That $300 a month med that you take is only being reimbursed to the pharmacy at less than $100. (most likely $70)
The problem is when comparing how much a medical cost is you can't go by the inflated self pay rate but go by its real market value. The real market value is what the insurance and copay pays.
What other industry do you know where the insurance company pays less for a service than you would paying yourself? If you wreck your car and take it to a body shop, if the estimate is $500 then the cost is $500 no matter who's pocket the money comes from.
On the other hand with heath care if the estimate is $500 it would be $500 to you but only $150 to the insurance company.
I had bowel resection surgery, I had a 20/80 insurance plan. They paid 80%, I paid 20%. The surgery was $20,000 so my portion was $4,000.
I got a letter from the hospital stating that the insurance company had decided that mine was a pre existing condition so the hospital had refunded the insurance company's portion bill. The insurance company's 80% was ONLY $5,000.
The true market price of that operation was $9,000. That is an $11,000 discount for the insurance company. Sorry 10% is a volume discount or even 20% but a 70% discount is a scam.
When I contacted the hospital to negotiate payment, they charged me the full $20,000 for a $9,000 operation. I told them I would only pay the market rate of $9,000 and was told they could not do that due to the contract they have with insurance companies.
Needless to say they were paid nothing. They lost everything on that operation because it was better business to write off the inflated $20,000 than get paid a fair rate.
The problem is when comparing how much a medical cost is you can't go by the inflated self pay rate but go by its real market value. The real market value is what the insurance and copay pays.
What other industry do you know where the insurance company pays less for a service than you would paying yourself? If you wreck your car and take it to a body shop, if the estimate is $500 then the cost is $500 no matter who's pocket the money comes from.
On the other hand with heath care if the estimate is $500 it would be $500 to you but only $150 to the insurance company.
I had bowel resection surgery, I had a 20/80 insurance plan. They paid 80%, I paid 20%. The surgery was $20,000 so my portion was $4,000.
I got a letter from the hospital stating that the insurance company had decided that mine was a pre existing condition so the hospital had refunded the insurance company's portion bill. The insurance company's 80% was ONLY $5,000.
The true market price of that operation was $9,000. That is an $11,000 discount for the insurance company. Sorry 10% is a volume discount or even 20% but a 70% discount is a scam.
When I contacted the hospital to negotiate payment, they charged me the full $20,000 for a $9,000 operation. I told them I would only pay the market rate of $9,000 and was told they could not do that due to the contract they have with insurance companies.
Needless to say they were paid nothing. They lost everything on that operation because it was better business to write off the inflated $20,000 than get paid a fair rate.
Had to go to the ER back in September. MY part is $1700. Never mind that I've already reached my deductible. Hate the stupid 80/20. DH and I are seriously debating filing bankruptcy because of all of these stupid medical bills. And OMG help me if you try to be responsible and pay your bill, but just can't pay what they want. Most places treat you better payment wise if you DIDN'T have insurance. Oh, this last ER trip netted 5 separate bills. Everybody wants at least $25/ mo. Sorry, my kids need to eat more than you need that bill paid. Ugh!!!!!!!!
