First, let me say that I work in the global health insurance field. It really pains me to reach this decision. I have also come to realize I no longer believe in my company’s mission. Up until now I have firmly advocated and supported the industry.
Second, realize health insurance is not insurance. It’s collective bargaining. The basic premise of insurance follows the distributive risk model. You have home owners insurance to distribute the costs of a bad event (your house burning down) across a sizable population. Everyone chips in to help the unfortunate person.
Heath insurance is something different. Everyone gets sick, old, and dies. If there is a 100% chance everyone’s home will burn down, homeowners insurance wouldn’t work. Thus, health insurance had to apply a different model. When you have Heath insurance, you are a part of a large population that uses its collective purchasing power to negotiate better rates for health services and prescription drugs. This is the benefit it’s suppose to bring. It’s collective bargaining.
Here is the story:
On May 6th of this year a series of events transpired which resulted in myself being admitted into a hospital emergency department. I am not going to go into all the details of what happened. I did have to undergo two CT scans and a full MRI. Because of the state I was in when I was admitted, I could not provide my health insurance then nor did I when I was discharged. The hospital gave me a phone number to call and told me to provide the details when I could. Needless to say I had a lot going on and did not get to the ‘providing my insurance’ thing promptly. This proved to be important.
Over the coming weeks I received my bill without insurance: $1800. I am surprised. Not bad. Huge sigh of relief. Okay, time to see what benefits my health insurance will bring. I call the hospital and provide them my health insurance details. Big mistake.
Over the coming days I am shocked to discover the hospital did not submit to the insurance company the $1800 bill they sent me. Instead they created a completely new bill and submitted a claim for $11,000. The hospital increased the service charges that were on the original bill and included a bunch of new billable things like a whole host of facility fees. My new out of pocket expense is $4,400.
I immediately thought this is a clear case of insurance fraud. The hospital changed the bill after they found out I have insurance to purposefully get more money out of the insurance company. Turns out I was wrong. I called both the insurance company and the hospital. I am shocked and angry. For them, of course this is what happened. It’s just business as usual.
So what is the benefit of having health insurance if you pay more with it than without? I see no reason to keep it so I am dropping all coverage at the end of the year.
submitted by /u/Skadi6
[link] [comments]
First, let me say that I work in the global health insurance field. It really pains me to reach this decision. I have also come to realize I no longer believe in my company’s mission. Up until now I have firmly advocated and supported the industry. Second, realize health insurance is not insurance. It’s collective bargaining. The basic premise of insurance follows the distributive risk model. You have home owners insurance to distribute the costs of a bad event (your house burning down) across a sizable population. Everyone chips in to help the unfortunate person. Heath insurance is something different. Everyone gets sick, old, and dies. If there is a 100% chance everyone’s home will burn down, homeowners insurance wouldn’t work. Thus, health insurance had to apply a different model. When you have Heath insurance, you are a part of a large population that uses its collective purchasing power to negotiate better rates for health services and prescription drugs. This is the benefit it’s suppose to bring. It’s collective bargaining. Here is the story: On May 6th of this year a series of events transpired which resulted in myself being admitted into a hospital emergency department. I am not going to go into all the details of what happened. I did have to undergo two CT scans and a full MRI. Because of the state I was in when I was admitted, I could not provide my health insurance then nor did I when I was discharged. The hospital gave me a phone number to call and told me to provide the details when I could. Needless to say I had a lot going on and did not get to the ‘providing my insurance’ thing promptly. This proved to be important. Over the coming weeks I received my bill without insurance: $1800. I am surprised. Not bad. Huge sigh of relief. Okay, time to see what benefits my health insurance will bring. I call the hospital and provide them my health insurance details. Big mistake. Over the coming days I am shocked to discover the hospital did not submit to the insurance company the $1800 bill they sent me. Instead they created a completely new bill and submitted a claim for $11,000. The hospital increased the service charges that were on the original bill and included a bunch of new billable things like a whole host of facility fees. My new out of pocket expense is $4,400. I immediately thought this is a clear case of insurance fraud. The hospital changed the bill after they found out I have insurance to purposefully get more money out of the insurance company. Turns out I was wrong. I called both the insurance company and the hospital. I am shocked and angry. For them, of course this is what happened. It’s just business as usual. So what is the benefit of having health insurance if you pay more with it than without? I see no reason to keep it so I am dropping all coverage at the end of the year.
submitted by /u/Skadi6 [link] [comments]Read Morer/HealthInsurance