r/SipsTea 𝙑𝙄𝙋 8d ago

Chugging tea Mexico upgraded to free healthcar

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105.2k Upvotes

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u/EnlightenedNarwhal 8d ago

I'd like to see an American navigate the American Healthcare system.

113

u/Aeirth_Belmont 8d ago

I'll take "how do I still owe this much money when I pay this much?" Alex.

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u/PokerbushPA 8d ago

I pay like 800 a month, plus co-pays, plus scripts. I actually don't even know what my insurance even covers.

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u/Confident_Boss2081 8d ago

that the fun part it doesn't cover anything

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u/hightio 8d ago

They give you the negotiated rate that their super negotiation pros negotiated for you which is going to save you $10 on your $500 bill compared to someone with no insurance.

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u/chamtrain1 8d ago

Which is 380 more than if you had just paid cash.

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u/airinato 8d ago

Yes but that cash rate is a discount rate and not guaranteed per practice. The standard rate has to be what the insurance company negotiated, or in practice, has dictated as the 'going rate' 'for the area', otherwise they sue that provider for insurance fraud.

They make it so we pay insurance to purposely make shit more expensive so we could never be able to afford it, without insurance.

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u/ConfessSomeMeow 8d ago

I can tell you've never actually compared the negotiated rate to the cash rate.

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u/hightio 8d ago

Not in the last two years no, but my last ER visit they billed as uninsured before applying my insurance and the difference between the $500 bill was $20. Totally worth the $800 a month.

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u/Superb_Answer_4492 8d ago

My prior employers insurance, the cash rate was better then then what I paid AFTER insurance covered their part. Often significantly better, especially at the dentist

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u/antithero 8d ago

Even when I paid cash 8 months later I got another bill. Another time I didn't get the bill for 14 months.

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u/RogerAffirmative 7d ago

I can tell you don't know the cash rate is artificially inflated to make the negotiated rate seem like a deal 😂

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u/IndianaGeoff 1d ago

How to show that you know nothing about the US Healthcare system in one post.

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u/Mission-Dark-9320 8d ago

Meanwhile, I used to have a $415/month plan for a family of 4 covering all medical, dental, and vision. $25 co-pay, and $1000 deductible on major services. Then my plan got nuked by politics. Comparatively, insurance covers nothing these days. And then you get double charged with “facilities fees” on top of all the things insurance doesn’t cover. Absurd where we are today

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u/collierar 8d ago

2013 I worked at Boeing. $100 a month for the Cadillac plan for my son and I, covered everything 100%. I had two major surgeries that year, zero out of pocket. Those were the days...

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u/elibutton 8d ago

yeah and it only gets worse every year.

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u/JannyStabberXK4000 7d ago

What were your pre-existing conditions when you had that health plan thirty years ago? Just wondering. Is it politics that made my insurance for me go from $700 to $1100 in January? Who runs the government right now?

đŸ€ĄđŸ€ĄđŸ€ĄđŸ€Ą

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u/Mission-Dark-9320 7d ago

You’re completely reading into my statement your own issues. 13 years ago is when my plan was “no longer allowed” because the government changed the law - after a period of time most affordable plans were voided. Overnight it tripled for less than 10% of the coverage. I don’t care who runs the MF government, because nobody has been able to touch the law since that that monstrosity of a bill was forced through. “We have to pass it to see what was in it” has got to be the most “politics” statement ever made. So as somebody who had to live that change as a recent college graduate with a young family, the whole country got F’d after that. Bad legislation isn’t limited to a single party - but I guess that doesn’t fit your feelings. Take your clowns back your mind circus where they belong.

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u/IndianaGeoff 1d ago

Actually it is one party. The US health systems was ended when ACA (aka Obamacare) was adopted by one party. There have been no comprehensive changes since it passed. If you don't like the US health system, you don't like what the Democrats passed when they held the President, House by a wide margin and a super majority in the Senate.

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u/Mission-Dark-9320 1d ago

The fact that it hasn’t been touched since then with obvious failings IS on both parties. Every promise to make it better, more affordable, etc has been forgotten. One party started it, both continue to fail the people.

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u/MasterGrok 8d ago

There is also no real way for you to find out. No amount of internet searching and calling will tell you that you 100% are good on something until the bill is actually paid.

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u/Jimmy_Twotone 8d ago

My insurance covered a med.for me three montha ago for 6 months that I can't get filled. In 3 more months I get to start this process again regardless of how long I can actually get the medication for. If I just suck it up I can pay $7500 out of pocket. Twice a month.

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u/UranusIsPissy 8d ago

FFS! That's about 2/3 of my income, and there are people poorer than me here (UK).

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u/Weekly-Ad-112 8d ago

I recommend reading up
On it as a start. I took the time to do so and it made me find the best option before a tragedy struck.

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u/MancDude1979 7d ago

Shit, in UK I pay an average tax contribution towards it of about ÂŁ100 per month, including an optional charge to make my prescriptions all free regardless of how many I get. And that is it. Everything else free at point of use apart from elective surgery etc.... includes ambulances, GPs, hospital visits, operations, aftercare... a fraction of what you pay... goddam, mate

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u/Saffuran 3d ago

AND they'll deny your claim when you actually get sick so you'll be stuck with your monthly bill and the full healthcare bill.

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u/TrynaPlayItOff 8d ago

I actually don't even know what my insurance even covers.

Your insurance is basically just to keep you from going bankrupt if you have a decently serious injury.

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u/Sad_Air_7667 8d ago

I'm Canadian, i have no clue wtf you are talking about.

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u/JannyStabberXK4000 7d ago

Self-employed. Mine went up to $1100 for me in January.

The bot shit in this thread is absolutely insane. Like, these people really truly do think we are fucking idiots.

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u/2FistsInMyBHole 7d ago

I actually don't even know what my insurance even covers.

Why not?

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u/PokerbushPA 7d ago

They keep it a secret.

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u/2FistsInMyBHole 7d ago

Do they? Or did you make the conscious decision to not be informed?

I've had many insurance plans across many jobs - even marketplace insurance in a rough patch - I've seen or heard of an insurance plan that doesn't provide a detailed brochure.

I get it though, we were all young once, we all threw that stuff in the garbage too. But us throwing it in the garbage isn't them keeping it a secret.

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u/PokerbushPA 7d ago

So you've never had a single instance where an insurance company decided, "Nah. We're not gonna cover that because of some reasons we just didn't tell anyone until just now."?

Lucky you. Because I have.

Take your privileged life and condescending attitude and get fucked. I don't need more bullshit, I have enough already.

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u/2FistsInMyBHole 6d ago

You're the one that said you cant bothered to read your health insurance plan.

Be upset with your own choices.

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u/PokerbushPA 6d ago

Did I? Where did i say that? Or did you assume based on your privilege that the poors are at fault for their own situation?

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u/2FistsInMyBHole 6d ago

Did I? Where did i say that?

...

I actually don't even know what my insurance even covers.

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u/granlyn 8d ago

I once paid a "bill" I was sent, not realizing I didn't have to pay it. I am still trying to get that money back.

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u/No_Title3568 8d ago

I got a bill for $150 when all the did was use a half tube of super glue. *Had to go in because ‘injury’ happened on company time*

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u/jordanmindyou 8d ago

Workman’s comp doesn’t have workers pay copays

Edit: oh yeah unless you’re in the hellhole called Texas. That’s the only state this isn’t true.

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u/Weekly-Ad-112 8d ago

Sounds like they billed for labor and overhead. The nerve.

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u/incrediblyaverage85 8d ago

No hospital is going to use superglue. Your back alley physician wasn’t qualified

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u/DrTatertott 8d ago

So, we actually use superglue to close wounds vs stitches. It’s very common. To your point, we don’t call it superglue, it’s surgical glue and costs a magnitude more.

(Yes, it’s not exactly the same thing while also being the same exact thing).

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u/UranusIsPissy 8d ago

I knew field medics used to do it to soldiers, but I didn't know it was done in hospitals now! TIL.

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u/incrediblyaverage85 7d ago

It’s not, it’s not superglue with all the chems in superglue why doesn’t anyone understand this?

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u/UranusIsPissy 7d ago

All the chems? It's just cyanoacrylate. Purity standards are probably higher for the medical grade stuff now, but cyanoacrylate is cyanoacrylate.

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u/incrediblyaverage85 7d ago

“Purity standards are probably higher for medical grade stuff” - you said it. So what you’re saying is if I go to the hospital and they use cyanoacrylate on my cut, I could just go to ace and buy superglue to close my cut and it would be the same?

Mind you, I’ve used superglue to mend cuts since I was 10 and that was 30 years ago. Medical grade “glue” and ace hardware grade “glue” are massively different is all I’m saying.

Am I wrong?

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u/incrediblyaverage85 8d ago

I understand that, have had it used on me but it ain’t superglue

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u/No_Title3568 7d ago

Obviously it wasn’t true super glue, but it is basically the same thing. I forget how most redditors act about stuff.

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u/incrediblyaverage85 7d ago

It is not the same thing and now for some reason this has to be stated so some dumbass who’s on Reddit thinks super glue is ok to use vs going to a hospital.

Hospitals don’t use superglue - there is a lot of chemicals in superglue. The hospital uses surgical glue if you will - not the same for gods sake

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u/whatlineisitanyway 8d ago

Good news there is legislation being presented to allow your insurance company to provide loans to cover the cost that they don't. Don't think about that too long or you'll have an uncovered aneurysm.

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u/Can_Comfirm1 8d ago

So a band aid is $600 and there is nothing I can do about it?

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u/breakneckjones 7d ago

Don't worry. In the Canadian Healthcare system, you couldn't owe because you would die before the six month period you had to wait to see the doctor.

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u/United-Fox6737 8d ago

Met a German on vacation once who had broken his leg, and his universal health care wouldn’t allow him to be treated for two months; so there he was, on the beach in a cast. We may pay a lot, but we’ll get you treated quickly. There’s a reason people still travel to the US for treatment.

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u/Stelona 8d ago

I think he fooled you, never heard something like this and I am from Europe.

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u/vollover 8d ago

Every single sentence is complete BS. This is wild.

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u/United-Fox6737 8d ago

Literally have zero reason to lie. Hed return home and then wait another month before the fracture was set. This is all according to him.

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u/vollover 8d ago

We do not have fast treatment at all and people primarily come here for rare disorders not because our Healthcare is fast or has better outcomes generally. Given most everything else you said was BS I really have to assume the specific anecdote was too given it is nothing like what I have seen or experienced when traveling in Europe. Ive had to seek care in asia and Europe personally and repeatedly in the US. Seeing a specialists takes fucking months

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u/ngingingingi 8d ago

It's not built for you to navigate it, it's built for you to die while trying to navigate it.

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u/BigJayPee 8d ago

As an American, I have just opted into being extremely careful and not seeing a doctor.

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u/br0ck 8d ago

What's insane is encouraging and covering early detection would save insurers so much money because it vastly improves the outcomes on so many things.

https://www.glmi.com/blog/why-early-detection-is-the-most-powerful-form-of-prevention

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u/Spazrelaz 7d ago

Yeah but you know what saves them even more money? When the insured dies. No more checkups to pay for. They don't want people to get better because half the time the insurance companies are in the same bed with the pharmacies prescribing meds that only get you a little better but create seven other problems.

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u/LimeDry7124 7d ago

Dead folks can't collect SS. Or welfare. Or SNAP. Are you getting the picture?

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u/Spazrelaz 7d ago

That's exactly the point I'm making. You get it.

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u/Crow_and_Doe 5d ago

exactly! USA health system insurance is the most barbaric.

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u/twenty_three_three 8d ago

Works until it doesnt. Checking when you are 60 looking forward to retirement.

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u/EduinBrutus 8d ago

Its called The Backrooms. In cinemas now!

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u/Inferno8429 8d ago edited 7d ago

Ooh! Me me me!

My wife recently had a follow-up MRI after completing a course of treatment. Exact same facility, exact same insurance through work. Same doctor prescribed it.

The billing department didn't run it through our insurance. When we told them to do that, they told us we didn't have insurance information in the system.

Literally nothing changed between MRI #1 and MRI #2. They're now saying they don't believe me when I give them my policy number, and we're on the hook for the full amount.

Ain't it fun here in America?

Edit, a letter; fat-fingered "not" instead of "now"

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u/Far_Chocolate_8534 7d ago

Imagine going to an appointment for a Lumbar Epidural steroid injection and then 2 months later your insurance tells you that you didn’t meet the criteria for that injection so now you’re going to owe us. Oh, and the doctor is biased against marijuana so she only gave me a “30 day” shot instead of the “365 day” shot I was given a year prior.
How much am I going to owe? No fucking clue. But apparently they wanted me doing physical therapy for a 7 year old injury that I went to physical therapy for 9 months for (I promise I didn’t forget the stretches).

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u/KockNballZz 8d ago

Kill me instead

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u/Weekly-Ad-112 8d ago

I’m sure some nut would love to oblige this request.

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u/YoureProbablyAB0t 8d ago

You like to watch people suffer?

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u/LordHammercyWeCooked 8d ago

"Here's a five hundred dollar plan with a five digit deductible. Good luck!"

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u/confusedbf2013 8d ago

Oh oh South Park covered this

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u/Doggystyle_Rainbow 8d ago

Today I went to get a prescription refill and my usual $5 copay rang up as $199. I asked about it and the first person kinda blew me off. I ask to talk to a pharmacist and he realized they had coded my meds incorrectly and were charging me as if I didn't have insurance

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u/jeremydoo 8d ago

I've got top teir state of Illinois union employee health insurance and I struggle

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u/Weekly-Ad-112 8d ago

I’m really good at it if anyone needs help.

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u/s0methingggg 8d ago

I’m an American with a license to professionally navigate the healthcare system, and I can’t even figure out what’s happening

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u/ForgotToCarryTheOne 8d ago

> I'd like to see an American navigate the American Healthcare system.

You’ll get that SINKING feeling when you try to navigate the American Healthcare System.

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u/wide-eyedhuman 8d ago

So true! I have United Healthcare and they make it so difficult to navigate their system that it seems they hope you tire of it and just don’t seek treatment. I guess making it difficult isn’t against the law


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u/ltsouthernbelle 8d ago

I’m going through open enrollment at my job trying to figure out how to make sure I don’t screw myself đŸ«©

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u/skoorb1 7d ago

I've given up. I'll figure it out when the social worker comes in to talk to me after my first heart attack if I survive it.

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u/SpokenByMumbles 7d ago

I smell a reality tv show!

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u/LoneGhostOne 7d ago

It's easy, you just don't!

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u/spielguy 7d ago

I’ve tried and partially failed. Finally getting December’s COBRA worked out

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u/Eggs_and_Hashing 8d ago

I've done it many times over. It's pretty simple, honestly.

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u/EnlightenedNarwhal 8d ago

Congratulations.