Tell the Curious Canadian how much it costs for medical aid in the USA...

In My Humble Opinion
21

The greatest inconsistencies I’ve seen (I’ve never been hospitalized or had surgery, aside from wisdom teeth) are in prescription coverage.

Example: This new acne cream I was prescribed, not covered at all - and I have “cadillac” insurance. A somewhat new thing is a “discount card”. This discount card, given to me by my dermatologist, says my max out of pocket is $25 for 4 times. I’m not going to get it, since after 4 times it will likely won’t be covered and the out of pocket would be retail, some $150. Which is absurd, because the product is basically a new combination of two very old drugs. I’ll enjoy the samples while they last.

A lot of prescriptions are on super cheap generic programs, 3 months for $10. My big issue is that the states regulate them - for example, you can get various types of generic birth control in Ohio, with the 3 months $10 amount (or $4/month). In PA, they’re restricted.

But back to your original question:

$5 copay for annual GP visit.
$15 if I’m sick or it’s a “I need bloodwork” visit.
$15 for any specialist, and I can just look someone up and make an appointment.
$35 for the ER - that’s a visit, more depending on what’s done.

I will say I absolutely loathe the wait times for certain physicians. It would drive me batty waiting 6 weeks, like I’ve heard some Canadian friends wait. As it is, I see a Physician’s Assistant in the dermatology practice instead one of the two dermatologists, because I can call a week ahead of time to get an appointment, instead of 3.

ETA: When I went to a orthopedic surgeon about my knee (patellar tendinitis), they automatically took x-rays (I had no out of pocket for them). This pissed me off to no end, and I voiced my disapproval - I wasn’t limping or on crutches, there was nothing to indicate I needed x-rays. It’s one thing to do an initial check and observe my mobility and pain, and then decide on x-rays, but it’s a totally different one to pass everyone whose insurance covers it into the x-ray room. It’s like they take advantage of people who have excellent insurance, under the guise of “you could have a tumor”. Thanks buddy, but I have four doctors in my immediate family, don’t pull a fast one on me.

22

Mr. Athena and I are self-employed, so we pay for our own individual coverage.

Currently, it’s at $430/month for the two of us. We have a $3850 deductible per year. Our plan is a very simple one; once we hit the deductible, they pay 100% of the costs.

I’m actually pretty happy with it - they have covered a lot of stuff that I’ve heard other insurances don’t, and they have never given me a hassle about anything. The one thing I don’t like about it is the constant increases. In 3 years, our monthly premiums have gone up 60%.

As I had no reason to believe they wouldn’t continue to go up at this rate until I was priced completely out of the insurance market, I’m personally quite happy that health care reform has gone through.

Tax-wise, being self-employed, all of the out-of-pocket expenses and the deductibles are tax deductions.

23

I haven’t had insurance for a couple years now. Since graduating college, I’ve been off my parent’s health insurance but I can’t find a job that will provide me with health benefits. A year and a half ago when I got really sick, it cost me $90 to go to a walk-in emergency clinic to get a diagnosis. Luckily the prescription they wrote me wasn’t too expensive, maybe $20 for antibiotics.

I recently called up my old gynecologist to make an appointment. Under insurance, it was a $15 copay. With no health insurance, they wanted $200 cash (why they want cash specifically I don’t know. Maybe they figured I’d run out halfway through yelling “Haha, I just got my vagina poked at for free!!!”)

24

I have to tell you, reading this thread was a chore - this is so friggin’ complicated!

25

For me (pre-existing condition) no amount of money will get me a private policy. for my company (2 employees) it would be $5400/mo. I decided this was insane and left he USA. I now pay $200/mo for the both of us - not valid in the USA tho.

26

I remember you’ve mentioned this before (though not the amount of money - $5400 a month is just insane!). When the new healthcare law takes effect, are you considering moving back to the US?

27

I have insurance through my company for which I pay nothing. Last summer, I took what I thought was a sprained ankle to my doctor and she referred me to an orthopaedic specialist. Stress fracture. Three visits to him, a cast, brace, etc - the “before insurance” bill was $7,000. I paid $67 not counting the MRI.

28

$15, $15, $100. With insurance that costs me $85/mo, my share.

29

Doctor visit 50 dollars, specialist 75.00, ER varies, at least 50.00. Childbirth I was not covered for one and prepaid. It was a thousand dollars a day and 2,500 for the OB visits. Surgery just cost me 2,700. The other one was about a grand with insurance but I was in the hospital a week with complications.

30

I’m finding that it puts a more–well, for lack of a better word, individual–spin on things. These aren’t general media or political statements involving huge figures applicable to thousands or millions of Americans; these are figures applicable to one individual at a time, from the individual him- or herself. I’m certainly finding it interesting, and I thank all who have posted so far.

31

I agree - this is why I’m scared to get sick here even though I have insurance through my employer. You go for surgery and get billed by the hospital and every doctor who came near you? What the hell? Why can’t you pay one bill and the hospital splits the money however it needs to? A friend recently went through this and she was getting bills from different specialists for months! Insurance covered most of it but that’s a lot of paperwork to keep track of.

I’m still weirded out about getting things that look like bills that say “this is not a bill” across the top and then having a number at the bottom that looks like what I owe somebody. I’m told this is normal. I hate it.

32

I broke my shoulder a couple of years ago, and had no insurance. ER visit = They knew I was broke. No bill.
Bone Specialist I had to go to every week til it healed =
$900 including X-rays. They billed me, and I paid a bit at a time when I could. They stopped sending bills when I was about half or 3/4 paid off, and I’ve never gotten a call from a collection agency. Lack of insurance in this country was never the problem it was made out to be. The HCR bill is thus political bullshit, and nothing more. Just a way for the Gov’t to grab more power for itself.

33

These payments do not even count the fact that there is a lot of money being paid for insurance coverage.
I am on Medicare. I pay about 100 a month for it ,after paying taxes for it for many years. Then it only covers 80 percent. I pay a small amount for doctor visits and then have to pay for prescriptions. If I want to pay for an insurance plan to cover the 20 percent, it has become very expensive.The insurance companies just tripled the price in the last couple years.

34

My employer splits the cost of health insurance 50/50 with me (I think – I’d have to double check).

I pay $32 per week for medical coverage. With that, I pay no annual deductible, a $15 physician’s office copay, no lifetime maximum, free “preventive care” visits, $15 ER copay, $0 for labs and xrays, 10% inpatient and surgical expenses, etc. I’m excited to finally have an insurance plan with no yearly deductible, as that was the primary reason I always skipped out on seeing a doctor for a few years now.

Vision insurance is amazing – I pay a little over a dollar per week. I don’t know the specifics of it, but that’s all I pay into my vision health – I wear disposable contacts, have the yearly exam, etc. and don’t pay a cent more than my buck a week.

Dental insurance is something like $4/week… again, I don’t know the specifics, but I’ve yet to receive any hefty dental bills.

All of my contributions are pre-tax.

As to the actual cost of procedures themselves, I really don’t know. I throw out most of those “this is not a bill” statements I get. From what I understand, my insurance plan is a pretty good one.

35

True enough.

36

Nobody’s mentioned dental coverage, either.

I’m fortune to have really excellent teeth; none of my grandparents and neither of my parents have had a single cavity, despite having spotty to nonexistent dental exams for years. My (stupid) younger brother even chewed tobacco for awhile, and after he quit, the dentist told him truthfully that he’d done no damage to his teeth or gums; genetically we’re jut that lucky. For years I flossed once a week, all while being told I had beautiful gums.

Anyways, dental insurance literally would cost more than our routine cleanings; any sort of dental emergency would fall under our health insurance in the case of an accident. So although I’m on my parents’ “cadillac” health plan, I have no dental insurance, and wouldn’t be any better off with it.

My SO, on the other hand, has very good dental insurance, but still pays quite a bit each year. He’s had a root canal and most of his teeth are filled (and he’s just 20 years old). Poor guy has tooth sensitivity to everything.

From working at a dental school, a lot is genetic, and so much is how one is raised. I thought nobody in the 21st century in the US had their teeth pulled, but ever week there’s at least one extraction. Some parents stare wide-eyed when told they can’t give their 5 year old sugared candy to chew on daily, or that brushing your teeth once a day isn’t sufficient.

I think dental coverage is the next frontier. With superstores running specials on 2 pairs of glasses for $100 (which covers most everyone - those who need bifocals can usually purchase a drugstore pair for $5), it seems like vision insurance isn’t a big deal for most.

37

I can’t remember exactly what my insurance covered, it has been too long since I had it. But my COBRA payments were $384 a month for the same plan, for just me. I had pretty good coverage for this area. $25 copay for a doctor visit, $1000 annual out of pocket, dental and vision coverage. 3 months of maintenance prescriptions for $14, $7 for something short term.

It I see a doctor now, it is $65. Well, for my regular doctor. If I see my neurologist, it would be between $60 and $170, but they won’t know what it will be until he sees me, so I haven’t seen him recently. I had an MRI last year, the hospital knocked 60% off of my bill because of low income, so I only owed them $1400.

And every cent they knocked off of your bill, they stuck on someone else’s. That is why there are stories like Desert Nomad’s and Little Nemo’s. And not every place is as forgiving about money that is owed them. I have already had one place start the collection agency route because of the $500 I owe them, because the doctor had them read the MRI to cover his ass. They just aren’t happy only getting $40 or $50 every couple of months.

The only bullshit about the HCR is the lies told by the Republicans for political gain, rather than looking out for their constituents the way they are supposed to.

38

And we were having such a nice, informative, non-partisan thread.