to pay off. If you don’t, you will be sent to collections, wrecking your credit, and making life an even harder uphill climb. Does all of this apply to the OP here? Maybe, maybe not. But it does apply to millions of other people in the US every year. Does this person not have a right to be angry? Should we just be ok with a health care system that is death by a thousand cuts? Or should we strive for a system in which a person can access health care without risk of financial distress? Unfortunately, many people can’t understand this point of view until they are on the receiving end of those medical bills. Health insurance companies don’t care about you. They are evil. Don’t settle for slightly less evil.